Collaborated with the Mayo Clinic's Centre for Innovation on a team project to envision a 2035 future for specialized healthcare providers. Researched trends and drivers from a social, technological, economic, political, environment and values perspective and applied strategic foresight/futures methods to create possible future outcomes. Designed strategies to influence a positive future and mitigate against negative outcomes. The final report was used by the clinic as an innovation input for their multi-year strategic planning activities.
Healthcare Rx: The Rise of the Empowered ConsumerCognizant
Market and digital forces have combined to enable the healthcare industry to treat much of what ails it — or be supplanted by newcomers who can more quickly seize the digital high ground.
AXA Europe- Unlocking value from digital healthLevi Shapiro
Unlocking value from digital health, presentation for mHealth Israel, May 19th, 2021, by Somesh Chandra – Chief Health Officer, European Markets, AXA Group. Health expenditure has outpaced economic growth, raising sustainability concerns. Barriers to access persist, particularly amongst the less well-off. Digital health services expected to grow at 21.8% CAGR from 2020-2030, adoption accelerated due to COVID-19 pandemic. 90% of the world's data has been created in the past 2 years. AXA-Microsoft Partnership – Launch of the Digital Healthcare Platform. AXA’s ambition is to be at the heart of the Health Ecosystem to meet customer demands in this new normal world. This Digital Health Orchestration requires close collaboration with all players (services providers, insurers,
companies, regulators etc.) of the health industry. AXA Italy Case Study – An integrated, outcome based and personalized journey focussed on solving customer’s health problems. Portal is already live! Solution is live & supporting customers to solve
their health needs in Italy & Germany.
Rethinking Health Plan Business Models for the Emerging On-Demand Digital Eco...Cognizant
Even as on-demand healthcare platforms disrupt the industry, they create possibilities for new value propositions, partnerships and business models that will further reshape the cost and delivery of care.
Digitalization in the health industry can take several forms, including increasing patient safety, enabling telemedicine, and improving interactions between doctors and patients. Some of the biggest innovations in healthcare include using microchips to model clinical trials, wearable technology like Google Glass, 3D printed biological materials, optogenetics, hybrid operating rooms, digestible sensors, robotic nurse assistants, light bulbs that disinfect, and electronic underwear to prevent sores. Digitalization aims to connect people and data in a meaningful and secure way to transform every aspect of care delivery.
This document discusses the growing market for connected wearable devices for health monitoring and how wireless technologies can transmit data from sensors on or in the body to clinicians. By 2016, over 100 million wearable devices are expected to be sold annually. Bluetooth is currently the most widely used protocol but Zigbee and the new 802.15.6 standard may provide longer battery life. Smartphones are also playing an increasing role through medical apps, though regulatory questions remain around which apps should be classified as medical devices. The market is now entering a period of significant growth and standardization.
This document provides an overview of innovation trends in healthcare in the US and India, focusing on how enabling technologies are addressing major pain points. It notes that wireless internet, declining costs of computing/devices, data analytics, AI, and social media have created an infrastructure to solve high costs, low quality/availability of care. Top trends highlighted are connected health technologies, telehealth, social media-aided care, data/AI, frugal innovation, and prevention rewards. The document predicts these trends will cause a tectonic industry shift, with AI providing "first opinions" by 2020 and personalized bionic tools-aided medicine becoming the norm.
mHealth Israel_Levi Shapiro_Israel Digital Health Overview Levi Shapiro
Overview of digital health investment sector, including investment, funding and exit trends in the US and Israel, as well as successful case studies of eHealth companies in the US and Israel
The document discusses several key healthcare trends and opportunities:
1) Demographic shifts like population aging are increasing demand for healthcare services. Chronic diseases are also rising due to lifestyle changes.
2) Technological advances and the empowered consumer are transforming healthcare delivery through telemedicine, mobile health apps, and more consumer-centric models.
3) New entrants like technology companies are disrupting the industry by introducing new products and services, while incumbents must decide whether to partner or compete with these new players.
Innovation in healthcare can be described as a new idea applied to address an unmet clinical need. It is important for healthcare innovation to be driven by real patient needs rather than just technological advancement alone. Successful healthcare innovation requires evidence that an idea works and creates value for stakeholders like patients and providers. The Biodesign process develops innovations to solve clearly defined healthcare problems. In recent years, investment in European healthcare startups has grown significantly, with many accelerators and universities helping to support early-stage companies in developing need-driven solutions.
Digital health utilizes technology to enhance healthcare delivery and make medicine more personalized. It represents a shift from reactive sick-care to proactive health-care. Technologies like artificial intelligence, augmented and virtual reality, digital medicines, and mobile health apps have the potential to disrupt healthcare processes and workflows by combining human and artificial intelligence. However, risks around privacy and security must be addressed for digital health to reach its full potential of improving patient outcomes.
Top 10 fastest growing healthcare tech companies 2021insightscare
The document discusses Claimocity, an AI-driven healthcare technology company that provides mobile practice management software. It highlights some key points:
- Claimocity aims to streamline administrative and billing processes for doctors to allow them to focus on patient care.
- Their all-in-one software and services solution reduces multiple vendors and systems into a single integrated platform.
- Their progress note generator feature combines clinical documentation and billing documentation into a single mobile workflow.
- CEO Jim Sholeff has played a key role in the company's success through his leadership, product development expertise, and focus on specialized solutions for specific customer needs.
Extending the Case for Digital: Health Plan Members SpeakCognizant
Cognizant's exclusive study shows that healthcare consumers’ appetite for digital continues to expand and deepen across all channels and age ranges: 10 key findings that will help health plans refine their digital member experience strategies in 2018 and beyond.
4 Digital Health Trends Affecting Your Revenue CycleMeduit
The document discusses 4 emerging digital trends impacting the healthcare industry: 1) Big data, with more health data being collected but not fully utilized; 2) mHealth and wearable devices increasing patient engagement and ownership; 3) The Internet of Things expanding connectivity of devices; and 4) Data security becoming more vital as digital innovation increases potential threats. These trends present both opportunities such as reduced costs and improved outcomes, as well as challenges around data sharing and protection that healthcare organizations must address. Behavioral analytics and a focus on data security are seen as important to manage risks in this evolving digital landscape.
This document discusses the evolution of healthcare and opportunities in digital health. It notes that healthcare is transitioning from a data poor to data rich science due to genomics, data science, mobile devices, and personalized medicine. This represents a shift from herd to personalized medicine. The document also discusses the growth of digital health funding and deals, increasing traction through FDA approvals and partnerships, and outlines a portfolio of digital health investment opportunities.
In July 2018, NITI Aayog published a Strategy and Approach document on the National Health Stack. The document underscored the need for Universal Health Coverage (UHC) and laid down the technology framework for implementing the Ayushman Bharat programme which is meant to provide UHC to the bottom 500 million of the country. While the Health Stack provides a technological backbone for delivering affordable healthcare to all Indians, we, at iSPIRT, believe that it has the potential to go beyond that and to completely transform the healthcare ecosystem in the country. We are indeed headed for a health leapfrog in India! Over the last few months, we have worked extensively to understand the current challenges in the industry as well as the role and design of individual components of the Health Stack. In this post, we elaborate on the leapfrog that will be enabled by blending this technology with care delivery.
The document discusses the current state of health information technology and digital health. It describes how federal agencies are investing in various initiatives that have the potential to spur medical innovations using technologies like mobile health, electronic health records, telemedicine, and connecting devices. These initiatives aim to harness big data, advance precision medicine, and promote research utilizing new technologies to improve patient-centered care and access. The emphasis is on collaboration between the public and private sectors to drive change in how medical research is conducted and applied.
The document discusses the growth of the Indian healthcare industry and opportunities for disruption through new technologies and models of care. It notes that the healthcare market in India is projected to reach $307 billion by 2025 but faces challenges around access, affordability, and quality. To meet future demand and improve health outcomes, traditional approaches would require building vast new infrastructure. However, the document advocates for a new "predict, monitor, and prevent" model of healthcare enabled by technologies like telemedicine, remote monitoring, and mobile health apps to improve access, costs and quality in a more scalable way.
Part of the "2016 Annual Conference: Big Data, Health Law, and Bioethics" held at Harvard Law School on May 6, 2016.
This conference aimed to: (1) identify the various ways in which law and ethics intersect with the use of big data in health care and health research, particularly in the United States; (2) understand the way U.S. law (and potentially other legal systems) currently promotes or stands as an obstacle to these potential uses; (3) determine what might be learned from the legal and ethical treatment of uses of big data in other sectors and countries; and (4) examine potential solutions (industry best practices, common law, legislative, executive, domestic and international) for better use of big data in health care and health research in the U.S.
The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School 2016 annual conference was organized in collaboration with the Berkman Center for Internet & Society at Harvard University and the Health Ethics and Policy Lab, University of Zurich.
Learn more at http://petrieflom.law.harvard.edu/events/details/2016-annual-conference.
Fico unleashes new analytics for fighting america's $700+ billion healthcare ...aldrencarlo
FICO Insurance Fraud Manager 3.3 adds link analysis, facility model to boost detection of fraud rings and suspicious providers
MINNEAPOLIS, Oct. 2, 2012 -- /PRNewswire/ -- FICO (NYSE:FICO), the leading provider of predictive analytics and decision management technology, today released the latest version of FICO® Insurance Fraud Manager, the most advanced system for detecting and preventing healthcare insurance fraud, waste and abuse. FICO® Insurance Fraud Manager 3.3 integrates link analysis with business rules and predictive analytics, and also adds a facility model for detecting fraud at a hospital or an outpatient provider.
"Fraud has always been a part of the insurance business, but the magnitude of insurance fraud today is startling," said Russ Schreiber, who leads FICO's insurance practice. "Experts estimate the annual cost of health care fraud, waste and abuse in the US to be upwards of $700 billion, and last May one Medicare fraud scam alone racked up $452 million. Now, with FICO Insurance Fraud Manager 3.3, insurers have a better way to fight back."
FICO Insurance Fraud Manager 3.3 boasts the first fully integrated link analysis capability with an insurance fraud application. Insurers who previously had to configure separate link analysis tools can now save time and improve results with an easy-to-use solution preconfigured to use health care claims data. With FICO Insurance Fraud Manager 3.3, insurers can investigate organized fraud rings using the visualization capabilities of a proven link analysis tool set, and easily create displays that reveal connections between disparate claims, patients and providers.
"Integrating link analysis with Insurance Fraud Manager's powerful analytics and our advanced business rules gives insurers three ways to combat fraud, waste and abuse," said James Evans, vice president of network and financial management at McKesson Health Solutions, which provides Insurance Fraud Manager's analytics to U.S. insurers via its InvestiClaim® solution. "This triple protection gives insurers a powerful tool for fighting fraud, waste and abuse."
The new facility model in FICO® Insurance Fraud Manager 3.3 scans enormous volumes of claims data for recurring, suspicious activity at a hospital or an outpatient provider. Telltale signs may include unusual scheduling with a single patient, unusually expensive procedures, and even such issues as patients being discharged and readmitted, which can indicate problems with quality of care.
Universal American, which piloted this model with FICO, received a 2012 FICO Decision Management Award this month for its use of FICO Insurance Fraud Manager to control costs and prevent fraud losses. Universal American, a leading provider of health benefits to people with Medicare, has implemented the FICO Insurance Fraud Manager solution into their claims workflow prior to payment, and integrated it with their claims platform, Facets.
The document discusses how healthcare is shifting from a hospital-centric model to a more distributed, data-rich and consumer-centric model driven by emerging technologies like the Internet of Things. Key factors driving this change include an aging global population, rising chronic diseases, and workforce shortages. The integration of data from various medical devices, health apps and other sources could help address inefficiencies but requires standards. The document outlines several policy principles around data standards, regulation, reimbursement and privacy to help unlock the potential of IoT and virtual care models to improve outcomes and reduce costs.
The Future of Specialized Health Care ProvidersJosinaV
This project is for the game-changers and rabble-rousers working within health care to create much needed transformation within the industry. For those that are frustrated with the way things are and seek a better future, this project is an example of the power of foresight to provoke deep insights and inform thoughtful strategic directions.
This project was completed by Phouphet Sihavong, Uma Maharaj, and Josina Vink as part of Ontario College of Art and Design University’s (OCADU) Master of Design in Strategic Foresight and Innovation (SFI) program in Toronto, Ontario.
Showcases digital health implementation in Ontario
hospitals.
Each story is focused around a key challenge,
an explanation of the process taken to address it, and
a reflection on the impact
20 tendencias digitales en salud digital_ The Medical FuturistRichard Canabate
Resaltado de las tendencias que darán forma a la atención médica post COVID19.
No se trata de enumerar estas tendencias, sino de dar una valiosa visión de los factores de conducción detrás de ellas mientras que es muy específico. Se trata de mostrar cuáles son las áreas exactas que deben destacarse entre todas las áreas en el tema "IA en la atención médica", por ejemplo.
This document is a report for a project to open a comprehensive satellite clinic in Pocahontas County, West Virginia. It provides background on the need for additional health services in the rural county, which only has one 25-bed hospital. An assessment finds that internal and external stakeholders support the project. A market analysis shows high rates of diseases and health issues among the county's aging population. A SWOT analysis identifies strengths like improving access to care, and weaknesses like the large upfront costs. The report recommends proceeding with the project to address unmet health needs in the community.
The ten predictions for 2020
1. Health consumers in 2020
Informed and demanding patients are now partners in their own healthcare
2. Health care delivery systems in 2020
The era of digitised medicine - new business models drive new ideas
3. Wearables and mHealth applications in 2020
Measuring quality of life not just clinical indicators
4. Big Data in 2020
Health data is pervasive – requiring new tools and provider models
5. Regulation in 2020
Regulations reflect the convergence of technology and science
6. Research and Development in 2020
The networked laboratory - partnerships and big data amidst new scrutiny
7. The pharmaceutical commercial model in 2020
Local is important but with a shift from volume to value
8. The pharmaceutical enterprise configuration - the back office in 2020
Single, global and responsible for insight enablement
9. New business models in emerging markets in 2020
Still emerging, but full of creativity for the world
10. Impact of behaviours on corporate reputation in 2020
A new dawn of trust
1) Developed countries aim to increase patient accountability and focus on education and awareness programs to promote healthier lifestyles.
2) Developing countries struggle to meet basic healthcare demands of large populations due to limited funding and infrastructure.
3) Examples provided of successful programs in Finland and the US that use incentives and competitions to encourage physical activity and reduce chronic diseases.
Assignment 1 Legal Aspects of U.S. Health Care System Administrat.docxbraycarissa250
Assignment 1: Legal Aspects of U.S. Health Care System Administration
Due Week 3 and worth 200 points
Prevailing wisdom reinforces the fact that working in U.S. health care administration in the 21st Century requires knowledge of the various aspects of health laws as they apply to dealing with medical professionals. Further, because U.S. health care administrators must potentially interact with many levels of professionals beyond the medical profession, it is prudent that they be aware of any federal, state, and local laws that may be applicable to their organizations. Thus, their conduct is also subject to the letter of the law. They must evaluate the quality of their professional interactions and be mindful of the implications and ramifications of their decisions.
Nearly 65 million surgical operations were performed in 2015 in the U.S. resulting in an estimated 200,000 deaths from complications or other post-operative issues (Ghaferi, Myers, Sutcliffe, & Pronovost, 2016). Ongoing innovation in healthcare can improve patient outcomes. According to the Harvard Business Review article, The Next Wave of Hospital Innovation to Make Patients Safer, over the past several decades, there have been three distinct waves of surgical improvement: technical advancements, standardizing procedures, and high reliability organizing.
Assume the role of a top health administrator at We Care Hospital. You are interested in propelling the hospital to the next level by applying for the Malcolm Baldrige National Quality Award. However, you want to ensure surgical outcomes for patient morbidity and mortality rates. You begin by researching the Surgical Care Improvement Project (SCIP) aimed to improve adherence to quality protocols. You need to ensure the hospital policy is consistent with the law and that the hospital is correctly reporting Sentinel Events to the Joint Commission, a hospital regulatory agency.
Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.
Write a three to four (3-4) page paper in which you:
1. Analyze how standardizing procedures and documenting steps can improve outcomes when performing a complex procedure. Review the peer-reviewed journal article, The Next Wave of Hospital Innovation to Make Patients Safer. Articulate your position as the top administrator concerned about the importance of professional conduct and negligence in SCIP quality guidelines.
2. High Reliability Organizing emphasizes the varying actions that can affect patient safety given that standardized systems ignore the fact that each patient is different. Ascertain the major ramifications when the health care team “fails to rescue” the patient. Identify what hospital policies should be in place and identify previous case laws.
3. Analyze the four (4) elements required of a plaintiff to prove medical negligence.
4. Discuss the overarching duties of the health care governing board in mitigating the effects of medical non- ...
Personal Connected Health Alliance StrategyMary Sheridan
Discover the new 5 year strategy of the Personal Connected Health Alliance (PCHA) to achieve personal health and wellness for everyone. Visit pchalliance.org for more information about PCHA.
Join us at the Connected Health Conference in Washington D.C. on December 11-14, 2016. For more information, visit www.pchaconference.org.
Personal Connected Health Alliance StrategyPCHA2016
Discover the new 5 year strategy of the Personal Connected Health Alliance (PCHA) to achieve personal health and wellness for everyone. Visit pchalliance.org for more information about PCHA.
Join us at the Connected Health Conference in Washington D.C. on December 11-14, 2016. For more information, visit www.pchaconference.org.
Personal connected health is currently characterized by limited thought leadership, insufficient coordination and collaboration, and a lack of awareness and understanding of the full potential by all stakeholders: public, providers, policymakers, industry and patients. The Personal Connected Health Alliance is defining the the field of personal connected health to inspire market and policy innovation, research and collective action for sustained adoption of personal connected health technology. The vision is better health and well being for all through increased personal responsibilities and connectivity as well as improved care delivery enabled by technology.
The document provides an overview of telemedicine case studies, including both successful and unsuccessful implementations. A successful Alaskan telemedicine program collaborated between multiple organizations to provide remote breast cancer counseling using video conferencing. Patients reported high satisfaction rates. However, a proposed telemedicine program in remote Beaver Island, Michigan failed due to a lack of technical infrastructure, administrative support, and long-term funding. The document emphasizes the importance of a co-creation model to define needs through collaboration between patients, providers, and organizations.
Running head VENICE FAMILY CLINIC 1VENICE FAMILY CLINIC.docxjenkinsmandie
Running head: VENICE FAMILY CLINIC 1
VENICE FAMILY CLINIC 4
Venice Family Clinic
Introduction
Venice Family Clinic (VFC) is well‐known for giving quality wellbeing services to populaces deprived through a powerful volunteer model. Established in 1970, it has a long history of volunteerism, which has been coordinated into the way of life of the association. There is great leadership involvement in the model just as an internal framework set up to enlist and support volunteer doctors, including clinic space, systems for scheduling patients, and a full‐time volunteer organizer. Additionally, VFC has longstanding relationships with private healthcare facilities in the region.
A department likely to exist within the organization
VFC has a unit that offers psychiatric health services that incorporates counseling, mental services, and psychosocial support identified with the social stress of poverty, homelessness, joblessness, and aggressive behavior at home. Services include emergency intercession just as an individual, family, and group treatment. Albeit, once in a while, challenges make it difficult to pick an ideal setting; it is significant as well, where conceivable, think about privacy. VFC thinks about confidentiality as one of the keys to excellent communication, as the client is probably going to reveal data of a private and sensitive nature (Carroll & Richardson, 2016).
The financial condition of the Clinic
Venice's family clinic financial report of 2012 current liabilities is 3,398, 342, while the total existing assets total up to 9,913,386. Therefore, 2.89 is the current ratio of the clinic. This ratio is somewhat high, which implies, the clinic is not using its financial capabilities resourcefully. The clinic, however, is in a position to meet its short-term financial obligation because it has good liquidity. Conversely, 0.21 is the debt to equity ratio, which means the facility can manage its daily operations without getting help from financiers. At the beginning of the year, net resources remain at 20,690,947, while toward the end of the year, the net resource was 18,876, 692, which suggests that the facility has a net loss of 1,841,255. This clearly shows the medical clinic will experience financial constraints in sustaining its operations. Therefore, the clinic needs to control its cost to avoid losing the money (Carroll & Richardson, 2016).
Healthcare trends likely to affect the Clinic
Today, health care systems are determined to provide a patient-centered treatment, which is a trend brought about due to technology proliferation. Most health centers are integrating technology in their operation, clinical aspects, as well as administrative. As healthcare transform to becoming more goals focused and systemic, they are coming up with approaches and techniques aimed to improve the patient’s experience. Analytics are also involved in helping hospitals foresee future trends and guide decision making.
In Venice Fami.
This document presents a framework for using data and technology to transform health and care outcomes in England by 2020. It identifies challenges facing the current system and proposes 12 actions to enable citizens to make healthy choices, give care professionals access to real-time patient data, make care quality transparent, build public trust in data sharing, support innovation, ensure staff can use technology, and get best value for taxpayers. The National Information Board will oversee implementing the framework through national support, local support, and development principles to help the health and care system meet its challenges.
This document summarizes discussions from a series of panel discussions on the future of post-acute healthcare. Key concerns discussed include the need for better coordination and pathways between acute and post-acute care to reduce hospital readmissions, ensuring clinical staff in skilled nursing facilities have sufficient skills and training, understanding new models like Accountable Care Organizations, managing increased utilization of managed care plans with lower reimbursement rates, and navigating changes to state Medicaid systems. Potential solutions focus on developing partnerships across settings, sharing clinical information, participating in advocacy, and using technology and analytics to improve coordination and decision making.
NURS 6050 GCU Nursing in Florida Presentation.docxstirlingvwriters
This document discusses a presentation for NURS 6050 on nursing regulation in Florida. It provides an overview of boards of nursing and professional nursing associations. The presentation assignment requires describing differences between these groups, the board that regulates nursing in Florida, and how federal and state regulations influence nursing practice and healthcare delivery, costs, and access. Key sources on nursing organizations are also provided.
This document discusses how sharing economy tools like social media and ICT can improve healthcare outcomes and reduce costs. It argues that connecting healthcare professionals through these tools allows for improved knowledge sharing, more rapid dissemination of best practices, and reduced errors and treatment times. The document reports that studies have found 30-40% reductions in healthcare costs when clinical pharmacists are integrated into care teams using sharing economy instruments like social media. It calls for incorporating sharing economy principles and management training into clinical pharmacist education to further optimize healthcare quality and costs.
This document discusses privacy and security concerns regarding mobile health (mHealth) systems. It notes that as mHealth applications collect more personal health and location data from devices like smartphones and sensors, questions arise around patient privacy, data sharing, security, and how to properly obtain user consent. The document examines these issues and their implications for the relationships between patients, healthcare providers, and other stakeholders in mHealth. It argues that addressing privacy, security, and regulatory challenges will be important to enable the continued growth of mHealth.
Presentation given by Eric C. Schneider, MD, Senior Vice President for Policy and Research of The Commonwealth Fund at the University of Michigan Institute for Healthcare Policy and Innovation in Ann Arbor, MI on December 7, 2017.
The document discusses technology challenges and opportunities for California's Whole Person Care pilots. It finds that common data sharing needs include care coordination platforms, data quality monitoring, analytics and reporting tools, and identity management. Challenges include building consensus on technology approaches, aggregating diverse data, ensuring technology complies with privacy policies, and overcoming partner skepticism. The document presents case studies of Contra Costa and Marin counties' approaches. It concludes that pilots have made progress establishing infrastructure for integrated care but continued work is needed, and technology can help but not solve organizational challenges alone.
SA Gastro Cure(gallbladder cancer treatment in india).pptxVinothKumar70905
SA Gastro Cure provides complete gallbladder cancer treatment in India, with Dr. Santhosh Anand's experience. Dr. Santhosh Anand delivers tailored care with modern procedures and advanced technologies to ensure efficient management and recovery. His significant knowledge provides premium therapy for gallbladder cancer, resulting in superior patient results at SA Gastro Cure.
Database Creation in Clinical Trials: The AI AdvantageClinosolIndia
The use of AI in creating and managing databases for clinical trials offers significant advantages, transforming how data is collected, managed, and analyzed. Here are the key benefits and approaches of leveraging AI in this context
Cost-Effective Hospital Marketing Strategies Maximize your reach without Brea...HMS Advisors Pvt Ltd
In today's competitive healthcare landscape, effective marketing is essential for attracting and retaining patients, but budget constraints can make extensive campaigns challenging. This article explores affordable marketing solutions to help healthcare providers maximize their reach without breaking the bank.
Enhancing Patient Safety in Digital Therapeutics: AI- Driven ApproachesClinosolIndia
Enhancing patient safety in digital therapeutics through AI-driven approaches involves leveraging artificial intelligence to ensure the effectiveness, accuracy, and security of digital health solutions. Here are some key strategies and benefits
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VENEERS: YOUR SMILE'S BEST KEPT SECRET.pptxSatvikaPrasad
Veneers are a transformative dental solution that offers a seamless blend of aesthetics and functionality, making them a popular choice for enhancing smiles. These thin, custom-fabricated laminates are primarily constructed from either high-grade porcelain or composite resin materials, both selected for their superior aesthetic and functional properties. Veneers are meticulously bonded to the labial surfaces of anterior teeth, providing a definitive solution for a variety of dental conditions, including intrinsic discoloration, enamel defects, minor malalignments, diastemas, and structural deficiencies such as chips or fractures. The preparation for veneer placement typically involves minimal reduction of the tooth structure, preserving the maximum amount of healthy tooth while allowing for optimal adhesive bonding. This conservative approach is pivotal in maintaining tooth vitality and structural integrity. The precise customization and application of veneers require a thorough understanding of dental materials, occlusion, and esthetic principles, underscoring their role as a sophisticated and effective treatment modality in contemporary prosthodontic practice.
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In the healthcare field, precise and comprehensive documentation is essential for delivering high-quality patient care. One of the most critical components of clinical documentation is the SOAP note. At GPAShark.com, we specialize in providing expert SOAP note writing services, tailored to meet the needs of nursing students, healthcare professionals, and medical practitioners. Our goal is to help you master the art of SOAP note writing, ensuring your documentation is thorough, accurate, and effective.
Understanding SOAP Notes
SOAP stands for Subjective, Objective, Assessment, and Plan. This structured method of documentation is used widely in healthcare settings to ensure consistent and clear communication among healthcare providers. Each component of a SOAP note serves a specific purpose:
Subjective (S):
This section captures the patient's narrative, including their chief complaint, history of present illness (HPI), past medical history (PMH), family history (FH), social history (SH), and review of systems (ROS). It reflects the patient's perspective and is crucial for understanding their condition and concerns.
Objective (O):
The objective section includes measurable and observable data collected during the physical examination and diagnostic tests. This might involve vital signs, laboratory results, imaging studies, and physical exam findings. Objectivity is key to providing a factual basis for the assessment.
Assessment (A):
In the assessment section, the healthcare provider synthesizes the subjective and objective data to formulate a diagnosis or differential diagnoses. This analysis helps in understanding the patient's condition and guiding the treatment plan.
Plan (P):
The plan outlines the course of action, including treatment strategies, medications, diagnostic tests, patient education, and follow-up appointments. It provides a roadmap for managing the patient's condition and achieving desired health outcomes.
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Module 7- Care Planning, Restorative Care, Documentation, Working in the Comm...Reliable Assignments Help
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CYLIC MEDITATION - STRESS MANAGEMENT CORPORATE YOGA
Step-I: Starting Prayer
• Lie on your back. Relax and collapse the whole body on the ground legs apart, hands apart, palms facing the roof, smiling face, let go all parts of the body. As you repeat the prayer feel the resonance throughout the body.
Prayer
Laye sombhodayeth chittam
vikshiptham shamayeth punaha
sakaashaayam vijaneeyat
Samapraptam na chalayet
Om shaanti shaanti shaantihi
Meaning: In the state of oblivion awaken the mind, when agitated pacify it, in between the mind is full of desires. If the mind has reached the state of perfect equilibrium, then do not disturb it again.
Step-II(A): Immediate Relaxation
• Bring your legs together, join the heels, toes together, palms by the side of the thighs. Keep your face smiling till the end. Gently bring your awareness to the tip of the toes. Stretch the toes, tighten the ankle joints, tighten the calf muscles. Pull up the kneecaps. Tighten the thigh muscles. Compress and squeeze the buttocks. Exhale and suck in the abdomen. Make the fists of the palms and tighten the arms. Inhale and expand the chest.
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1. OCADU Foresight Project | 2011
Prepared by Phouphet Sihavong, Uma Maharaj, and Josina Vink
The Future of
Specialized
Health Care
Providers
2. This project was completed within the time constraints of a twelve week semester by students in
Ontario College of Art and Design University’s Master of Design in Strategic Foresight and Innovation
program in Toronto, Ontario. For more information on this program please visit:
www.ocad.ca
Acknowledgements:
A special thanks to our project ambassadors at the Mayo Clinic Center for Innovation for their ongo-
ing input, guidance and support on this project. Thank you, Steve Bartz, Meredith Dezutter, and
Allison Dunphy, for offering up your industry insights, sharing your strategic thinking and going back
to the future with us!
Also, thank you to our instructors Suzanne Stein and Greg Van Alstyne for your valuable feedback and
dialogue with us as we experimented with new methodology.
And to our brilliant classmates that make every Thursday worth getting up for, thank you for playing
well in the sandbox and for continuing to raise the bar as we learn and contribute to the emerging
field of foresight in Canada.
3. 3
This project is for the game-changers and rabble-rousers working
within health care to create much needed transformation within the
industry. For those that are frustrated with the way things are and seek
a better future, this project is an example of the power of foresight to
provoke deep insights and inform thoughtful strategic directions.
The Need for Transformation 4
About the Project 5
Project Process 6
Environmental Scanning 7
Trends 8
Drivers 20
Creating Future Scenarios 21
Back to the Future 26
From Scenarios to Strategies 33
Wind-Tunnelling 34
Three Horizons 35
Strategic Directions 38
Moving Forward 46
A Call for New Thinking 47
Appendix 48
References 49
4. 4
The Need for
Transformation/
C
anadians brag about their health
care. Universal health care is a strong
part of our country’s identity. But the fact is
our health care system is not measuring up.
Canadians brag about their health care.
Universal health care is a strong part of our
country’s identity. But the fact is our health
care system is not measuring up.
There are numerous problems with the sys-
tem including issues around timely access
to care, quality, safety, security, availability
of services, and financial stability1
- not to
mention the fact that interaction in the
space often leaves patients feeling like they
have been catapulted twenty years back in
time. The status quo is not sustainable.
The cost of care has continually increased in
Canada. Health spending, which is ad-
ministered by the provinces, has increased
from nearly 35% of provincial budgets in
1999 to 46% in 2010. In Ontario, if nothing
changes this number is expected to reach
80% by 2030.2
Furthermore, Canada’s aging
baby boomers will put an unprecedented
strain on the health care system3
compris-
ing approximately 25% of the population by
2036.4
It is becoming more challenging for the tra-
ditional health care system to provide some
of the basic levels of care to Canadians. The
median wait time for being referred to a
specialist and receiving treatment in Cana-
da is 17 weeks.5
Furthermore, Canadians are
looking to new sources of care as the out-
of-pocket payments of private households
have grown to represent approximately 15
percent of total national health expendi-
tures.
If the health care system is going to meet
the needs of future Canadians and survive
the compounding pressures, transforma-
tion is needed. The complexity of the
system, institutional cultures, financing, and
evidence-based philosophies make health
care a slow system to change. Foresight
methodology offers hope for improved
understandings of the range of future chal-
lenges and inspiration for refined long-term
strategies for the industry.
5. 5
About the
Project/
This foresight project focuses on the fu-
ture of specialized health care providers in
Canada, with a strong spotlight on outpa-
tient services – an area within the field of
health care that will certainly face numer-
ous challenges as the future evolves. The
purpose of this study is to challenge special-
ist providers to consider health care reform
through the lens of strategic foresight and
to demonstrate the value of this emerging
tool for those changemakers already work-
ing in this space.
This work was completed by students in the
Strategic Foresight and Innovation gradu-
ate program at Ontario College of Art and
Design University. The work was guided
by project ambassadors at the Mayo Clinic
Center for Innovation through regular col-
laborative dialogues throughout the course
of the three month project.
The project began with general environ-
mental scan of the industry and related
systems to identify strong and weak signals
of change. This led to the development of a
small trend deck. Through analysis of these
trends, their interactions and the underlying
drivers, enablers and blockers, five key driv-
ers were identified. The cone of plausibility
method then used these drivers to develop
scenarios. The scenarios helped to answer
the following question: what will the future
interaction between traditional health care
specialists and patients look like in 2030?
From the scenarios, strategic options were
generated and a wind tunneling exercise
was completed leading to the identifica-
tion of the following three robust strategic
directions:
1. Build a smart, electronic health system
2. Integrate service delivery
3. Improve the patient experience
These strategies where then enhanced
through the development of a preferred
future and thoughtful analysis using the
three horizons method. Lastly, a simple,
modified backcasting method was used to
establish milestones and signposts for mov-
ing forward. This document will provide an
overview of each step in the process and
demonstrate how these strategic directions
came into view.
For clarity, the definition of specialized health care provider
used in this project refers to those health care organization
that offer services provided by medical practitioners that
generally do not have first contact with patients and offer a
highly technical level of health care.
6. The diagram outlined below providers a snapshot of the key
methods used in this project. The arrows represent the criti-
cal inputs and outputs of each step in the process.
6
Project
Process/
7. 7
Environmental
Scanning/
Through discussions with the project
ambassadors, some areas of interest for
thinking about the future of the health care
industry and its environment surfaced. Sig-
nals like the development of IBM’s Watson
and crowdsourced diagnosis on the New
York Time’s website surfaced immediately.
This dialogue was extended through an
environmental scan that looked for poten-
tial signals and trends related to or influenc-
ing the health care industry. By combing
through sources like newspapers, scholarly
articles, and social networks, patterns of
change were identified.
The STEEPV framework (social, technologi-
cal, economic, environmental, political and
values) was used to help ensure breadth
within the environmental scanning process.
Unfortunately, due to time constraints a
comprehensive list of trends for each ele-
ment of the framework was not fully devel-
oped. However, the twelve trends identified
provided valuable directions for thinking
about the future of health care. The result
of this process was a set of trends that de-
scribe the signals, preliminary implications,
extrapolations and countertrends in the
health care space. The trend deck that fol-
lows mainly highlights trends in the social,
technological and economic space.
8. 8
Technology
Trend
In-home robot assisted patient care.
Robot Assisted/
Overview:
Robot assisted care works with an integrative
health system that combines remote video
communication, networked 24/7 on-call health
support team and a mobilized robot to deliver
in-home patient care. Robot assistant can
travel with nurse practitioners or other health
care workers to patient homes or retail clinics
to provide remote Doctor check-ups.
Signals:
• Care-O-bot® Mobile robot assistant14
• Asimo Robot developed by Honda. Robot
that can be controlled by human thinking15
• Paro robots migrating therapeutic baby
harp seal robot from Japan, to be used in
health care facilities16
• Kompaï is a robot developed by Robosoft
specifically designed to assist dependent
persons at home17
• Android-F Android developed in Japan that
have lifelike movements18
Implications for Patients:
Users that are located in remote locations that
have limited access to health care services can
have the opportunity to stay connected and
have remote visits from their general practitioner.
Isolated users that require more care can have a
live-in robot to help with their dependent living.
Patients can stay home longer before needing
long term care facilities.
Implications for Providers:
Decentralization of care delivery with robots
will see a rise in online health service platforms,
health call centre services and remote services.
Payments may be in the form of a monthly
membership fee that is reimbursed. Demand
increase for health call center services. Smaller
companies will partner with other service
providers to create a mash-up of health care
services. Larger corporations will try to own
the health service delivery channel to secure a
stronger brand connection with customers.
Extrapolations:
In a decade, humanoid robots will become the
new homecare providers. Built with sensors,
they will be better equipped to detect changes
in people’s biometrics to help alert and prevent
medical problems.
Countertrends:
Patients may resist the remote care because
they value in-person experiences rather than
machine connections. Resistance against
robots taking away human jobs can prevent
adoption of new technology.
5
9. 9
Technology
Trend
Access to health information at anytime.
Ubiquitous Health/
Overview:
Users access and manage their health
information at anytime as part of everyday life.
The seamless interaction between patient,
doctor and expert database across a wireless
network will revolutionize the delivery of health
care.
Signals:
• Me MD is an online health care service
that provides webcam consultations with
health care providers that give diagnosis,
treatment plan and prescription19
• Genomera is a movement dedicated to
using online crowd-sourcing to make new
health discoveries20
• SMART networked home design that help
users manage their home more efficiently
• IBM’s Watson Supercomputer partners with
Wellpoint Health Benefits to provide online
diagnosing for patients21
Implications for Patients:
Visualization tools along with data analytics will
allow the user to diagnose their own symptoms.
Users will become better informed and change
their health care from being episodic to continuous
care.
Implications for Providers:
Decentralization of care delivery will see the
rise of lower cost health service solutions.
Health insurance companies will start to take a
more active role by partnering with technology
companies to develop online personal health
care programs to promote preventative
care. Additionally secure cloud-based health
databases will be required to store and
process all the patient health informatics.
Extrapolations:
In a decade, the convergence of mobile
technology and a connected health system
will create a seamless integrated health care
system that automatically alerts patient and
physician to problematic changes in the
person’s health signs. An integrative health
system will allow users to also monitor and
care for their circle of friends and family,
thus fostering a community of care where
the individual is now a caregiver by treating
others. This could lead to “peer-to-peer MD”.
Globalization of online health care services will
help keep service costs down.
Countertrends:
Privacy and security concerns over the
ownership of personal health information
may deter users from subscribing to health
monitoring. Complications with health legal
liabilities may prevent level of adoption for both
patient and service provider.
5
10. 10
Technology
Trend
Wireless internal monitoring of the human body.
In Vivo surveillance/
Overview:
in vi·vo [in vee-voh] noun (of a biological
process) occurring or made to occur within a
living organism or natural setting.6
In vivo surveillance is wireless monitoring done
by nanobots from inside the human body.
Doctors can give the patient a pill size nanobot
to swallow, which monitors health signs
remotely for three days before exiting the body.
Signals:
• Spider Pill is a remote control ingestiable
pill that provides surveillance imagery7
• Smart Pill transmits data continuously for
72 hrs about pressure, pH and temperature.
• Nanomedical capsule used in cancer
treatment for targeted drug delivery8
• Internal surgery using ingestible robots that
assemble inside the human body9
Implications for Patients:
Users don’t need to have boxes strapped to
their sides or have tubes stuck down their throats.
in vivo surveillance will provide a more non-invasive
and painless experience for users. This level of
real-time monitoring will allow health care service
providers to become more accurate in putting
together personalized treatment for patients.
Implications for Providers:
Stomach and colon procedures can be
conducted internally without having to make
any outside incisions. Costs will be greatly
reduced for hospitals with less recovery
time. The ability to monitor and do real-time
surveillance on patients from the inside will
lead to greater discoveries and may alter
the course of drug administration which will
disrupt the pharmaceutical industry. Imagine if
a non-invasive cure for cancer was discovered
through “smart pills”, what kind of negative
economic impact it would have on businesses
that relied on cancer treatment demand?
Extrapolations:
In a decade, there will be nanorobots that
are atomic and molecular in scale. They can
interact on the same level as bacteria and
viruses, thus allowing nanobots to become the
new medicine. Molecular size nanobots can
body repair the human body without opening
the patient for surgery.
Countertrends:
The “yuck” factor of knowing there is a
robotic bug swimming inside you will generate
resistance to the approach. There will be
debates between science and ethics as to
how far we go in repairing our bodies. There
could be government resistance through the
regulation and control of nanotechnology to
prevent nano weaponry.
5
11. 11
Technology
Trend
Mobile sensing devices that assess patient health.
Mobile Diagnostics/
Overview:
The consumerization of mobile devices has
created a new business line of emerging
sensing mobile devices and accessories
that capture users’ health data and provides
diagnostic feedback almost instantaneously.
Signals:
• Cellscope is a portable, low-cost
microscopy that uses a cell phone camera
to take high-resolution images of a
patient’s blood cells10
• New online mobile health monitoring
service, MedApps, wins 2011 Best New
Product Edison Award 11
• Use of RFID and GPS technology in patient
medical wristband in hospitals to monitor
patient location and transfers within the
hospital12
Implications for Patients:
Affordable mobile health accessories that measure
and monitor health, means the patient has more
control over the management of their own health
because they are now better informed. Patients
can get online medical diagnosis instantly without
having to physically access a health care facility. In
addition, real-time monitoring helps keep patients
compliant with their health prescription.
Implications for Providers:
Health care practitioners can alter treatment
quicker with more accuracy. Points of care
delivery will change from a centralized model
to more out-patient and convenient care
options. Health care industry will experience
a technology innovation shift from large fixed
technologies to more compact lower cost
technologies. This will force hospitals to be
more competitive as patients have more
choice in the diagnostics space.
Extrapolations:
In a decade, there will be pop-up mobile
hospitals servicing communities based on
recorded health patterns monitored by the
city. Wearing a sensing device will become
part of the norm in society. People will become
obsessed with improving their health signals
and more sensitive to slight shifts in numeric
values that move above or below the norm.
Countertrends:
Complex privacy and security regulations
around access to health information may
prevent level of adoption from both patient and
service provider.
5
12. 12
Economic
Trend
Everyone and anyone is providing health services.
New Kids on the Block/
Overview:
There is a growing number of new provid-
ers with disruptive approaches entering the
health care space. Among these new entrants
are established technology companies, new
entrepreneurial start-ups, employers, insurance
companies and creative non-profits. As a
result, there are more ‘mash-up’ products and
services on the market that integrate health or
health care services as ‘value-added’ to other
products and services. While traditionally there
has been a lack of competition within health
care because of third party reimbursement,
increasingly the traditional providers are not the
only game in town.
Signals:
• Best Buy recently partnered with Meridian to
explore sales of health monitoring devices41
• Safeway has an extensive health promotion
program42
• Genworth Financial created ‘CareScout’ a
business that provides support services43
• CellScope has developed and inexpensive
technology that enables people to check ear
infections at home44
Implications for Patients:
How will patients navigate through the clutter?
There are more options for patients to chose
from, but it is difficult to know which alterna-
tives are effective and trustworthy.
Implications for Providers:
How will specialist providers compete with
these new and different health service op-
tions? Care models will be forced to change to
compete with low cost models. There is a de-
professionalization of services occurring where
tasks that were once performed by physicians
are being provided by nurses, personal sup-
port workers, devices, caregivers or patients
themselves.
Extrapolations:
In a decade, the market will be bombarded
with so many providers that consumers feel
paralyzed. Patients will buy and download
health services from providers around the
world like they do music on itunes today.
Countertrends:
There is a competing stubbornness among
consumers around the growing need to trust
the sources of their care and seek out tradi-
tional institutions and physicians that they can
be confident will provide the best care. There
is also a counter trend toward increased regu-
lation and restriction of health care products
and devices.
5
13. 13
Economic
Trend
The rise of the Economic East brings a new global centre
Made in China/
Overview:
As the global economic power shifts East,
there is an increasing reliance on countries
like India and China for innovation and
development in health care. Further, the
East is playing an increasing role in dictating
international health care policy and action
through structures like the G-8 and the World
Health Organization. With an increasingly
globalized health care industry, medical tourism
will continue to grow and people will travel to
the East for lower cost, ‘Made in China’ health
solutions and the Chinese population will look
for Made for China solutions elsewhere.
Signals:
• The Central Government of China released
its five year plan which invests in health care
innovation45
• Mayo announced the opening of a new
hospital in India
• Canadians with Multiple Sclerosis traveled
abroad for the new liberation treatment46
Implications for Patients:
Will patients choose their next vacation based on
the location of their preferred health care provider?
Patients will have more choice and will engage in
more travel for specialized services. They will also
nurture an increasing interest in Eastern Medicine.
Implications for Providers:
How will providers differentiate themselves
among global competitors?
Providers must compete for pricing and ser-
vice options on a global scale and cater to an
international market.
Extrapolations:
In a decade, Canadians will purchase most of
their health care products and services from
multinational corporations. The wealthy and
middle class will think little of going to the other
side of the word for regular treatments. All
of the top health scientific discoveries will be
coming from the East.
Countertrends:
There is also a growing push to maintain and
strengthen local services, such as that in rural
communities. Additionally, there is a strong
movement in the US and Canada to embrace
and uphold western medicine as the only ef-
fective, proven approach to providing health
care.
5
for health care progress.
14. 14
Economic
Trend
The rise in demand for seniors’services results in broken
Granny Breaks the Bank/
Overview:
As the population in the US and Canada
ages, seniors comprise the majority of national
health care costs and are beginning to suck
the health care system dry. Their demands
for quality, complex care are expensive and
both state programs and families are beginning
to feel the detrimental consequences to their
pocket books. There is insufficient funding,
labour and planning to support these seniors
as desired.
Signals:
• American economists are projecting that
Medicare will be bankrupt by 202449
• Almost all caregivers in Mayo’s dementia
support group report significant financial woes
• Ontario’s Long Term Care bed shortage has
put a major burden on hospitals and families50
Implications for Patients:
Patients experience troubles accessing a full
system. There is increasing dependence on
family members as caregivers with major financial
restraints.
Implications for Providers:
There are not enough providers in the market
to meet demand so existing providers are
overwhelmed with users, often collapsing their
systems.
Extrapolations:
In a decade, there will be a new model of
health care reimbursement because the old
system didn’t work. There will be a reduction
in reimbursements for seniors care, families
will be forced to look after elders at home,
and there will be a large rise in personal
bankruptcies in North America.
Countertrends:
There is a major push toward reducing
the costs of caring for the sick and aging
population by encouraging seniors to stay at
home. There is also a growing desire among
users to seek a high quality of life rather than
longer quantity of life resulting in choices not to
get curative treatment.
5
health systems and insufficient funds.
15. 15
Economic
Trend
Get health care services anytime, anywhere.
Health Care On-Demand/
Overview:
There is an explosion of low cost venues and
channels that provide patients with instant
health care communication, information and
service wherever they are. Retail clinics are
dotting the continent and there is a rise in the
use of tele-health and virtual consults. These
models alone are contributing to a significant
surge in direct-to-consumer payment models
where patients pay for health care products
and services out-of-pocket
Signals:
• The development of the Mayo clinic store in
the Mall of America51
• GreatCall has a successful subscription-based
program for a 24-hour nurse hotline52
• mDhil provides services via text messaging,
mobile web browser53
Implications for Patients:
Will patients have the money needed to get
what they want? Patients will finally get more
of the care they want, using the channels that
they use for everything else.
Implications for Providers:
How will doctors offer impeccable instant
services? Providers are expected to be more
flexible, and will need to adapt to new care
models. This will require alternatives to the ‘fee
for service’ model for compensation.
Extrapolations:
In ten years, almost all of the care that we
received in the hospital or doctor’s office will
be provided through mobile technologies
and completed at home or on the go, often
instantly as needed.
Countertrends:
There is also a growing trend toward the
centralization of specialized services.
Furthermore, in some circles there is a growing
emphasis on the in-person doctor-patient
interaction demonstrated by the resurgence of
home visits.
5
16. 16
Social
Trend
Increased social entrepreneurship and advocacy for
Health care for All/
Overview:
Building on the idea of social justice, there
is an increased focus on the gap between
the haves and have-nots regarding health
care. There are more groups self-organizing
to advocate for equitable access to health
care, to shine more attention on problem
demographics and to increase participation for
those on the fringes of society.
Signals:
• Increased emergence of non-profit health
organizations focused on ethnic, teen,
children, bottom of the pyramid health
issues22,23
• Growth of social entrepreneurship in the
recent past, emergence of social entrepreneur
online courses and partnership with global
corporations24
• Increased reporting of successes in
community based health interventions in rural
communities25
• Evidence of corporate incentives/matching
of funds for community based health
interventions26
Implications for Patients:
More patients will receive access to health care
but treatments may not always align with their
beliefs. Their influence will further challenge the
concept of health care to be viewed in terms of
the social, emotional and spiritual well being of
people across cultures.
Implications for Providers:
Providers will experience competition
for funding as now political, business,
philanthropic and celebrity funds can now
be redirected to non-traditional health care
avenues for the redistribution of equitable
health care. This puts pressure on providers to
perform better. Patrons will have to be courted.
There will be opportunities to partner with
social entrepreneurs for health promotion and
care. Having a greater focus on diversity of
the larger patient base reached through health
social entrepreneurship will be beneficial for
providers and will also help in attracting health
care professionals who can fit in and care for
the respective cultures. Medical interpreters,
translators and counsellors will be needed
to work with patients to determine the most
appropriate care.
Extrapolations:
The increased diversity of the patient base will
have an impact on the definition of health care
and future treatments will encompass a more
holistic set of health and wellness services.
Countertrends:
Competition for funding may counter the
effectiveness and impact of a growing number
of health social enterprises.
5
those without access to proper health care.
17. 17
Social
Trend
Individuals actively seeking out information and
Patient Empowerment/
Overview:
Individuals are becoming increasingly involved
in their health care – managing their clinical
data, researching relevant medical info and
having more informed discussions with their
health care providers. No longer are doctors
the ones with the medical knowledge. The
internet and social media are democratizing
medical information and individuals are
not only benefitting from this knowledge to
influence aspects of their health.
Signals:
• Increased emergence and success of
health information sites27
• More social media courses being offered to
health care professionals to improve their
practice and engage their patients28
• Increased number of health-related apps and
tools available on the internet29
• Increasing anecdotal evidence of the
effectiveness of patient peer-to-peer support
in healthcare30
Implications for Patients:
Patients are torn between having access to health
information and feeling overwhelmed by it. They
will increasingly have power over their physicians
in demanding treatment types. Their updated
personal health records become tools for
further patient empowerment.
Implications for Providers:
To capitalize on the abundance of patient
data in the public domain, there needs to be
further integration of this data and that from
assistive devices under approved guidelines
into personal health records. Providers will
have to invest in more collaboration and
conflict management to maintain relationships
with knowledgeable patients. Providers will
work with government to revise government
regulations/policies in health care re: blurred
boundaries between personal/public health
care and self-tracking/epidemiology.
Extrapolations:
In a decade, there will be increased
transparency on mainstream social media
regarding the health status of individuals.
Health providers will be using social networks
to determine health levers and will be capable
of implementing a social intervention for
society’s well-being.
Countertrends:
There may be individuals who choose not to
get on the medical health bandwagon but
may gravitate to alternative healing methods
– Eastern medicine, spirituality, natural
movement. The overload of information may
cause individuals to become uninterested and
disengaged.
5
asserting control over factors affecting their health.
18. 18
Social
Trend
Measuring oneself in various situations in everyday life
Quantify Oneself/
Overview:
For some individuals, data is critical for them
to understand what is happening with their
bodies. Data is the only thing they can
trust. They monitor quantities like weight,
sleep, location, messages, genes, body
chemistry, performance, productivity, or any
other of a thousand metrics to view their
bodies, minds, and spirits through the lens of
data. Measurement can be done actively or
passively through technology gadgets.
Signals:
• Advances in cheap sensors,
communication and data tools for tracking
your activities and moods32
• Increasing number of Quantified Self members
and meetups in over 13 countries33
• Increasing venture capitalist interest in the
Quantified Self movement34
Implications for Patients:
Patients will embrace the opportunity to measure
and track their health metrics for customizable
treatments that could come about with increased
tracking. When their data starts to become
integrated in health systems and used for disease
prediction, patients will balk at the line between
quantified self and ultimate surveillance. Some
degree of their privacy will be sacrificed. They will
also question what data they own and what
they allow others to access.
Implications for Providers:
Providers have an opportunity to leverage all
this data to create customized treatments for
their patients but to effectively do this, they will
have to build capability in data analytics and
visualization to first understand the data and
then explain its meaning to patients. Providers
can also use this data to perform probabilistic
medicine - predicting the likelihood of disease
and proactively treating patients.
Extrapolations:
There will be increased transparency on
mainstream social media regarding health
status of individuals. Since the Quantified Self
members are already measuring moods, in the
future it will be possible to measure subjective
states such as happiness, anxiety, or pain.
This would allow researchers to find the neural
correlates of personality and behavioural
patterns (neurodiversity) with positive
implications for removing the stigma on mental
diseases.35
Countertrends:
Information overload and complexity may
slow the growth of this movement. And as
more self-tracking data is pushed to research
organization and providers, increased
government legislation in response to privacy
concerns could counter the growth.
5
to improve mind and body health and performance.
19. 19
Environmental
Trend
Increasing adverse effects on society’s health related to
Weathering Health/
Overview:
Climate change results in environmental
consequences such as sea-level rise, changes
in precipitation resulting in flooding and
drought, heat waves, more intense hurricanes
and storms, and degraded air quality. These
consequences adversely affect human
health both directly and indirectly. Linkages
have been made to an increasing number of
conditions such as asthma, cancer, foodborne
diseases, heat related morbidity, human
developmental defects, health and stress
related diseases, neurological, zoonotic and
waterborne diseases.
Signals:
• Increasing frequency of deaths due to heat
waves35
• More variable precipitation patterns
compromising freshwater supply and leading
to water-borne disease outbreaks36
• Rising sea levels and flooding causing vector-
borne diseases like dengue37
• Urban air pollution causing 1.2 million deaths
each year, mainly by increasing mortality from
cardiovascular and respiratory diseases38
• Reports of natural catastrophes have more
than tripled since the 1960s.39
Implications for Patients:
If unchecked, effects from climate change will
plague patients in the form of new diseases,
pandemics, increased stress and loss of life.
Patients will look to providers as a source
of security and comfort as they search for
information on prevention and care.
Implications for Providers:
Government and provider collaboration is
critical to care for the projected increase in
patients with these new diseases. Providers
will also play a greater role in disease
prevention related to the effects of climate
change as they collaborate with ecological
partners in their attempt to do vulnerability
mappings and health impact assessments for
public health actions.
Extrapolations:
Over time, confronted with decreased
productivity and increasing costs to care for
populations whose health is adversely affected
by climate change, more governments will
put climate change at the top of their agenda
leading to greater international cooperation.
Countertrends:
Linking health effects due to climate change
could create movement for mass conversion
to alternative energy sources, reforestation,
adoption of environmental agreements, which
will cause an increase in support for the
environmental movement.
5
climate change and environmental degradation.
20. Drivers/
Using the trends as a starting point for
analysis, we set out to determine the
driving forces behind some of the major
changes that are happening in the health
care industry. There was extensive dialogue
about how trends influenced each other
and underlying pressures within the system.
Influence mapping was used to complete
a basic systems analysis and identify key
drivers, enablers, blockers, and friction. A
simplified systems map is shown to the left
identifying five key drivers.
The key drivers identified were:
1. Access to Health Information – The ease
with which patients and practicioners
can obtain data and information on
health issues.
2. Patient Engagement – Patient initiative
in manging their health.
3. Complexity of Health – The advance-
ment of illnesses and the number of
conditions people have.
4. Personal Health Metrics – Collection of
health data from individuals.
5. Patient/Physician Interaction – The re-
lationship between patients and physi-
cians and their cooresponding actions.
20
21. Using the key drivers identified, the cone
of plausibility was used to develop future
scenarios that would answer the question:
what will the future interaction between
traditional health care specialists and pa-
tients look like in 2030 in Canada?
The purpose of developing the scenarios
was to think creatively about what special-
ist providers want to know about the future
to strengthen strategic planning and offer
insights that would help them be leaders in
working toward a preferred future. The cone
was chosen because of its suitability to the
slow-to-change health care industry with
a logical progression over time, incorpo-
rated visioning and room for surprises. This
method is also very applicable for strategic
planning because of the strong linkages to
the few key drivers.
The cone of plausibility is a scenario plan-
ning technique that uses a series of drivers
and key assumptions of the drivers to de-
velop a range of possible future scenarios.54
The technique involves developing a base-
line scenario with the logical extrapolation
of the drivers and assumptions to the target
date. Alternative scenarios are then generat-
ed by making small and radical adjustments
to the key assumptions. In the case of this
project, the basic method was modified as
a preferred scenario was used instead of the
baseline scenario with the idea that special-
ist providers want not simply to react to the
future, but also create it.
The following section summarizes four
future scenarios for 2030 that resulted from
using the cone of plausibility. The graphic
novel that follows brings these futures to
life through a story about the Mayo broth-
ers, the founders of one of the first collab-
orative specialist medical clinics.
21
Creating Future
Scenarios/
What will the future inter-
action between traditional
health care specialists and
patients look like in 2030
in Canada?
22. 22
Interconnected/
Preferred Scenario
In this world . . .
When visiting the specialist provider, pa-
tients enjoy a seamless experience with per-
sonalized, high-touch interaction. Patients
also have the benefit of new health care
roles - health navigators and coordinators
who ensure that the patient’s time is effec-
tively managed at the clinic and that they
understand all aspects of their treatment
options.
Specialist providers are able to treat pa-
tients within a robust medical network.
Specialists strive for effectiveness in their
practice using a high degree of collabora-
tion with primary care providers and care-
givers to achieve success. Providers are
reimbursed based on how effectively they
treat patients and patient wellness.
Patients have become more knowledgeable
about their health and ways to manage it.
The access to health information is high.
There are several tools on the market that
patients keep track of their health informa-
tion and it is automatically fed into a central
database within the health care system. For
the chronically ill, the social worker be-
comes critical in providing interim commu-
nication and navigating the system.
However, the cost of specialized health care
has increased. Medicare cannot handle
costs associated with the issues relating
to complexity of health of seniors. A two-
tierred health care system in Canada is
prominent. Typically, only the upper middle
class can afford timely specialist care.
Engaged patients have personal,
high-touch interaction with con-
nected providers.
Winners in this scenario:
• Patients who can afford high quality,
specialized care
• Health care navigators and coordinators
whose services are in demand
Losers in this scenario:
• Patients who cannot afford specialized
care
• Specialist providers who are highly
valued and get reimbursed based on
treatment effectiveness
23. 23
Do It Ourselves/
Plausible Scenario
In this world . . .
With increased access to health informa-
tion, patients are highly engaged in manag-
ing health and are seen as experts of their
own health. They derive great benefit from
online networks where their questions are
answered instantly and they can get an
estimated diagnosis in a matter of minutes.
Informal social networks gather around
people who need support. Patients who
do not have strong social supports are left
behind.
There are hordes of health management
tools in a generally unregulated market.
Patients are willing to pay out-of-pocket for
treatments the way they want them. Most
patients stay at home or in their community
throughout the course of their illnesses.
There is a growing role for life doulas and
other medical coaches to guide patients
through their many choices. Due to the
increased competency of patients, it is now
appropriate for them to prescribe their own
drugs bypassing the physician. Pharmacists
now become the gatekeepers of diagnoses
and prescriptions of treatment.
The reliance on health-related social net-
works and the health management tools
for critical decisions means patients often
make bad decisions regarding diagnoses
and treatment. During interactions with
specialist providers, patients often have dis-
agreements as both have very strong views
on what treatment is required. Specialist
providers are caught between doing what
patients think is best and growing malprac-
tice liabilities.
The Canadian government now penalizes
citizens that chose unhealthy consump-
tion and behaviour by imposing taxes on
unhealthy goods and services.
Winners in this scenario:
• Pharmacists who now have greater
influence
• Engaged patients who demand treat-
ments
Losers in this scenario:
• Patients that face barriers to engage-
ment in their own care or have low
social support
• Specialist providers who face pressure
from patients and insurance companies
Patients take on a leadership role
in defining and administering
their own treatment.
•
24. 24
Calculated
Possible Scenario
Craziness/
In this world . . .
It seems like technology has taken over.
Genome mapping is the same cost as get-
ting blood work done is today and on-going
personal biologic surveillance through ac-
cessory gadgets is the norm.
Many technology companies are leading
key developments in the health market and
regulation can’t keep up. Real time health
updates and availability of genetic infor-
mation allows for immediate, completely
individualized treatment for prevention of
disease and timely reactions to condition
changes. The high availability of informa-
tion due to advances in technology allows
for data mining of information. This en-
ables the Canadian government to improve
policy around promoting population health
and promptly respond to emerging health
issues.
Many self-monitoring devices are available
on the market. Patients are increasingly
involved in monitoring their bodies and its
information. Patients often feel stressed,
anxious and fearful because of a greater
knowledge about their genetics and con-
tinual feedback from their health devices.
There has been a significant rise in the num-
bers of patients with mental health issues.
Specialists have a more technical role in
care. Patients are supported by a prominent
new role - the health data analyst. These
practitioners synthesize information and
help the patient understand their genomic
profile and the implications for his/her
health.
Insurance companies have much more
personal information and those with poor
genetics have extremely high insurance
rates. This information carries over into
many spheres of life such as employment
and even marriage contracts. This causes
high levels of anxiety and stress for many
who don’t understand the meaning behind
the numbers.
Ethical issues around sharing personal ge-
netic information and genetic engineering
of new life come to the forefront. Debates
abound but there is no real direction or
resolution.
Winners in this scenario:
• Insurance companies have better infor-
mation on“risky individuals”
• In-house genetic data analysts who as-
sist patients
Losers in this scenario:
• Patients who have“bad”genes
Patients are bombarded with
health metrics and measures.
25. 25
Healthy Immortal/
Extreme Scenario
In this world . . .
Science offers a way to significantly extend
human life through genetic reprogramming
treatment. The production of synthetic
organs is a quick and effective way to cure
disease and injury. Patients are generally
engaged in making healthy choices and
they can live extremely long, healthy, and
functional lives. Chronic diseases have been
basically eliminated because of powerful
medical and scientific developments.
Patients tend to only interact with physi-
cians for one-time quick fixes to deal with
injuries and for assisted death. In this
world, because of the high life expectancy,
many patients decide when they are ready
to die. Euthanasia has been legalized to
accommodate this need. For those who are
grounded in religion, there are conflicting
values around lengthening and creating life.
Because of the“immortality”that has been
achieved due to technological advances,
some people end up taking more risks
because they feel more invincible and this
behaviour is what fuels the demand for
health services.
New developments mean people
can live to at least 150 years of
age.
Winners:
• Patients who get injured
• Specialist providers who can play“God”
to heal and restore
Losers:
• Those that don’t have access to medical
advances
• Those that feel lost as they live long
past their natural life-expectancy
26. The intention of the graphic novel was to help interested
parties understand the world within each scenario and bet-
ter determine potential implications for stakeholders.
26
Back to the Future/
T
he following graphic novel tells the story
of going back to the future with the Mayo
Brothers, the founders of the first integrated group
practice in Rochester, MN.
Bringing Scenarios to Life
The story goes like this. One day Charles was
futzing around in the supply closet when
he discovered this machine that had lots of
blinking lights, dials and buttons.
He wondered what it was. His curiosity got
the better of him and he started pressing
some buttons and turning some dials. The
room started to rumble and shake.
He saw a set of numbers turn to 2030 and
he felt himself being pulled through thin air
(which was actually a time worm hole).
And Charles ended up in a different world . . .
33. 33
From Scenarios
to Strategies/
T
o utilize new insights garnered from
the scenarios, a list of strategic op-
tions were developed for specialist pro-
viders. These strategies were then tested
against each of the scenarios for strategic
fit.
First, informal conversations about potential
strategies took place for the purpose of sur-
facing existing strategies and long-standing
intentions. Then, the scenarios were used
as triggers to generate additional strategic
options by asking the question“what would
a specialist provider want to do if this future
was the reality?” Internal, external and
transactional options were identified.
The process of options surfacing, eliciting existing orga-
nizational and industry strategies, and option generation,
developing new strategy options were utilized to develop a
relatively comprehensive list of strategic options
Some of the options were recognized to
be closer to the tactical level and removed
from the process that followed. This left
twenty-five options that were then clus-
tered into a more manageable set of four
possible strategic directions by grouping
options that required consideration of each
other in implementation.
The four strategic directions that resulted
from the iterative process of refinement
were:
1. Develop a smart, electronic health
system
2. Integrate system delivery
3. Improve the patient experience
4. Serve more patients, more efficiently
These strategic directions along with their
corresponding options were then evalu-
ated against the range of possible futures
outlined in the scenarios.
34. Wind-Tunnelling/
This wind tunneling matrix outlines the twenty five strategic
options and four overarching strategic directions. . Each op-
tion is tested for strategic fit within each scenario and rated
high (solid circle), medium (thick circle), or low (light circle).
34
Using a wind-tunnelling matrix, the stra-
tegic fit of each option within the environ-
ment of each scenario was determined and
rated high (shown as a solid circle), medium
(shown as a think circle), or low (shown as a
light circle). The level of risk and uncertainty
of each option was analyzed through these
multiple futures. Those strategic options
that were recognized as“robust”(or had a
medium or high rating in the first three sce-
narios) were highlighted. The fourth scenar-
io, the Healthy Immortal, was used not used
to inform the overall level of robustness due
to its‘extreme’orientation, but it became a
useful trigger for thoughtful consideration
and conversation.
The wind tunneling matrix shows a quick
overview of the results of this process. At
a glance you can see that the first three
strategic directions were generally robust
and appropriate for the range of plausible
futures, while the fourth direction of ‘see-
ing more patients, more efficiently’ was
rather uncertain when tested against each
scenario.
The three robust strategic directions identi-
fied offer important long-term approaches
for specialist providers moving forward, but
still the process of acting on these direc-
tions remains unknown. And rather than
simply be reactive to the changing environ-
ment, the question remains,“How does a
specialized health care provider lead in the
creation a desired future?” Three horizons
method helps to answer this question and
strengthen implementation of these strate-
gies.
35. The Three Horizons/
35
The three horizons method55
illustrated to
the right represents the prevailing system
(Horizon 1 - the Closed/Physican-Centric
System), the unstable space of transition
(Horizon 2 - the Decentralized Mess) and
the vision for the future (Horizon 3 - the
Integrated/Patient-Centric System). Horizon
3 was developed from a combination of the
first three original scenarios.
The Three Horizons model diagram shows
the dominant system falling away followed
by the rise of the patient-centred model of
care with the transitional space in between
made up of tensions and unresolved issues.
The model also shows that there are“pock-
ets of the future”embedded in the present
that represent both Horizon 2 and Hori-
zon 3. These weak signals of the patient-
centred model of care include changes in
reimbursement models toward bundling in
other countries and signals of the decentral-
ized mess include incidents of leakage of
health information and growing numbers
of people getting their health questions
answered online.
36. 36
The Three Horizons framework
seemed particularly appropriate
because of the radical transition
that seems immanent within
the health care industry and the
strongly held vision of a desired
future among many industry
thought leaders . Descriptions
of each of the three horizons are
provided in thed diagram to the
left.
The framework offers indications
of the range of strategic innova-
tions that would help a specialist
health care provider, not only
survive, but lead in the develop-
ment of the desired future.
In the short-term, Horizon 1
requires strategies that improve
current operations or incremen-
tal innovations to help keep the
system relevant longer. Horizon
2 requires strategies that ex-
tend current competencies and
address the growing tensions
within this space. Horizon 3 de-
mands radical innovations that
change the nature of the indus-
try and bring to life the vision for
an integrated, patient-centred
system.
37. 37
Three Horizons also calls out
tensions between the status quo
and the prefered state. These
tensions are highlighted in the
diagram on the right. It is find-
ing strategic ways to navigate
these tensions that will allow
providers to successfully transi-
tion to a patient centric system.
There is a tension between the
traditional physician power and
the growing patient empower-
ment. This suggests a need for
colloration and partnership
between patient and providers.
In the transition, there is tension
between the fragmentation of
services in the current state and
the integration that is envi-
sioned in the prefered state. This
calls for coordination to improve
the patient experience within
the mess of Horizon 2.
The current model of medicine
that is reactive to illness must
transition toward prevention
and prediction requiring part-
nerships with primary care pro-
viders and other practicioners
within the community.
The tension between standard treatement
and individualized care requires new mod-
els of assessment and deeper understand-
ing a patient profiles.
The transition from complex processes
within the health care space to easy to use
systems suggests the need for appropriate
technologies and systems changes.
The shift from valuing quantity of service to
patient wellness will require new reimburse-
ment models, ongoing health management
and truly collaborative practices.
As specialized health care providers transi-
tion toward Horizon 3 navigating the ten-
sions within Horison 2 will be critical.
38. Strategic Directions/
38
Bringing forward the robust
strategic directions from the
wind tunneling exercise, the fol-
lowing pages outline how these
three directions can be thought-
fully implemented by using
the Three Horizon’s method as
a conceptual framework. The
three strategic directions are
outlined on the right. Together
these strategies work to create
Horizon 3 and a patient centred
system of care.
39. 39
Smart Electronic
Heath System/
B
ecause the health care transformation
will be significantly information driv-
en, one critical element of a patient-centred
system for 2030 is a smart electronic health
system.
Access to health information and services
that will meet the needs of the future
patient requires the integration of multiple
databases into one centralized electronic
health record system that can be accessed
at every point of patient interaction. This
requires a solid information technology
foundation that is scalable and flexible
enough to meet the demands of many
collaborating practitioners. The electronic
health records system will lay the ground
work for integrated delivery and ongoing
health management.
The system must provide a single unified
comprehensive view of the patient, their
medical history, and their biological profile
that can be accessed using any device or
system. Creating a smart visual dashboard,
with an‘at a glance’view for patients and
providers, will improve decision-making.
Furthermore, the system must be able to
learn from all the aggregated health in-
formation within it. The electronic health
system needs built-in analytics to enable
predictive modeling. Having a smart system
will allow practitioners to gain actionable
insights from data analytics.
Unfortunately, implementation of this de-
sired end state will not happen overnight.
While the basics of this strategy is not a new
aspiration for specialist providers in
Strategic Direction One
40. 40
Canada, there have been significant barriers
to progress and implementation over the
last decade including: separate information
silos, incompatible legacy systems, current
time requirements for information technol-
ogy, and the complexity of many systems
currently on the marketplace.
The three horizons framework offers guid-
ance on a stratified approach to implemen-
tation that is fit to weather the storm of
the‘decentralized mess’that lies within the
desired transition.
Strategies appropriate for horizon 1 are
incremental improvements to the current
system that create the foundation for the
electronic system and would help to pre-
pare for the transition. These strategies
include identifying the electronic needs of
practitioners, patients and organizational
operations and establishing design guide-
lines to share with technology developers.
These steps will help to encourage the de-
velopment of technology that is compatible
with and useful for the provider.
In addition, utilizing existing tools within
current operations and services, such as
using trusted iphone applications, has the
potential to make improvements to ser-
vices and establish practitioner readiness
for more radical system changes. Engaging
patients early on in conversation about their
desired and current use of electronic health
information will help to establish an under-
standing of what is needed from a patient
perspective as well as establish trust in the
space as the organization moves forward.
Horizon 1:
Determine Foundation of
Electronic System
Horizon 2:
Position as Experimenting
Expert
Horizon 3:
Establish Smart, Electronic
Health System
Incremental Improvements
• Dialogue with patients
• Identify system needs
• Utilize existing tools
• Establish design guidelines
New Related Activities
• Prototype new tools/systems
• Partner in technology
development
• Position as think tank
• Accredit technology
System Changes
• Shared e-health record
• Standard platform and interface
• Aggregate information
• Algorithms for prevention
• Collaboration in system
• Security safeguards
41. 41
Actions appropriate for Horizon 2 and
surviving the chaos are those that posi-
tion specialist providers as relevant and
trusted experts amid the clutter of other
offerings. Activities include partnering with
technology companies to assist in develop-
ment of appropriate technology, openning
up network to test out different points of
interaction within the system, and provid-
ing feedback to improve the products for
mutual benefit. In addition, acting as a
thought leader by publishing white papers
and calling out the next steps will help dif-
ferentiate specialist providers and attract
the right partners for moving toward the
desired electronic system.
Furthermore, to emphasize specialist pro-
viders as trusted experts, providers could
investigate developing an accreditation
program for tested, secure technology to
help patients and providers alike navigate
the mess and make better choices related to
using information technology for managing
their health.
In working toward the end goal of develop-
ing a smart electronic health system, several
fundamental developments are needed
including establishing a standard elec-
tronic health record early on and adopting
a standard platform for connecting, sup-
ported by cloud computing technology for
point of care communication. The common
system should then be utilized by aggregat-
ing health information from all collected
patient data to gain actionable insights
for more personalized care and to develop
algorithms to help prevent diseases. The
standard platform would then be used to
move beyond connections between practi-
tioners to collaboration among all patients,
providers, communities, and beyond.
Implementing actions for all three horizons
is critical to the transition toward a smart
electronic system that will in turn lay the
ground work for integrated delivery and an
improved patient experience.
42. 42
Strategic Direction Two
Integrated
Service Delivery/
O
ne critical element in the transition
toward the commonly sought after
patient-centred system is integration. While
integration is not a new idea for Canada’s
health system, there have been many barri-
ers to progress in this area.
The first diagram illustrates how the closed,
physician-centric system that is dominant
today can be improved by creating linkages
between typically disconnected providers.
Informal actions such as a phone call be-
tween a specialist and a primary care physi-
cian to provide an update on patient status,
can improve the overall health manage-
ment of the patient. In the same vein, other
simple actions that can help create linkages
in the current system include the utilization
of shared patient artifacts (such as patient
books written in by all providers); efforts by
practitioners to help patients navigate the
system (such as making referrals to commu-
nity support organizations); and establish-
ing collaboration protocol within specialist
organizations. These actions don’t offer a
sustainable path toward integration, but
rather band-aid-type solutions that can help
specialist providers remain relevant in the
short term.
Increasing integration within in the‘decen-
tralized mess’requires investment in new
tools, roles and partnerships that move
beyond the status quo to the provision of
services designed to coordinate the patient
experience. Tools such as case manage-
ment and care coordination do not change
the overall integration of the system itself,
but they help coordinate care, manage
patients’health, connect patients to ap-
propriate resources, and improve resource
The Three Horizons method offers a frame-
work for organizing the continuum of strat-
egies related to integration and indicates
how a specialist provider can move from
the current state toward complete integra-
tion. The figure to the left identifies areas of
strategic innovation that are appropriate for
each horizon and can be adapted based on
organizational readiness.
43. 43
monitor, manage and share health informa-
tion instantly between providers57
. Pooled
or bundled funding is another critical ele-
ment which provides incentives for provid-
ers to collectively ensure patient health.
Using this reimbursement model, there is a
set amount of funding, regardless of ser-
vices provided and a network of providers is
collectively responsible for their wellness58
.
Co-location strategies, collective gover-
nance between providers, and team-based
care have also proven effective in achieving
system integration.
For specialist providers in Canada to con-
tinue to be leaders in their field, they must
invest in strategic innovations to help them
survive and thrive in the future across all
three horizons as they transition toward
integration. As illustrated in the Three Ho-
rizons Diagram, remnants of each horizon
exist in the present and specialist provid-
ers need to implement strategies now to
ensure they are prepared as the level of
strategic fit of Horizon 2 and 3 increase with
time.
While each specialist provider in Canada
is working in a different context and has a
different level of readiness around systems
integration, the milestones outlined below
offer general indications of the progress
necessary to lead the transition toward
complete integration. These milestones
offer providers a way to monitor their ef-
forts and environmental change as well as
provide an indication of when alternative
strategies may be necessary.
For example, if standard, shared electronic
health records have not been implemented
by the end of 2018, an alternative strategy
for a local shared information network
is needed in order to develop a provider
network with collective governance and
a truly collaborative practice. Similarly, if
a bundled reimbursement model is not in
place by 2024, other incentive for collective
responsibility around patient wellness will
need to be explored and developed. This
general pathway offers a guide and targets
for organizational decision-makers, but
a individual time line for each provider is
needed.
Horizon 1:
Linkage Within The Current
System
Horizon 2:
Coordinate Care
Amid The Mess
Horizon 3:
Establish A Truly Integrated
Delivery System
Incremental Improvements
• Informalcommunication
• Shared patient artifacts
• Practitioners act as navigators
• Collaboration protocol
New Related Activities
• Casemanagement
• Carecoordination
• Single points of entry
• Service partnerships
• Careplans
System Changes
• Shared e-health records
• Co-location
• Collective governance
• Team-based care
• Pooled funding
efficiency.56
These tools are appropriate for
specialist providers seeking to remaining
relevant in a highly chaotic and decentral-
ized system. These tools also lay the ground
work and develop relationships critical for
Horizon 3.
The innovations directed at Horizon 1 and
2 fall short of establishing a completely
integrated system for the future. These ho-
rizons are the testing and building ground
for Horizon 3, the preferred state, which
requires radical system changes.
One of the most fundamental elements
of an integrated, patient-centric system is
shared electronic health records. Electronic
health records provide an efficient way to
44. 44
I
mproving the patient experience is at the
core of the transition toward a system that
is truly patient-centred.
Improving the patient experience is at the
core of the transition toward a system that
is truly patient-centred. Being patient-
centred or organizing delivery of services
around the needs of patients seems like
a simple and obvious approach, but in a
system as complex as health care, little is
simple. While some specialist providers cur-
rently have organizational missions that ref-
erence a patient-centred approach, services
are often far from patient-centred, leaving
patients with an experience that is no better
than mediocre. The fact that providers are
giving lip service to‘patient-centred care’
with little change in service provision is
evidence of the growing tensions space in
Horizon 2.
More can be done to make a thoughtful and
strategic transition toward a radically differ-
Improve
the Patient
Strategic Direction Three
Experience/
ent patient experience enabled by patient-
centred services. It requires a holistic,
preventative approach that works toward
wellness and quality of life, supports mental
health, and involves friends and family in
a patient’s care. Patient-centred services
require ongoing communications and
health management as well as easy access
to personal health information. It means
services that are transparent, flexible and
convenient for patients, including providing
services online and in locations where pa-
tients already are. Patient-centred care goes
beyond expanded patient consultation to
seeing patients as partners, key decision-
makers, and collaborators. It encourages
and enables self-care and self-management.
Patient-centered care for 2030 requires indi-
vidualized, tailor-made interventions based
on biological and clinical data provided in
a compassionate, comfortable way by a
trusted source.
Getting to this desired end state requires
simultaneous actions that: improve the
patient experience in existing services,
extend service and delivery options and
offer holistic, individualized services with
patients as partners. These three directions
enable specialist providers to maintain and
radically improve services by implementing
actions appropriate for each horizon.
In the first horizon, incremental improve-
ments, such as training for practitioners on
improved patient-service and relationship
management, can significantly enhance the
patient experience in the existing system.
45. Horizon 1:
Improve Existing Services
Horizon 2:
Extend Service and
Delivery Options
Horizon 3:
Offer Services that are Truly
Patient-Centred
Incremental Improvements
• Train practitioners
• Enhancecommunication
• Expandconsultation
• Family involvement
New Related Activities
• Pilot new wellness services
• Test new supporting roles
• Improve scheduling flexibility
• Increasecommunication options
System Changes
• Patient collaboration
• Individualized medicine
• On-going health management
• Coreservices online
• Holistic, preventative offerings
• Transparencyand access of
information
Increased informal communication with
patients can improve the connection be-
tween patients and providers and is proven
to impact patients’perception of quality
of care. However, the shift toward patient-
centred care is not minor one; it requires an
important and thoughtful adjustment of
organizational culture and values which can
certainly take root in Horizon 1 starting with
the messages and decisions of leadership.
For those specialist providers looking to
transition toward an improved patient
experience enabled by patient-centred
services, navigating the tensions within
‘the mess’is critical. It requires specialist
providers to‘walk the talk’of being patient-
centred by expanding service and delivery
options that reflect the paradigm shift.
Extending wellness services and testing
out new practitioner roles, such as mental
health workers, data analysts, care coordi-
nators, or wellness coaches, will help serve
patients more holistically within an organi-
zational environment that is still somewhat
fragmented and an external environment
that is increasingly cluttered. In addition to
the types of services offered and roles, im-
proving ways in which services are provided
is also critical to competing in Horizon 2.
Actions like implementing same day sched-
uling, enabling a patient to have all of their
clinic work done in one day, or increasing
communication channels between patients,
providers, and families, help a specialist
provider stay relevant and meet the chang-
ing demands of future patients.
Still the strategies aimed at preparing a
provider for the decline of the status quo
and the rise of values-related tensions is not
enough create the radical improvements
necessary to the patient experience that
would reflect a system that is truly patient-
centred. Horizon 3 requires a complete
paradigm shift that supports patient col-
laboration and integrates holistic thinking
and palliative care in all interactions – a
proactive approach to care. Building capac-
ity to offer a range of truly individualized
treatments with preventative and predictive
offerings, is instrumental to understanding
and meeting the needs of future patients.
For Horizon 3, seamless integration be-
tween practitioners and other providers
enables ongoing management by a team
of professionals that are deeply invested
and accountable for patient wellness. This
means that patients see the right person, at
the right-time, in the right place to address
and prevent individual health issues. Such
services would include the option of get-
ting core services, such as key consultations
and even diagnosis online. The effect is
that the patient derives valued care from
every touch point with the health system.
Ensuring the most appropriate, personal-
ized service for each individual will create
a very different interaction and experience
46. Moving Forward/
An indicator of a growing horzon two is
patient adoption of private health services.
Monitoring uptake of these services can
help to make sure that strategies targeted
at Horizon 2 are implemented at the appro-
priate time for the environment.
Similarly, the implementation of bundled
reimbursement model is a signpost for the
rise of Horizon 3. If this is not in place by
2024, other incentives for collective respon-
sibility around patient wellness may need to
be explored and developed.
The organizational milestones offer a
general targets for organizational decision-
makers, but an individual timeline for each
provider is needed. These milestones are
important check-ins along the journey for
providers.
For example, if shared electronic health
records have not been implemented by
2018, an alternative strategy for a local
shared information network is needed in
order to improve delivery integration and
the patient experiene.
This timeline should be used as a generic
guide from which targeted timelines with
milestones and signposts can be developed
that are specific to each provider.
The timeline above outlines key organiza-
tional milestones and environmental indica-
tors for specialist providers. While each
specialist provider in Canada is working in
a different context and has a different level
of readiness for these strategies, the mile-
stones outlined offer general indications of
the progress necessary to lead the transi-
tion toward a patient centric system. These
milestones offer providers a way to monitor
their efforts and environmental change as
well as provide an indication of when alter-
native strategies may be necessary.
46
47. A Call for
New Thinking/
47
T
his foresight project challenges specialized health care pro-
viders and others working in the health care space to think
differently about strategic planning. It demonstrates powerful,
creative methods for pondering the future and offers thoughtful
approaches for transitioning toward a desired future. Especially for
one of the most valued and also outmoded systems in this country,
foresight offers hope and much needed inspiration for change.
48. 48
Appendix/
STRATEGIC
DIRECTIONS STRATEGIC OPTIONS
INTER-
CONNECTED
POWER
TO
THE
PEOPLE
CALCULATED
CRAZINESS
HEALTHY
IMMORTAL
Integrate
service
delivery
1 Integrate with local community providers* H H M L
2 Partner other specialist providers L H L L
3 Integrate internal health care practitioners H M L L
4 Provide ongoing health care
management*
H H H L
Improve
the patient
experience
5 Increase front-end consultation* M H M L
6 Increase provision mental health services* M M H M
7 Increase use of palliative care teams L M H H
8 Expand preventative care offerings L H H M
9 Increase offerings for genomics based
individualized medicine*
H M H H
10 Increase alternative medicine options L M L M
11 Increase remote care offerings* M H H L
12 Provide core services online* M H H L
13 Offer e-consultations for front-end and
follow-up consultation*
H H M L
14 Offer in-home services direct to patient
and caregiver
L H H H
Develop
a smart,
electronic
system
15 Develop capabilities for data analytics* M M H M
16 Partner with technology providers* M H H L
17 Ensure strong security governance* H H H L
18 Provide accreditation to companies L H H L
19 Develop centralised digital health record* H H H M
20 Improve transparency of care* M H M L
Serve more
patients,
more
efficiently
21 Reduce hospital stay-time* H M M H
22 Increase patient through-put L M M L
23 Focus on more complex patients H L H L
24 Further centralize specialty care H L L L
25 Stay comprehensive and treat everyone
well
L M L L
This matrix details the results of the wind-
tunnelling excercise. Those strategic op-
tions that were recognized as“robust”(had
a medium or high rating in the first three
scenarios) were highlighted (identified in
the chart with *).
49. 1 - Soroka, S. N. (2007)“Canadian Perceptions of the Health Care System”. McGill University. Retreived on November 29, 2011 at http://
www.queensu.ca/cora/_files/PublicPerceptions.pdf
2 - (2010).“Follow the Leader – Provinces crack down on prescription-drug spending.”The Economist. Retrieved on November 29, 2011 at
http://www.economist.com/node/16542808
3 - (2011).“Canadian health care system feels strain from boomers.”Winnipeg Free Press. Retrieved on November 29, 2011 at https://www.
aarpglobalnetwork.org/netzine/Industry%20News/SeniorLivingNews/Elderly%20Services/Pages/Canadian%20healthcare%20system%20
feels%20strain%20from%20boomers800540146.aspx
4 - (2010).“Population projections: Canada, the provinces and territories.”Statistics Canada. Retrieved on Nov 29, 2011 at http://www.
statcan.gc.ca/daily-quotidien/100526/dq100526b-eng.htm
5 - (2010).“International Profiles of Health Care Systems.”The Commnwealth Fund. Retrieved on November 29, 2011 at http://www.com-
monwealthfund.org/~/media/Files/Publications/Fund%20Report/2010/Jun/1417_Squires_Intl_Profiles_622.pdf
6 - In Vivo. (n.d.). Retrieved 2011, from Dictionary: http://dictionary.reference.com/browse/in+vivo
7 - Savov, V. (2009, Oct 12).‘Spider pill’bowel scanner will be ready within a year. Retrieved from Engadget: http://www.engadget.
com/2009/10/12/spider-pill-bowel-scanner-will-be-ready-within-a-year/
8 - Nanomedical capsule in cancer treatment. (2010, Mar 9). Retrieved from Nanotechnology Now: http://www.nanotech-now.com/news.
cgi?story_id=37127
9 - Torre, C. d. (2010, May 20). Ingestible Surgical Robots—Hard To Swallow Concept? Retrieved from Singularity Hub: http://singularity-
hub.com/2010/05/20/ingestible-surgical-robots-hard-to-swallow/
10 - Consumerization. (2011, 10 31). Retrieved from Wikipedia: http://en.wikipedia.org/wiki/Consumerization
11 - Professor Daniel Fletcher, B. (2011). CellScope for Disease Diagnosis. Retrieved from Cellscope: http://blumcenter.berkeley.edu/global-
poverty-initiatives/mobile-phones-rural-health/remote-disease-diagnosis
12 - MedApps Mobile Wireless Remote Patient Monitoring. (2011). Retrieved from MedApps Health Monitoring: http://www.medapps.net
13 - RFID and GPS HOspital Patient Monitoring and Records. (n.d.). Retrieved 2011, from Beacon RFID and GPS Hospital Patient Monitoring
and Records: http://www.beacontechnology.com/rfid/hospitalpatient/
14 - Care-O-Bot – Let Robot Handle your Needs by Ken on July 19, 2008 at http://www.hardwaresphere.com/2008/07/19/care-o-bot-let-
robot-handle-your-needs/
15 - Humphries, M. (2009, apr). Honda updates Asimo robot with thought control . Retrieved from Geek.com: http://www.geek.com/ar-
ticles/gadgets/honda-updates-asimo-robot-with-thought-control-2009041/
49
References/
50. 16 - 1,000 Paro robots migrating to Denmark. 21 Nov 2008 [Sources: Jiji, Chunichi] http://pinktentacle.com/tag/smart-tech/page/2
17 - Kompai by Robosoft http://robosoftnews.wordpress.com/category/kompai/
18 - ACTROID-F in AIST Open Lab 2010 02 (lifelike humanoid) http://www.youtube.com/watch?v=cFVlzUAZkHY&feature=related
19 - Me MD. Retrieved 2011, from Me MD Health care Virtually Anywhere: http://www.memd.me/
20- Genomera Health the World. Retrieved 2011, from Genomera: http://genomera.com/
21 - WellPoint and IBM Announce Agreement to Put Watson to Work in Health Care. (2011, Sep 12). Retrieved from IBM: http://www-03.ibm.
com/press/us/en/pressrelease/35402.wss
22 – Mair, J (2010).“Social Entrepreneurship: Taking Stock and Looking Ahead.”IESE Business School, University of Navarra. Retrieved on No-
vember 29, 2011 at http://www.iese.edu/research/pdfs/DI-0888-E.pdf
23 – Friesen, C (2011).“Social Entrepreneurs Mushrooming In Britain: Social Enterprise UK Report.”Social Innovation Europe Retrieved on No-
vember 29, 2011 at http://www.socialinnovationeurope.eu/node/2196
24 – Johnson-Tomaszewsk, M (2010).“Trend Spotting: The Rise of Social Entrepreneurship.”University of St. Thomas. Retrieved on November
29, 2011 at http://www.stthomas.edu/bmag/2010/Fall/Trendspotting.html
25 – (2011).“WHO study shows community-based health interventions reduce stillbirths and newborn deaths.”World Health Organization.
Retrieved on October 16, 2011 at http://www.who.int/child_adolescent_health/news/archive/2011/24_01_2011/en/index.html
26 – (2010).“Ashoka-Incubated Social Enterprise, Healthpoint Services, and Procter & Gamble Join Forces to Transform Rural Health care.”
Ahoka Website. Retrieved on November 29, 2011 at http://ashoka.org/press/7644
27 - Mangano, J (2011).“Despite Reports of Decline, Health Websites Retain Popularity.”ComScore. Retrieved on October 18, 2011 at http://
blog.comscore.com/2011/08/health_websites_retain_popularity.html
28 - Talon, M (2011).“Building a Social Media Presence.”Sprout Insights. Retrieved on October 18, 2011 at http://sproutsocial.com/in-
sights/2011/11/medical-social-media/
29 - (2010).“Health care & Social Media: Growth & Guidelines.”Agile Dudes Social Media Solutions. Retrieved on October 18, 2011 at http://ag-
iledudes.com/all/social-media-health-space/
30 – Fox, S (2011).“Examples, please: peer-to-peer health care.”Epatients.net. Retrieved on October 18, 2011 at http://e-patients.net/ar-
chives/2011/06/examples-please-peer-to-peer-healthcare.html
31 – Sanders, L (2011).“Think Like a Doctor (The Contest).”The New York Times. Retrieved on October 18, 2011 at http://well.blogs.nytimes.
com/2011/03/23/think-like-a-doctor-the-contest/
32 – Singer, E (2011).“Tools for Quantifying Yourself.”Technology Review. Retrieved on October 16, 2011 at http://www.technologyreview.com/
biomedicine/37858/
2 - (2011).“Quantified Self Meetup Groups.”Meetup.com Retrieved on November 29, 2011 at http://quantified-self.meetup.com/
33 – Moss, F (2011).“Our High-Tech Health-Care Future.”New York Times. Retrieved on November 29, 2011 at http://www.nytimes.
com/2011/11/10/opinion/our-high-tech-health-care-future.html
50
51. 34 – Hamamoto, B (2011).“The Future of Science, Technology, and Well-being 2020 Forecast Map.”Institute for the Future. Retrieved on October 16, 2011 at http://
www.iftf.org/system/files/feature/SR1309_%202020%20Forecast%20Map_S%2526Treader.pdf
35– (2005).“Climate and Health.”World Health Organization. Retrieved on October 16, 2011 at http://www.who.int/globalchange/news/fsclimandhealth/en/index.
html
36 - (2010).“Waterborne Diseases.”Centers for Disease Control and Prevention. Retrieved on November 29, 2011 at http://www.cdc.gov/climatechange/effects/water-
borne.htm
37 – Narain, J (2009).“Climate change brings natural disasters and disease.”Science and Development Network. Retrieved on November 29, 2011 at http://www.
scidev.net/en/opinions/climate-change-brings-natural-disasters-and-diseas.html
38,39 – (2010).“A Human Health Perspective on Climate Change.”National Institute of Environmental Health Sciences. Retrieved on Nov 1, 2011 at http://www.niehs.
nih.gov/health/assets/docs_a_e/climatereport2010.pdf
40– Segrave, A (2009).“Techneau Report on Trends In The Netherland.”Techneau.org. Retrieved on November 29, 2011 at http://www.techneau.org/fileadmin/files/
Publications/Publications/Deliverables/D1.1.14.pdf
42 -Dolan, B (2011).“Merdian tests consumer health waters.”MobiHealthNews. Retrieved on November 26, 2011 at http://mobihealthnews.com/special-edition-9-mo-
bile-health-hospitals/.
42- Burd, S. (2009)“How Safeway is cutting health care costs.” Wall Street Journal . Published June 12,2009. Retrieved on November 26, 2011 at http://online.wsj.com/
article/SB124476804026308603.html.
43-Genworth Financial (2011).“Care-Scout”. Retrieved on November 26, 2011 at http://www.carescout.com/.
44- Sprey, K. (2009).“The CellScope: transforming the cell phone into a mobile microscope”. Gizmag.com. Published April 14, 2009. Retrieved on November 26, 2011
at: http://www.gizmag.com/cellscope-mobile-microscopes/11463/.
45 –KPMG (2011).“China’s 12th five year plan”. Retrieved on November 28, 2011 at http://www.kpmg.com/cn/en/IssuesAndInsights/ArticlesPublications/Documents/
China-12th-Five-Year-Plan-Healthcare-201105-3.pdf
46 – MultipleSclerosisSurgery.com (2010).“MS-liberation treatment - New Delhi, India”. Retrieved on November 28th, 2011 at http://www.multiplesclerosissurgery.
com/ms-liberation-treatment-new-delhi.html
47 – McKinnon, M. (2011).“It’s about medicare, stupid.”The Daily Beast. Published June 10, 201. Retrieved on November 28, 2011 at http://www.thedailybeast.com/
articles/2011/06/10/medicare-malpractice-how-doing-nothing-will-bankrupt-america.html
48 - The Canadian Press (2010)“Ontario’s long-term care strategy failing: Opposition”
CBC News. Published August 5, 2010. Retrieved on November 28, 2011 at http://www.cbc.ca/news/canada/ottawa/story/2010/08/05/ont-aged.html.
49 – McKinnon, M. (2011).“It’s about medicare, stupid.”The Daily Beast. Published June 10, 201. Retrieved on November 28, 2011 at http://www.thedailybeast.com/
articles/2011/06/10/medicare-malpractice-how-doing-nothing-will-bankrupt-america.html
50 - The Canadian Press (2010)“Ontario’s long-term care strategy failing: Opposition”
CBC News. Published August 5, 2010. Retrieved on November 28, 2011 at http://www.cbc.ca/news/canada/ottawa/story/2010/08/05/ont-aged.html.
51 – Fiercehealthcare (2011).“May exclusive: Why Mayo clinic set up shop at Mall of America.”Retreived on November 28th, 2011 at http://www.fiercehealthcare.com/
story/mayo-qa-how-clinic-fits-mall-america-non-traditional-healthcare/2011-11-03#ixzz1fAp6dstj
51
52. 52 - AnyData (2011).“GreatCall Announces Introduction of the 5Star Responder”. Retrieved on November 28th at http://www.anydata.com/Press_10_19_11.html
53 - mDhil (2011). Retrieved on November 28th, 2011 at http://www.mdhil.com/.
54 - Rhydderch, A. (2009).“Scenario Planning”. Foresight Horizon Scanning Centre, Government Office for Science.
55 - Curry, A. and Hodgson, A. (2008).“Seeing in multiple horizons: connecting futures to strategy”. Journal of Futures Studies 13(1). Pp. 1 - 20.
56 - Canadian Home Care Association (2005).“Home care case management: summary of proceedings”. Health Canada. Retrieved at: http://www.hc-sc.gc.ca/hcs-
sss/pubs/home-domicile/2005-cas-mgmt-gest/index-eng.php on November 14, 2011.
57 - Adair, C. E., Armitage, G. D., Oelke, N. D., and Suter, E. (2009). Ten key principles for successful health systems integration. Health Care Quarterly. 13(Sp). Pp. 16-
23. Received from: http://www.longwoods.com/content/21092 on November 19, 2011.
58 - Camillus J.A. and de Brantes F. (2007).“Evidence informed case rates: a new health care payment model. The Common Wealth Fund. Retrieved at: http://
www.commonwealthfund.org/usr_doc/deBrantes_evidence-informedcaserates_1022.pdf. on November 20, 2011.
52