eHealth Business Opportunities in the

United States

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David WhitlingerExecutive DirectorNew York eHealth Collaborative

New York eHealth Collaborative (NYeC)

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Not-for-profit organization working to improve healthcare for all New Yorkers through health information technology.

• Promote the adoption and use of electronic health records.

• Build the Statewide Health Information Network of New York (SHIN-NY): A secure network for sharing electronic medical records across the state.

• Create an ecosystem fostering innovation by leveraging the massively valuable clinical data stored in the SHIN-NY.

• Develop policies and standards in conjunction with industry stakeholders.

• Through the HEAL grant program, the NY State Department of Health helped create 9 RHIOs in New York.

• The total investment since 2006 is $943 million (public and private sources).

• Each RHIO has built a local network of stakeholders including hospitals, practices, long term care, and payers and is actively connecting participants in its region to enable sharing of data.

• All the RHIOs together form the SHIN-NY, the largest HIE in the USA.

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SHIN-NY: the Network of Major Healthcare Providers within New York

SHIN-NY PARTICIPANTS• 197 hospitals (84%)• 50,000 providers• 7MM patients

Our Vision

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Health IT tools enable collaboration between patients, providers, public health agencies, and payers. They improve quality of care, efficiency, and patient satisfaction.

• No single entity can deliver this set of tools alone.

• It will take an ecosystem working together.

• And this ecosystem needs a basic infrastructure to build upon.

A universally accessible, reliable, public utility of clinical health information on every New Yorker for every New Yorker.

Snapshot of the U.S. Market

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U.S. Population• 319 million

Health Expenditures• U.S. $3.2 trillion (For context, the entire GDP of France is US $2.7 trillion)• 22% of U.S. GDP Funders/PayersU.S. healthcare is financed, or paid for, in a variety of ways:

• A majority have health insurance coverage as a benefit from their employment. • Military personnel and their dependents, as well as veterans, are provided health care

coverage through the federal government. • Older Americans are provided care through Medicare. • Low income individuals receive health care assistance through Medicaid.• Individuals may pay directly for services received.

Key Healthcare Trends in the U.S.

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Healthcare Reform: the Patient Protection and Affordable Care Act (ACA) Signed into law in March, 2010. The ACA Expands Access to Care:*

• 16.4 million uninsured gained health insurance between the Marketplace, Medicaid expansion, young adults staying on their parents plan, and other coverage provisions.

• 35% reduction in uninsured as of March 2015.

• 5.7 million young adults (aged 19-25) stayed on a parent’s plan until age 26.

However, employer-provided insurance remains our nation’s health insurance bedrock, despite the alternatives offered by the ACA.

With only some exceptions, employers continue to provide their employees with insurance and in many instances are the leading innovators in devising high-quality, lower-cost care.

*http://obamacarefacts.com/2015/03/16/obamacare-enrollment-numbers-as-of-march-2015/

Key Healthcare Trends in the U.S.

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Shift in Payment and Care Models The ACA’s incentives, along with the soaring cost of care of Medicare and Medicaid, is pushing the market to emphasize value and outcomes, compared with the outdated focus on volume.

• Insurers are focused on health outcomes for patient populations.• Providers are changing how they care for patients through new delivery networks.• Pharmaceutical & medical device companies are changing their investment and product

development strategies. Delivery System Reform Incentive Payment (DSRIP)

$6 billion program to transform New York State’s Medicaid program to increase sustainability, better coordinate care, and improve health outcomes of approximately six million Medicaid beneficiaries.

• Key goal of the program is to reduce avoidable hospital use by 25 percent over five years. • Program will require previously disparate networks of providers to work together in Performing

Provider Systems and deliver population-based healthcare.• Implementation of innovative strategies and technology solutions in patient engagement, care

coordination, and provider workflow is key to success.

Key Healthcare Trends in the U.S.

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New Models Require New Tools…Resulting in Unprecedented Investment & Innovation

Health organizations are aware of the need for substantial investments in new technologies beyond legacy solutions if they are to address the challenges and opportunities presented by the shift toward patient-centric and value-based care.

2014 was a landmark year for health technology investment in the U.S.

Funding in 2014 more than doubled from last year with $6.5B invested compared to $2.9B in 2013.

Subsector $ Invested # Deals

Big Data/Analytics $1.46B 90

Population Health $1.14B 33

Navigating the Care System $974MM 52

Diagnostics $962MM 60

Consumer Health $880MM 69

Key Healthcare Trends in the U.S.

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The Consumerization of Healthcare

• The patient as the consumer is an emerging force of change in healthcare.

• Patients expectations are starting to change…that their experience as patients resemble that of their other consumer experiences: on-demand, digitally enabled, user-friendly interfaces, clearly defined pricing, and a wide selection of product options.

• In addition, they’re more actively participating in their health through the explosion of wearable tech, mobile apps, social communities.

Health Tech in New York

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New York Continues its role as a Leading Hub for Health Tech Innovation

• U.S. $722 MM was invested in 44 New York health tech companies in 2014.

Notable New York Health Tech Companies

Health IT Marketplace Gaps

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• Broader access to patient information by all of the healthcare providers contributing to a patient’s care.

• Secure methods for sending health information between healthcare organizations.

• Notification, alerting, and monitoring – the ability to proactively manage patient care via real time events.

• Cross community care plan management tools for teams of providers and family care givers.

• Patient access to their own health information and engaging consumer-level health tools.

• Analytics to help manage and measure the healthcare system – you can’t change what you can’t measure.

Intensive, five-month program run by NYeC and the Partnership Fund for NYC for early- and growth-stage digital health companies that are developing cutting edge technology products for healthcare providers in the areas of care coordination, patient engagement, and workflow management.

Program Highlights • 33 pilots launched with healthcare providers • The companies created over 120 new high tech jobs in New York State• Participants have raised an additional $54 million from outside sources; Two

companies were acquired within 6 months of graduating the program

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NY Digital Health Accelerator

The ability of the participants to engage directly with the senior leadership of a broad network of 23 healthcare provider organizations in New York for mentorship and pilot programs.

PROGRAM’S UNIQUE FEATURE

INVESTORS

SPONSORS

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Digital Health Accelerator Network

ANALYTICS

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Digital Health Accelerator Portfolio

PATIENT ENGAGEMENT  

CARE COORDINATION

DRIVING HEALTHTECHNOLOGY ADOPTION

Assists healthcareproviders in the adoption

of EHRs and innovativetechnology solutions.

INDUSTRY EXPERTISE Understands the

processes, policies, and politics of working with provider organizations.

NY DIGITAL HEALTH ACCELERATOR Leads one of the largestfunded Health IT acceleratorsfor growth-stage health tech companies.

ECOSYSTEMDEVELOPMENT Cultivates relationships with providers, entrepreneurs, investors, and governmentthrough a number of programs, initiatives, and events.

STATEWIDE HEALTH INFORMATION NETWORK OF NEW YORK (SHIN-NY)

Manages the nation’s largest publicHIE containing millions of clinical records.

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Catalyzing Innovation Through Expertise and Relationships

We Want to Hear from You!

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Reach out to us if you’re looking to make connections in New York State.

www.nyehealth.org

New York eHealth Collaborative

@NYeHealth

facebook.com/NYeHealth

Appendix

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Partnerships are Key to Thriving

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• The health sector is proving to be highly adaptive to disruption and innovation. Joint ventures, open collaboration platforms, and non-traditional partnerships are leading towards new competitive strategies.

• Many traditional healthcare companies may find tremendous value in partnering with new entrants that are disrupting the health system with new care delivery and payment models.

• Incumbent health businesses will face mounting pressure from competitors that are already engaged in industry-defining relationships.

• E.G. Walgreen’s partnership with blood test innovator Theranos to bring new affordable testing services to Walgreen’s stores. Not only are Theranos’ tests low cost (50% of the cost of Medicare reimbursement rates or less) and covered by major insurance carriers, but test results can also be made available in hours, accelerating diagnosis and treatment decisions.

Partnerships are Key to Thriving

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Partnerships are Key to Thriving

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To thrive in this hypercompetitive new environment, the most successful companies will work together on innovative products and services and seek expert partners to help fill the gaps in their businesses.