Healthcare

Merck and Pfizer - Strange bedfellows?

Deborah Toscano — Tue, 30 Apr 2013 14:12:46 GMT

In a surprising announcement made yesterday, Merck and Pfizer are teaming up to commercialize Pfizer’s SGLT2 inhibitor ertugliflozin for diabetes. This announcement took the pharma world by surprise, especially since Merck in particular is not known for forming partnerships with other big pharmas. Typically these partnerships leverage the individual areas of expertise of each company, and in this case it would seem to be Pfizer’s compound and well-demonstrated marketing expertise along with Merck’s solid performance in the diabetes therapeutic area as demonstrated by the success of Januvia, the first-in-class DPP-IV inhibitor. However, the diabetes add-on market is now cluttered with DPP-IV inhibitors and interest has moved on to other novel therapeutics, such as SGLT2 inhibitors, the first of which, Johnson & Johnson’s Invokana (canagliflozin), has just entered the U.S. market. Although Januvia still holds the lead among DPP-IV inhibitors and is not likely to lose that position any time soon, newer classes such as SGLT2 inhibitors could start to eat away at DPP-IV market share once physicians get comfortable with them. While SGLT2 inhibitors have glucose control efficacy on par with DPP-IV inhibitors, they are viewed as having several key additional benefits, notably weight loss and positive effect on blood pressure which could translate into cardiovascular benefit. They do, of course, also have several negatives such as an association with genital and urinary tract infections (SGLT2 inhibitors work by helping the body shed excess glucose through the urine) and contraindication in patients with severe renal disease since they work through the kidneys. Regulatory approval of this class was a point of great uncertainty for quite a while, but now that the first one has gotten its foot through the door, Merck was likely more receptive to the idea of adding one to their diabetes portfolio. Two other SGLT2 contenders are already partnered: Bristol-Myers Squibb’s dapagliflozin, partnered with AstraZeneca (approved in Europe but still awaiting U.S. approval); and Boehringer Ingelheim’s empagliflozin, partnered with Eli Lilly. Both of those partnerships also give access to a DPP-IV for an attractive SGLT2 + DPP-IV fixed-dose combination: dapagliflozin with Bristol’s saxagliptin, and empagliflozin with BI’s linagliptin. With the Pfizer/Merck partnership, a fixed combination of Januvia and ertugliflozin is now a possibility. Moreover, Pfizer stands to gain from Merck’s experience in speeding Januvia through development and market launch. So, as strange as it may seem considering their respective histories, this partnership makes great commercial sense.

Umbilical Cord blood - A savior !

Deepika Pramod Chopda — Tue, 30 Apr 2013 09:29:44 GMT

http://www1.umn.edu/news/features/2013/UR_CONTENT_440332.html

Cloud and Mobile Technology Set to End Innovation 'Drought'

Andrew Milroy — Wed, 03 Apr 2013 03:18:35 GMT

It is often stated by senior management figures within large enterprises, that innovation is a key area of focus for them. Despite this focus, the past 50 or 60 years has witnessed a distinct lack of breakthrough innovations. Indeed, there has been an innovation 'drought'.

Innovations made between the late nineteenth century and about 1950 are the ones that are having the most profound impact on our lives today. To be specific, I am referring to innovations and discoveries such as the internal combustion engine, the jet engine, the electric light bulb, the television, the telephone, the radio, modern computing and antibiotics. For a London, Paris or New York City resident who travelled in time from 1910 to 1960, the future would be completely unrecognisable. For a resident of one of these cities who travelled in time from 1960 to 2010, there would be few surprises. In fact, the 1960 time traveller may be disappointed that people were not flying to work, using their own personal jet packs.

Since the 1960s, we have seen some major innovations and discoveries but less than in earlier years. Why has innovation slowed down? Well, there are many views on this matter. Some say that it because of too much regulation. Others say the opposite. My view is that there are several key reasons for this change.

Firstly, as wages increased in the late nineteenth and early twentieth centuries, there was greater focus on finding innovations that could replace labour. This wage growth, in developed economies, slowed dramatically in the 1970s. In mature economies, real wages have not grown significantly since the 1970s. Firms have focussed, to a greater extent, on increasing shareholder value by controlling real wages as opposed to engendering innovation.

A second reason is that firms are also focussing on extracting the largest possible amount of value from existing assets. Since the 1970s, a popular way of doing this is by entering new markets around the globe. So, innovations made in Western countries and deployed in the 1950s and 1960s have been sold into emerging economies in the 1980s, 1990s and 2000s, greatly enriching large multinational organizations, but shifting emphasis away from innovation.

Another key point is that new innovations may impede the ability of large enterprises to maximize the value they get from existing assets. For example, is it in the interests of pharmaceutical firms to develop more effective treatments for cancer, which may affect their ability to fully profit from existing treatments? Is it in the interests of a plastics manufacturer to support research into 3D printing?

Today, breakthroughs in IT are creating enormous opportunities for innovation. We have seen rapid incremental innovation in the IT industry itself. But, new technology has yet to be deployed in a manner that fosters significant innovation across different industries. This is set to change. In any industry, from the automotive industry to, discrete manufacturing to healthcare, the combination of high speed networks, cloud computing and mobile technologies are driving change and, yes, innovation.

I’d love to write about the impact of these technologies on all industries. To make my point, I will focus on examples in the automotive industry, discrete manufacturing and healthcare.

In the automotive industry, GM and others spent years trying to develop autonomous (self driving) cars. By taking advantage of recent IT developments, Google demonstrated how the convergence of IT and the automotive industry leads to innovation. In August 2012, Google announced that a fleet of autonomous vehicles had completed half a million kilometres of accident free test runs. Autonomous cars are expected to become common over the next 10 years. Further innovation around transportation is inevitable and IT is enabling this.

In the manufacturing sector, 3D printing allows designs and techniques to be sourced from the cloud by any device, in any location. This could potentially drive a new industrial revolution and move the world away from mass manufacturing towards the customization of products in locations that are close to the source of demand. Will people make their own goods, to their own specifications, from home? The potential is enormous.

In the healthcare sector, high speed networks and cloud computing can potentially enable care to be delivered to patients in any location. We can expect care to increasingly be given in the patient’s location. At the same time, a decreasing proportion of care will be given in hospitals. Technology can totally change the dynamics of healthcare provision. As these dynamics change, the opportunities for radical new innovation will be immense.

In summary, the last 50 years have witnessed a slowdown in innovation. However, as IT becomes embedded into industries and high speed networks and cloud computing become commonplace, we can expect to enjoy a sustained period of rapid change and innovation.

Biosimilars: blockbuster or lackluster?

Deborah Toscano — Thu, 21 Mar 2013 17:48:29 GMT

In follow up to my last blog, as a result of the Omontys recall, Affymax has resorted to a 75 percent reduction in staff in order to stay afloat, and may even be forced into bankruptcy. Although Affymax is a small company who is reliant on this single product, they were forecast to earn peek sales from Omontys in 2018 of approximately $484 million according to Evaluate Pharma. There were evidently no signs of immunogenicity concerns prior to these unfortunate events, and such could be the case for biosimilars that may not have the same degree of exposure that their predecessors had in clinical development. Even the Wall Street Journal has taken notice of the struggles and reactions of potential players in this space. One issue which may cause some to think twice about entering this space is the subject of interchangeability. If a biosimilar is deemed to be interchangeable by the FDA, then a pharmacist would be able to automatically substitute a biosimilar for a prescribed biologic. Even if a biosimilar were to be granted this level of approval (which I believe is highly unlikely in the foreseeable future), states can govern whether or not the consumer must be notified if a switch has been made or to follow “dispense as written” instructions, and many states are introducing such legislation to thwart automatic substitution in the interest of patient safety. Virginia is the first state to sign such a bill into law, and similar legislation is under consideration in several more states including Maryland, California, and Colorado. Without automatic substitution, biosimilar manufacturers will have to invest more in marketing than they might have anticipated, driving up the price alongside the cost behind the extensive analytical and clinical data that will be needed for approval and market acceptance. Bottom line - entering this risky market is not going to be the no-brainer that it may once have been portrayed as, but those companies that can manage to contain costs while still producing a high quality product with the expected cost savings will be doing a great service to all stakeholders involved.

More Calls to End Fee for Service: A Look at Recommendations from the National Commission on Physician Payment Reform

Nancy Fabozzi — Mon, 18 Mar 2013 21:46:01 GMT

“Our nation cannot control runaway medical spending without fundamentally changing how physicians are paid.”

The National Commission on Physician Payment Reform, March 2013

In March 2012, the Society of General Internal Medicine (SGIM) assembled an expert commission to look at ways of changing physician reimbursement in order to improve patient outcomes and control exploding expenditures. One year later, on March 4, 2013, SGIM’s National Commission on Physician Payment Reform (NCPPR) released its recommendations which call for transitioning most physicians out of the traditional fee-for-service (FFS) reimbursement system over the next decade. The NCPPR is an independent commission comprised of twelve members representing various realms of academia, industry, and government. The commission is chaired by former Senate Majority Leader William “Bill” Frist, M.D. and Steven Schroeder, M.D. of the University of California, San Francisco. Robert Wood Johnson Foundation (RWJF) is a co-sponsor of NCPPR along with SGIM.

Recognizing the reality of how entrenched the FFS system is in the U.S. healthcare system, the NCPPR foresees a two-phase transition period. First will be a five-year period designed to address the most pressing flaws and inefficiencies in physician reimbursement practiced by government and commercial payers. This phase should incorporate the majority of physicians in a mix of new payment models and tighter controls on traditional FFS. This initial phase will be followed by another five-year period where remaining physicians will be brought into a fixed-payment reimbursement system.

NCPPR's Recommendations for Transitioning out of FFS

The following summarizes NCPPR’s core recommendations -

Stand-alone FFS payment is inherently inefficient, causes problematic financial incentives, and should mostly be eliminated and replaced by a fixed-payment model.
A five-year transition period should begin, incorporating testing of a reimbursement system based on quality and value with the goal of broad adoption within ten years. Features of this transition should include -

Encouragement of behavior that improves quality and cost-effectiveness and penalizes misuse or overuse of care
Government and commercial payers should increase annual updates for evaluation and management codes; updates for most procedural diagnosis codes should be frozen for a period of three years
Eliminate higher payment for facility-based services that can be performed in a lower-cost setting
Incorporate quality metrics into the negotiated reimbursement rates in FFS contracts
Encourage small physician practices accepting FFS to form virtual relationships and share resources to achieve higher quality care
Focus initial fixed payment programs on areas where significant potential exists for cost savings and higher quality such as chronic care populations
For providers in fixed payment models, incorporate measures to safeguard access to high quality care, assess the adequacy of risk-adjustment indicators, and promote strong physician commitment to patients
Eliminate the Medicare Sustainable Growth Rate (SGR)
Pay for repeal of the SGR with cost-savings from the Medicare program including both cuts to physician payments and reductions in inappropriate utilization of Medicare services
Increase the transparency and diversify membership for the AMA’s Relative Value Scale Update Committee (RUC) that sets rates for Medicare reimbursement. In addition, CMS should develop an open, evidence-based, and expert processes to establish and update relative values

FFS and Lack of Pricing Transparency - The Root of All Evil?

The fee-for-service reimbursement system is characterized by separate payments for each medical procedure, office visit, or ancillary service. There is growing consensus that FFS simply does not encourage clinicians to practice cost-effective medicine and instead encourages them to perform more procedures (and more complex procedures) in order to earn more money or, perhaps, to practice defensive medicine due to fear of malpractice lawsuits. In addition to causing cost inflation, FFS is widely believed to contribute to the crisis in primary care, where 60 million patients lack access to a physician due to a growing shortage of providers. This is because the FFS system encourages higher payments for procedures performed by specialists verses primary care providers. It’s no surprise that healthcare cost inflation is a situation that is causing considerable angst across a wide swath of U.S. society, particularly as patients are paying an ever-greater portion of the bill. As Steven Brill noted in his brilliant piece published in Time Magazine on Feb. 20, 2013 (Bitter Pill: Why Medical Bills Are Killing Us), “Health care is eating away at our economy and our treasury”.

It's Not Going to Happen Over Night

Moves towards alternative payment methods for physicians and bundled payments are not new to the U. S. healthcare system, but are gaining considerable traction today thanks in no small part to the Accountable Care Act (ACA). Fixed or bundled payments for healthcare are believed to drive efficiencies that help control overall costs. Public and private health insurers, as well as employers, recognize the importance of changing the way physicians are compensated so that the provision of care and the payment for services is more closely aligned with preventive services, improved clinical outcomes, and enhanced patient safety. The NCPPR report adds to the momentum for the need to address the inherent inefficiencies around FFS reimbursement and to demystify the pricing of medical services. In calling for a phased transition period, I believe the NCPRR lays out a realistic time frame for achieving the transformation away from FFS, particularly given the influx of new patients coming into the system as a result of ACA.

The End of FFS Does Not Mean the End of Administrative and Documentation Hassels

The move away from FFS to a fixed payment environment presents considerable financial risk for physician practices and they will need time to adjust their workflow. Physicians will be strongly motivated to put systems and procedures in place that will help them effectively manage financial risk-informed contract negotiations with payers. In the short term, this will likely result in a higher burden for administrative and clinical documentation requirements for physician practices. During the next five years, expect to see a continued flurry of new products and services specifically desgined to help smooth the many pain points associated with transitioning out of FFS. The move to value-based reimbursement is already a key driver for health IT systems; the momentum will accelerate going forward.

Could the U.S. biosimilars market suffer from a recent branded biologic's misfortune?

Deborah Toscano — Mon, 25 Feb 2013 20:59:28 GMT

Affymax’s and Takeda’s biologic drug for anemia, Omontys, is the latest victim of the discovery of serious adverse events in the post-marketing setting. Less than a year after the FDA granted marketing approval, reports of serious anaphylactic reactions, three of which were fatal, prompted the companies to recall the drug. Omontys is a similar drug to Amgen’s Epogen, a multi-billion dollar biological agent, the kind of lucrative franchise that biosimilar manufacturers would love to be able to tap into. However, despite the arrival of a pathway through which companies can file for approval of biosimilars in the U.S., there are still many wrinkles to be ironed out, which has (so far) kept anyone from actually submitting an application to the FDA. Ironically, one of the key concerns of the FDA these days is immunogenicity of all biologics, including biosimilars, and they have just released draft guidance for industry on the assessment of immune reactions such as anaphylaxis. The timing of these two events is sure to garner much attention on the potential safety concerns that key stakeholders have in follow-on versions of biologics. The chemical synthesis of conventional drugs and their generic counterparts is a whole different animal compared to the comparative scenario in the realm of biologics, where subtle changes in the environment could lead to important unintended alterations in the final product, such as immunological reactions. For branded biologics manufacturers, promoting a positive safety track record will be important for maintaining market share when faced with generic competition, and for biosimilar manufacturers, it will likely be a game of balancing the costs of extensive analytical and clinical testing sufficient to boost confidence in their products and ensure the absence of immunogenicity concerns with the possibility of slow (but hopefully steady) uptake by a cautious market.

City as a Customer

Jinu Mathew — Wed, 13 Feb 2013 03:30:49 GMT

Written by Archana Vidyasekar and Akshay Gakhar

Understanding the Macro to Micro Impact of the Urbanisation Mega Trend and Identifying the Inherent Business Opportunities in Tomorrow's Cities

By 2025, the world urban population will reach 4.6 billion and account for 58% of total population. This means that 6 out of 10 people will live in urban areas by 2025. In developed regions, the growth of urban population will be unprecedented with urban population accounting for 81% of total population by 2025. This rapid rate of urbanisation is not surprising given the aggressive industrialisation the world has seen supported by emerging transport and freight corridors, better trade ties and relaxed government migration policies. This mass exodus to urban areas is transforming cities into enormous economic communities representing huge business and investment opportunities for companies and corporations.

Understanding the flow of urban population, the spatial patterns and identifying the future urban centres is a key exercise that businesses must undertake in an effort to ready themselves for the challenges that will arise as a result of urbanisation. Urbanisation could mean sustainable business practices to ensure ample supply of energy and water in the future against increasing demand, or investment in research & development to identify new material for smart buildings. It could also mean realignment and convergence of businesses' supply chains to make logistics less cumbersome and more agile in urban areas. Opportunities for new products and solutions in FMCG, real-estate, retail and construction industryare also huge and multiple. The implications of urbanisation, therefore, are varied and numerous and cities are in the centre of this key phenomenon.

Provided below are key trends in the evolution of the cities describing the growth of mega cities and other types of cities that will evolve with planned investment, infrastructure and technology development.

The Growth of Mega Cities

As 58% of the world population will be living in urban environments by 2025, there is a large drive for the expansion of cities around the world to become Mega Cities. Mega Cities are large metropolises which have a population of 8 million and above and have a GDP of $250 Billion or more. Currently there are 12 mega cities, however by 2025 this number is set to increase to 35. With Asia contributing to nearly two thirds of the global population in 2025, there is a massive push towards the expansion of their cities due to an increase in urbanisation. As a result Asia will have 18 mega cities which accounts for 50% of all the mega cities in the world. China alone will account for 72% of the mega cities in Asia. By 2025, mega cities will contribute an enormous $30 trillion to the global economy and will have a combined population of 541.6 Million people. The top 10 mega cities alone are going to contribute 13% of the global GDP.

In response to the mega growth in the cities, there are various types of cities that are being developed or planned with a specific focus on technological innovation, environmental efficiency, connectivity, safety and economic growth.

Types of Future Cities

Smart Cities: Smart is the New Green

Green concepts will be replaced by 'Smart' concepts in the future, creating smart cities that are built on Smart Technology, Smart Healthcare, Smart Governance, Smart Healthcare, Smart Energy, Smart Buildings, and Smart Mobility.

Smart Technology will connect the home, office, mobile phone and car on a single wireless IT platform and include adoption of smart grid system, smart home solutions, high speed broadband connection, and roll out of 4G technology. Smart Governance will introduce a host of e-government solutions, green policies and public transport management to the citizens delivered through the IT and mobile platforms. Smart Healthcare will includes energy efficient healthcare system, integrated security solutions in the healthcare units, intelligent healthcare infrastructure, connected home health service and healthcare data governance. Smart Energy will offer a cohesive solution to power management which through a network of technologies and digital solutions will offer improved management of power. Availability of Smart Energy will augment development of Smart Buildings which are green, energy efficient, and intelligent buildings with advanced automated infrastructure.

Smart Cities will also offer Smart Mobility that will allow people and goods to move in the most optimum and sustainable manner with convenient and safe multi-modal transport, electric mobility and infrastructure, reduced congestion and environmental cost, and efficient management of traffic. By 2025, there will be 26 such smart cities that will feature the aforementioned aspects. More than 50% of smart cities will be from Europe and North America. Copenhagen in Denmark will become the first carbon neutral city in the world by 2025 and is set to become the first eco-metropolis of the world.

Sustainable Cities: Aiming for Long-Term Self-Reliance and Sustenance

Sustainable Cities are those cities that have been built on eco-friendly, sustainable initiatives that cut across some or all levels of infrastructure, housing, transport system, and healthcare. By 2025, there will be around 92 sustainable cities globally and Europe will be home to 50% of them. These cities aim to be developed to reduce carbon emissions drastically and aim for a low carbon economy. An example of a sustainable city would be the Sino-Singapore Tiangin eco city which aims to see up to 90% of green mobility and use 20% of recycled energy by 2020.

Billionaire Cities: The Wealth Clusters

Billionaire cities are cities that house the biggest billionaires in the world. They are vital in building investment opportunities due to the large number of multinational corporations they are home too. As a result, billionaires operate out of these cities since they are hubs for investment and economic growth within a country. Moscow has the highest combined wealth of billionaires whereas New York Metropolitan Area has the highest number of billionaires in the world. However with Asian countries experiencing tremendous economic growth there has been a large growth in business activity and the amount of billionaires there. Especially cities like Hong Kong, Mumbai, Beijing, Tokyo and Taipei are experiencing an increase in the amount of billionaires and their net worth. Majority of the youngest billionaires in the world are based in the San Francisco bay area which can be explained due to the great success of technology companies such as Facebook, Google and Apple which are based in California.

Connected Cities: The Fastest Cities of the Future

As connection to the internet has become a day to day necessity and also a human right in a few countries, penetration of internet users is increasing drastically. The concept of a connected city relies heavily on internet connectivity being the backbone of the city, allowing the citizens to be connected to each other, the city and its services and the entire world. By 2020 there will be 10 connected cities with a broadband penetration rate of 100%. They are expected to have connection speeds of more than1Gbps and 3 of the 10 are expected to have speeds of more than 500Gbps. An example is Seoul in South Korea which is set to be the world's first fully connected free Wi-Fi city by 2025.

The future global map, therefore, will be full of new urban territories, comprising of various types of cities representing a range of opportunities depending on need, infrastructure and resources. Cities are no longer just generic target markets which exhibit the same characteristics as most urban areas. They have unique needs and demands and require the same positioning and attention that businesses would offer potential customers!

City as a Customer: Cities and not Countries will Drive Wealth in the Future

Cities are not only set to become dominant contributors of their country's economy, but also the global economy itself. The sheer economic scale of these mega cities will result in them wielding an economic and investment clout on par with that of countries. Eventually cities, rather than countries, will be targeted as hubs of investment, wealth creation and economic growth and they will be on par with countries in terms of their economic and investment influence.

Each city will become a customer showing uniqueness in its infrastructural demand offering cross-sectoral micro implications and opportunities in mobility, healthcare, logistics, smart products, security and retail sectors. This in turn would result in companies altering their product portfolio and in-house services to target cities as a customer. The city infrastructure market will also develop into a new industry offering various new white space marketing opportunities, highly customized and innovative city solutions and new urban business models.

Discussed below are snippets of our research into understanding the micro implications on such industries of urbanisation:

The Urban Future: Are you ready?

With economies displaying rapid urbanisation rates and ever expanding cities developing into mega cities, smart cities and sustainable cities the impact of urbanisation will result in drastic changes made to business models. Companies those are able to look at cities as customers and position themselves as partners and solution providers to cities will not only benefit from new business and investment opportunities but alsoavoid future bottlenecks, wastage and diseconomies of scale by improving their thought-leadership on cities.This would require, in addition to contingency planning, a lot of visionary innovation and realignment of operations from businesses. Partnerships between city governments, solution providers (businesses), and academia will become the working model for most future city projects. Convergence between industries, players, technology and products is inevitable as the world itself converges into urban clusters.

So, are you ready for the great urban challenge?

Apple, iPhone, and the Shifting of Coolness

Katherine Burns — Wed, 06 Feb 2013 18:16:16 GMT

There’s a wonderful scene in “Almost Famous” in which Philip Seymour Hoffman tells the teenage aspiring writer/protagonist, “I met you. You are not cool.” I’ve always loved that line, because I feel like what he was really saying was, “You are your own kind of cool.”

On my best days, this is how I would describe myself – my own kind of cool. I’m not cool by normal standards: no crazy college stories, nothing like that (unless you count that I used to channel Monty Python and click coconuts together on many long, horseless walk to the library… by the way, if you think that’s cool… you’re not either).

If the coconuts story doesn’t have you convinced, here are some other reasons why I’m not cool:

1) Old movies. This makes you cool at the Turner Classic Movies film festival, but that’s about it. Couldn’t care less that this makes me not cool. To me, this just represents a deficiency in taste on the part of my peers.

2) Pop culture basics. For better or worse, I tuned out the music and TV of my youth. No Cosby Show, no In Living Color, no… I’m not sure what music I didn’t listen to, because I’m not sure who was big then, because, well, I didn’t listen to it then and I don’t listen to it now. Tiffany. Was that a thing?

3) Technology. I always seem to be one (or a dozen) steps behind in adoption of gadgets. As an example, I got my first iPhone this past December. This phone is the coolest, you guys! I can take videos! The photo quality is great! The background noise is almost nonexistent! I realize that these remarks were far more relevant in, say, 2007. This is what I mean by being not cool.

Which brings me to my next point. As I said, I’ve just come around to how great my iPhone is, and I’m enjoying the heck out of it. And then I open up the Wall Street Journal today, and I see this article comparing the iPhone to the Model T. The Model T! The must-have car of 1924! Whether you were an early adopter or a late one like me, you’d have to be living under a rock not to know that the iPhone (its many iterations, launches, sleek design, nifty-looking headphones) has been one of the most exciting, have-to-have-it product introductions of our lifetime. It’s still flying off the shelves as I write this. What on earth could the iPhone possibly have in common with the car that pioneered the power of mass production in early 20^th Century America? Here’s the author’s argument:

The Model T couldn’t have been the Model T unless the automobile were on its way to becoming too interesting a product for consumers ever to be satisfied with a single model, a single manufacturer, a single design statement.

The same is true of the iPhone. Different customers not only want different things from their smartphones, they want difference for its own sake, which explains the otherwise inscrutable shifting of coolness cache from the iPhone to Samsung’s Galaxy S line.

In sum, the smartphone market that Apple essentially pioneered now wants to “explode into diversity,” and Apple may not be ready for it. You can have any phone you want, so long as it’s white?*

I think the remark about the inscrutable shifting of coolness cache is interesting. For a very long time (an eternity in technology time, really), the iPhone has been a status symbol phone. This author seems to be arguing that it’s someone else’s turn now. Uncool people like me are starting to embrace the iPhone, and that must mean it’s not cool anymore. If it’s not cool anymore, something else is, and at least in this author’s opinion, that something may be the Galaxy (which, by the way, I considered purchasing instead of the iPhone, but it was frankly too cool for me…I’m not making that up).

Anyway, if I worked for Apple, I would cringe at any comparison of our trendiest, most breakthrough product to a car whose time passed almost a century ago. The stakes, and the challenges, for Apple are now extremely high. Reinvent the category yet again, or be surpassed by those with a new idea.

I’ll leave the adoption of those new ideas to the trendier set. For me, the iPhone is perfect. It’s just the right amount of cool – its own, very distinct, kind of cool. Just like its owner.

*I know that the iPhone also comes in black. But it’s more poetic to stick to just one color. Go with it.

Katherine is the Director of Strategic Communications for Growth Team Membership, a premier best practices research group within Frost & Sullivan. You can follow her on Twitter: @KatherineSBurns.

PubMed's Pre-Formulated EHR Search - A Great Resource for Healthcare Market Research

Nancy Fabozzi — Wed, 30 Jan 2013 00:44:59 GMT

(Share Clip)

Confused about EMRs, EHRs, PHRs, HIE, HIO, RHIO, HL7, IDC-10, LOINC, ONC, and on and on with the alphabet soup of digital health? Here’s one great resource you’ll want to get familiar with.

The U.S. National Library of Medicine (NLM) is a major participant in the development and promotion of electronic health records (EHRs) and the home of the PubMed website, which provides free access to MEDLINE, “the NLM database of indexed citations and abstracts to medical, nursing, dental, veterinary, health care, and preclinical sciences journal articles”. Click here for more details on PubMed. The PubMed website offers a handy way to keep up-to-date on key government programs, citations to peer-reviewed journal articles, and other sources of information pertaining to EHRs and related aspects of health information technology by grouping key resources on one page—part of their “topic specific queries” service. The MEDLINE/PubMed Search & Electronic Health Record Information Resources website features a variety of useful features for sophisticated researchers and novices alike, including links to additional information resources from NLM, the U.S. Department of Health & Human Services (HHS) and other government agencies, associations and foundations, international organizations, and more.

One of the most helpful tools on the site is a link to a very convenient, pre-formulated search of journal literature indexed in PubMed as well as details on the (very comprehensive) search strategy. This feature can really save time when you just want a quick look at the latest articles (citations are listed chronologically; PubMed is updated five days per week).

Please be aware that, for the most part, this search will not bring you into the full-text articles. However, some citations will have links to the publisher’s website where you can either purchase the article in full-text or, in some cases, retrieve the article for free. (PubMed’s electronic health record search results page indicates that 4,994 free, full-text articles related to the EHR search are available in PubMed Central.) If the citation does not have a link to a full-text source, you can save the citation and retrieve the article from a medical library.

PubMed offers a variety of ways to narrow a search, including searching only for free full-text, full text available, abstract included, or by other criteria. Refining a PubMed search is something you’ll want to learn how to do given the volume of articles. As I said, the search strategy is very comprehensive and really covers a range of health IT issues, not just EHRs in the strictest sense. Included in this concept is health information exchange (HIE), personal health records (PHRs), and numerous other areas. For example, the electronic health record pre-formulated search brings up a total of 37,388 citations, beginning with the first article from 1957 (something about “health cards, in Portuguese…) to the most recent article added as of today (January 29, 2013) on enhancing patient safety with EHR usability. (BTW, this looks like a great article! Patient safety is one of the key issues I’m tracking this year. Here’s the cite and link - Middleton B, Bloomrosen M, Dente MA, et al. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA. J Am Med Inform Assoc. 2013 Jan 25. [Epub ahead of print]).

Another really great feature of this pre-formulated search is a bar chart showing results by year. This provides a quick look at how the topic is tracking in terms of numbers of articles published in the peer-reviewed literature. Looking at this graphic, it is immediately apparent to see the dramatic uptick in health IT articles over the years. Just for fun, I ran some numbers to see look at the increase in articles over a few ten-year periods. In 1980, there were 87 articles based on the search strategy, which increased to 621 articles in 1990, amounting to a compound annual growth rate of 21.7 percent. This seems logical as this is really the period when PC’s became ubiquitous throughout industry. From 1990 to 2000, when there were 1,114 articles, the annual growth rate declined (or stabilized) to 6.3 percent. Looking at the period of 2002 to 2012, we can see that the annual growth rate in the number of articles has increased a bit, but not much, to 7 percent (see chart). Not surprisingly, the period from 2009 to 2010 saw a 16.7 percent increase in articles, undoubtedly influenced by HITECH.

Anyway, the main point is, NLM’s PubMed is a great resource to keep up with studies on health IT. Even though much of the literature is targeted to a “professional” audience, business researchers should be aware of the value of medical literature as a an important tool for tracking industry trends. While a PubMed search will not link to citations of proprietary market research studies that provide in-depth market and business analysis like we do at Frost & Sullivan, a review of the clinical medical literature is a key component of any thorough market analysis pertaining to the healthcare industry.

One in Three American Adults Use the Internet to Diagnose Medical Conditions but Majority Still Depend on Healthcare Professionals for Information

Nancy Fabozzi — Thu, 17 Jan 2013 15:05:09 GMT

Findings from a recent study by the Pew Research Center reveal that thirty five percent of U.S. adults have gone online within the past twelve months to diagnose a medical condition that they, or someone else, might have.

Source: Susannah Fox and Maeve Duggan. Health Online 2013, Pew Internet & American Life Project, January 15, 2013.

The study is the latest health-related survey conducted as part of Pew’s Internet & American Life Project that began in 2000 with the objective of measuring the social impact of the internet across the U.S. population. Health Online 2013 contains responses from 3,014 U.S. adults obtained from telephone interviews conducted from August 7 to September 6, 2012. In addition to an analysis of how people use the internet for medical diagnosis, the report covers a range of issues around general health information seeking behavior including a look at the most common health-related topics searched for online. Survey data are segmented by respondents’ gender, age, income, educational level, and insurance status. The report also looks at the use of smartphones in searching health information as well as peer-to-peer health information seeking behavior.

Select Findings

The study identifies two key categories of user types segmented from the 81 percent of the U.S. population that uses the internet—specifically, “online health seekers” and “online diagnosers”. Online health seekers are those that say they looked online for health information within the past year. This category consists of 72 percent of the total internet user population, with women, younger people, white adults, and those in higher income and education brackets dominating. Of this population, the vast majority, or 77 percent, began their search with a search engine such as Google, Bing, or Yahoo; 13 percent began with a health information specific website like WebMD; 2 percent began at a more general site like Wikipedia; and 1 percent began at a social network site like Facebook. Online diagnosers are a sub-segment (59 percent) of online health seekers and categorized as those that say they have gone online specifically to identify a medical condition they or someone else might have. This group constitutes 35 percent (one in three) of U.S. adults. Of this population, 53 percent say that they followed up with a clinician after their web search while 46 percent did not.

Additional findings of interest include -

41 percent of online diagnosers ultimately had their diagnosis confirmed by a physician
52 percent of smartphone owners have looked up health information on their phone, compared with just 6 percent of other cell phone owners
26 percent of online health seekers have been asked to pay for access to information while just 2 percent did so

The study authors conclude that, despite the relatively large number of people seeking health-related information online, most people are still dependent on their healthcare providers for direct, or offline, information. Specifically, the study finds that 70 percent of all U.S. adults sought information, care, or support from a doctor or other health care professional; 60 percent sought information or support from friends and family; and 24 percent sought information or support from peers (those with similar conditions).

Implications for Providers and IT Vendors

People are naturally curious about medical conditions and often seek to learn more via numerous on-and offline channels. Today, many Americans are taking a more proactive approach to managing their healthcare and seek to have a more informed interaction with their providers. Thus, it comes as no surprise that many people turn to the web, or “Dr. Google”, for health-related information. But what are some of the pros and cons of doing so? In terms of pros, the internet offers immediate, 24/7 access to information, especially when the web is accessed through a mobile device like a smartphone. As indicated in the Health Online 2013 report, most people start a health-related query at a search engine like Google as this is the most familiar and user-friendly option. Google allows one to “cast the net widely” in terms of the initial search strategy (which can be good and bad). The fact that large numbers of people use Google to look for health information or to diagnose symptoms is also beneficial for health researchers. Aggregated online search behavior is now being analyzed to track health trends across a defined population. The Google flu tracker has been in the news quite a bit lately and is a good example of this.

On the downside, there are many concerns about the trustworthiness, or authority, of medical information found on the open web in additional to potential problems with lack of information specificity, accuracy, and timeliness, all of which can result in potentially harmful misinformation. Most people deploy unsophisticated and very general online search strategies that can yield millions of results from millions of sources and, usually, only the top few results are selected for viewing. In addition, the quality of information found through search engines can vary significantly, which may lead a person to over- or underestimate the seriousness of the situation.

Healthcare providers are entering into a new era of outcomes-based reimbursement which will entail the need to maximize the quality of care to ensure the greatest safety and efficacy. As a result, providers will increasingly step up efforts around patient education. Many providers will employ online solutions like patient portals that will offer a way for people to easily seek out health related information in addition to performing other communication and administrative tasks with their providers. We foresee a great uptick in the adoption of patient portals during the coming years and firmly believe that this technology can go a long way in helping patients get access to information that can help them understand and better manage their health status. However, even if a provider offers a patient portal, it is still highly likely that many, if not most, people will continue to use the internet to access health-related information. Therefore, it is important that providers have a strategy to educate patients about the smartest way to use the open web when seeking health information and to encourage them to reach out to qualified health professionals when they have questions about the information they find on via Google, Facebook, or even through peer-reviewed medical literature found through WebMD or Medline. Health IT vendors must also keep close tabs on how online searching behavior is evolving among various population segments and use that information to develop products with user-friendly search capabilities that closely mimic the Google experience albeit it with more targeted and robust search results.

Providers should take comfort in the fact that the Pew research confirms that they are still the central source for health information for most people. Also, the fact that people are becoming more comfortable with searching online for information, as opposed to in person or via a phone call, is also encouraging for providers who are thinking about deploying a patient portal.

The Designer's Playlist

Jannette Whippy — Wed, 19 Dec 2012 15:51:31 GMT

Silence has always been a distraction for me. I need music or a medley of conversations to help me focus and concentrate. I always have music in the background, and when I work on something important, I have a few favorite playlists that help inspire and focus me. Recently I took a closer look at one of my favorites: Leonard Cohen, a musician/poet from Canada. I found some fun and interesting connections between his songs and how to best work with designers. Here are five Leonard Cohen songs to keep in mind when working with a designer:

1. First We Take Manhattan

Clarify your needs. Be a good partner in the design process, let your designer know what you want from the project, and of any designs that appeal to you. Communicating your needs is never a bad thing. Just like in the song, spell it out: "First we take Manhattan, then we take Berlin." Specifying your needs and making sure that everyone involved knows what is expected of them will leave more room to engender creativity: your designer won’t take Berlin before first taking Manhattan.

2. The Future

Include pertinent deadline information, always. Most designers work on multiple projects at the same time. They need to adjust their priorities based on concrete information, like deadlines. As Leonard Cohen would say, "Get ready for the future: it is murder." Hopefully the deadlines associated with the project don’t end in murder, but keeping your designer in the loop for when the future is nigh will ensure your project will remain on track, with no loss of life.

3. Who By Fire

Explain your issue; don’t just try to solve it. Instead of asking to make a font bold or bigger, tell the designer what you need the title or sentence to do in relation to the rest of the design or page. As the lyrics go, "…who shall I say is calling?" Knowing the concept behind the changes allows your designer to come up with innovative ways to solve the issue. However, if you do have an idea about how you might solve the problem, include it (but don’t forget to explain what the problem is so that your designer has a chance to offer a solution).

4. Anthem

Trust your designer’s skills. You hire designers for a reason; don’t micromanage their creative process. Be willing to give them space, space to innovate and create; you might be pleasantly surprised at what comes of it. My favorite line in Anthem is, "There is a crack, a crack in everything, that’s how the light gets in." Trust that your designer can break through and shine a light on your work.

5. Waiting for the Miracle

Give your designer time to work well. Time—time to marinate, mull, and sketch—is a necessary part of creating good design. One must wait for the miracle to come. Patience is best, as the lyrics suggest: "Nothing left to do when you've got to go on waiting, waiting for the miracle to come." Give a designer time to work and you will see what miracles of design emerge.

Once you collaborate with, and trust in, your designer, a world of opportunities will open up. In a similar vein, HCL Technologies realized the importance of its people and reassessed their strategies to capitalize on their strengths. GTM members can click here and learn how HCL Technologies uses a three-step transformation process to invest in a collaborative, employee-focused, customer-centric business model. If you are not a member, check out the sample on slideshare.

Jannette is the Senior Graphic Design Artist for Growth Team Membership, a premier best practices research group within Frost & Sullivan. You can follow her on Twitter: @jwhippy.

Accountable Care Movement Taking Hold Throughout the Market, Surprising Many Industry Thought Leaders

Nancy Fabozzi — Tue, 13 Nov 2012 01:28:40 GMT

The November 2012 issue of Health Affairs takes a look at the rapidly emerging market for Accountable Care Organizations (ACOs). Among several articles about ACO’s in this month’s issue is an informative piece by Harris Meyer that provides a good overview of where things towards the end of 2012. Meyer, H. Many Accountable Care Organizations Are Now Up and Running, If Not Off to the Races. Health Affairs, 31, no. 11 (2012): 2363-2367. Available at http://content.healthaffairs.org/content/31/11/2363.full.html

ACO Demographics

The article points to research from Leavitt Partners indicating that, as of early October 2012, a total of 318 public and private ACOs were in existence in 48 states, with another 26 ACOs in the planning stages. Out of the total 318 ACOs, 161 work with private payers, 126 with public payers, and 31 with both private and public payers. The majority of the ACOs are sponsored by hospital systems and independent practice associations, while others are sponsored by commercial payers or nonprofit community organizations. The article mentions that, even though hospitals have taken the lead in ACOs up ot this point, there is a growing trend for more physician groups to get involved in ACO formation. At this time, most of the ACOs are based in larger metropolitan areas, particularly in Southern California and Boston. Other states and cities picking up in ACO formation include Minneapolis, Detroit, and central Ohio. In addition, Medicaid ACOs are starting or are planned in Massachusetts, New Jersey, Arkansas, Utah, Colorado, and Oregon. The article mentions the experiences of several public and private ACOs across the country including North Texas Specialty Physicians and Texas Health Resources, Optimus Health Partners in north central New Jersey, Advocate Health Care in Illinois, Dignity Health in California (formerly Catholic Health West), and University Hospitals in Cleveland.

The Purpose of ACOs

ACO’s are primary care focused entities designed to improve the quality and efficiency of patient care by enabling better coordination of care among a range or providers and settings. They are designed to operate with a global budget that will be used to care for a defined patient population. There is a considerable financial risk component to the ACO model. Specifically, if ACOs are able to meet or exceed designated performance standards, they will share cost savings. However, ACOs may also lose money if performance standards are not achieved. Even though many ACOs in existence today do utilize a fee-for-service model, it is hoped, although not proven by any means, that ACO’s can ultimately help to “bend the cost curve” by shifting providers from volume-based fee-for service reimbursement to performance-based global payments per members.

As Meyer points out in the Health Affairs article, it’s too early to tell whether public and private ACOs can accomplish their goals around reducing costs and improving quality. The provision of healthcare services in the U.S. is complex, multi-faceted and notoriously difficult to coordinate across an extremely fragmented delivery system. Furthermore, ACO’s depend heavily on primary care providers who are in increasingly short supply. Another concern is that implementation costs for ACOs, including administrative infrastructure and health IT systems, could be so high as to cancel out any potential savings resulting from better care coordination. Finally, many ACO’s should expect to confront challenges in branding and building awareness of the concept of accountable care among key stakeholders including physicians and patients. Nascent ACOs must have strategies in place to explain why these new organizations could be of value to them and to encourage them to consent to sharing their health data across the ACO so that it can be leveraged to improve quality and efficiency.

Overcoming Initial Skepticism

When CMS released the initial ACO regulations on March 31, 2011, there was a great deal of skepticism among many analysts—including yours truly—about the feasibility of the market taking to what was seen as a significantly complex and rather risky new model of care. However, the initial rules were subsequently revised and relaxed a bit so that, as is now increasingly apparent, more participants have been encouraged to take the plunge. This is the case for ACOs catering to public payers (that is, Medicare and Medicaid), and private commercial insurers like Aetna, UnitedHealth, and others. In fact, our recent discussions with industry thought leaders indicate that 60 to 80 percent of the commerical payer market is currently moving in the direction of ACOs. So, no doubt about it--the ACO movement is gathering steam. Whether or not they will ultimately be successful is another issue.

What's Driving the ACO Movement?

If we take a closer look at what is driving the ACO movement, we can point to three key issues—1) the impact of healthcare reform; 2) growing concerns about excessive costs; and 3) market consolidation. Clearly, the fact that we now have more certainty about the fate of the Affordable Care Act (ACA) is a major driver for ACOs. The re-election of President Barack Obama pretty much removes the majority of lingering doubts about ACA, ensuring that focus will now shift away from debating its legitimacy to implementing its key provisions. As reality sinks in, the need to transform patient care becomes more clear and that means ACOs will continue to grow and will, in fact, accelerate quite rapidly. Complaints about the excessive costs of healthcare are nothing new. However, there is growing consensus that fee-for-service simply does not encourage clinicians to practice cost-effective medicine. Most industry thought leaders believe that the U.S. healthcare system is irrevocably moving away from fee for service. The key focus now is on controlling costs and preparing for shifts in payment models. As the healthcare market rationalizes in response to market pressures, horizontal consolidation and vertical integration will continue to drive the development of ACOs. Hospitals will continue to merge and physicians, who have been slower to form ACOs than hospitals, are increasingly recognizing the need to form strategic partnerships with hospitals and/or be owned by them outright.

Where Things are Headed

The move to ACO’s will result in integrated, coordinated entities that depend upon data analytics and metrics to ensure the quality of care and contain costs. Such entities must be enabled by a robust IT infrastructure. It is inevitable that ACO’s will need to extensively leverage health IT to effectively carry out their mission. The core IT infrastructure for ACOs includes EHRs, HIEs, business intelligence and predictive analytics, clinical decision support, and patient portals including PHRs. None of this comes cheap. Cost estimates for building the IT infrastructure for ACOs range from $1 million to $4 million and up, depending on the number of providers involved in the ACO.

No one really knows if ACOs will fully deliver on their promise to improve care and control costs. What we do know is that the experiment is well underway and there will likely be many bumps in the road. Expect to see an increasingly elastic definition the concept of an ACO and adjustments in how these organizations are formed and operate to transform healthcare. The move away from fee-for-service and towards integrated, accountable, value-based care requires extensive capabilities in health IT.

We expect the ACO movement to be a key market driver for health IT purchasing over the next 12 to 24 months.

Connected Health: Global Perspectives on Identifying and Establishing Your Markets

Daniel Ruppar — Sat, 15 Sep 2012 12:11:22 GMT

Frost & Sullivan Growth Opportunity Briefings in Asia Pacific (Tokyo, Seoul, Singapore). Covered by the Korean media in Seoul, Korea. Speakers: Daniel Ruppar, Ajay Sunder from Frost & Sullivan giving combined perspectives from our Healthcare and Information/Communication Technologies groups on this important area of cross-industry convergence and healthcare transformation.

Digital Daily http://www.ddaily.co.kr/news/news_view.php?uid=95205

Access, Action, and Attitudes: ONC Accelerates Efforts to Engage Consumers and Patients with Health IT

Nancy Fabozzi — Fri, 14 Sep 2012 20:43:48 GMT

The Seventh Annual National Health IT Week, sponsored by the Health Information Management Systems Society (HIMSS), the Institute for e-Health Policy, and the College of Healthcare Information Management Executives (CHIME), took place during the week of September 10, 2012. National Health IT Week features a variety of live and online events hosted by numerous partners and sponsors including nonprofit associations, academia, industry, and government agencies, all designed to raise awareness of the importance of health information technology to enabling health system transformation. As part of their participation in this event, the U.S. Department of Health and Human Services (HHS) in conjunction with the Office of the National Coordinator for Health Information Technology (ONC), held its second annual consumer health IT summit in Washington on September 10. The Summit brought together a variety of constituents across public and private sectors focused on efforts that encourage the use of health IT among consumers and patients. A video from the conference posted on YouTube presents a conversation between Dr. Farzad Mostashari, National Coordinator for Health IT, ONC, and Lygeia Ricciardi, Acting Director, Office of Consumer eHealth, Office of the National Coordinator for Health Information Technology, HHS in which they discuss ONC’s comprehensive strategy for driving consumer engagement. In the video, Dr. Mostashari and Ms. Ricciardi outline three core elements seen as essential to moving the needle forward: 1) Access, which means getting information into the hands of patients and caregivers; 2) Action, which pertains to engaging consumers to use information to improve health; and 3) Attitudes, which is about how increased access and action enable new attitudes about the traditional roles of patients and providers. Key announcements from the Summit that further depict ONC’s efforts on this three-point strategy for consumer engagement include:

Push to Leverage Blue Button-Type Functionality: “Blue Button” refers to a VA-led initiative launched in 2010 that allows veterans to download their personal medical information by clicking a blue button on a secure website. The Blue Button approach is a simple and straightforward way for patients to gain access their health data. The program is very popular and more than half a million veterans have already downloaded their records. ONC is strongly encouraging technology vendors and providers to extend this concept to the broader patient population. Dr. Mostashari emphasized that these stakeholders must focus on the “view, download, and transmit process” via blue-button type technology as a key way to drive consumer engagement. ONC has also established a Twitter hashtag of #VDTnow to encourage people to post about their efforts in this area.
Stage 2 Meaningful Use Raises the Bar on Patient Access: The recently released rules for Stage 2 calls for hospitals and physicians to confirm that 5 percent of patients access their medical information online. ONC designed this requirement to help motivate patients and providers to get more involved in their own care. The 5 percent requirement in the final rules is a compromise from the proposed rules which called for confirming that 10 percent of patients access information online—a requirement that was widely contested by providers. ONC believes that the lesser requirement should, nonetheless, still be quite helpful in encouraging their goals for patient engagement via health IT.
Two New Workgroups Formed to Assist Policy-Making: ONC announced plans to add two new workgroups to its advisory Health IT Policy and Standards committees that will focus exclusively on patient engagement. Members of the public will be able to nominate committee members to serve on those committees
Results of PHR Video Challenge: This past July, ONC launched a video challenge to promote PHR use. The "What's in Your Health Record??" invited people to create a brief video depicting ways in which they are getting access to their personal health information. The contested was intended to inform the public of their legal right to access their health records and to illustrate the importance of how being informed and involved leads to better care. Six awards totaling to $7,700 were presented at the Summit.

Patient-Centric Care Means Patients Need to Be in the Information Loop

We hear a lot about how health IT can enable “patient-centric” health care. The patient-centric concept can mean a variety of things. From a provider’s perspective, it has mostly pertained to using technology that integrates disparate sources of information so that there is a “single source of truth” offering a complete, comprehensive view of a patient’s history and status. Access to this information is also important for patients and their family members. Thus, a truly patient-centric health care system must include patients in the information loop, and that means using information technology. Acknowledgement of the need to engage consumers and patients with health IT is not new but efforts are accelerating and taking on more urgency. As with provider health IT, ONC, providers, and technology vendors are emphasizing potential improvements in the quality of care and as well as patients’ rights to their own data as the reasons for their interest. However, another very important driver of this movement to consider is the shift to accountable care and bundled payments. In a health care system where reimbursement will increasingly be based on the concept of value (defined as the overall quality of care in terms of process and outcomes that is derived from total resources expended), the issue of patient compliance takes on a particularly critical role. Problems around patient compliance have long been seen as a critical factor influencing outcomes. The physician and care team can do everything right but if the patient is non-compliant with treatment protocols, outcomes are often negatively impacted. This is one of the core dilemmas in health care and it grows in importance with value-based reimbursement. Thus, in an era of reform and transformation, there is no getting around the fact that people must take on more responsibility for their own health care. Patients need to be accountable too. For payers and providers, this comes down to changing human behavior, a difficult-- but not impossible—challenge. That means efforts will accelerate to help develop informed and engaged consumers of health services. Those efforts will include shared decision-making, actively tracking and monitoring compliance with treatment protocols, and having ready access to their personal health data and various educational tools. A variety of approaches and technology tools are needed to enable patient engagement including PHRs, patient portals, mobile apps, telehealth solutions, and remote patient monitoring. Not all patients will be able to participate equally in health IT—and many never will do so, realistically. However, as more innovative and user-friendly technology tools like Blue Button features become more widespread, cultural attitudes about health IT will inevitably change among larger numbers of patients as they have among health care providers. The VA experience is proof of this concept. Using health IT tools will become more comfortable and natural for people and will ultimately pervade every aspect of their health care experience, from the initial point of engagement with payers and providers on through active treatment, post-treatment, and ongoing monitoring and maintenance.

Pay Attention to the Voice of the Patient

The need to engage patients and consumers is greater now than ever as witnessed by accelerated activity among numerous public and private entities. Patient behavioral change is a key component of health system transformation and the “voice of the patient” must be a key focus for all market participants. A comprehensive, concerted effort among all stakeholders is necessary to ensure success.

Good Design is Innovative

Jannette Whippy — Tue, 11 Sep 2012 18:20:36 GMT

Dieter Rams, a German industrial designer, introduced ten principles of good design. I am going to focus on one principle in this blog post: good design is innovative.

I am not a product designer, but innovation is something I work toward in my page and infographic designs as Senior Graphic Design Artist for Frost & Sullivan’s Growth Team Membership program. Creating clever and different ways to explain processes and data takes time; I call it marinating time.

Speaking of marinating, I love to grill. And I love a good marinade. I think marinated food is just fabulous. However, sometimes (most times) I don’t build in enough time to marinate and I get (what I feel are) sub-par grill results. Talking about grilling right now makes me a little sad what with fall just around the corner. I love the change in seasons (probably because I grew up with only two in the Pacific: rainy and dry); fall is one of my favorites, despite the shorter daylight hours and the temperature drops that deter me from venturing outside to grill. So while grilling (for me) is a late-spring, summer activity, marinating can be done year round (when I remember to plan ahead). Just like marinating food, marinating on design takes time: time to think and time to allow myself to follow meandering thoughts, jot down many sketches (I go through a lot of paper), and come at ideas sideways.

These marinating sessions require me to think loosely about a problem or page. When I let my mind wander, flashes of inspiration hit and I come up with some unique and clever ideas. It is a rush when an idea flashes and I grab it and run with it, sometimes the idea fizzles once I start fleshing out the details, but more often than not, the idea solidifies into a great page or a lovely section of an infographic.

I often tell my team that I need time to marinate on a page or an infographic. This time to muse and reflect is crucial to my design process. If you find yourself stuck on something, the flow of a presentation or even just one page; I highly recommend setting aside time to marinate, the brain often comes up with interesting solutions when you allow yourself to think sideways.

Jannette is the Senior Graphic Design Artist for Growth Team Membership, a premier best practices research group within Frost & Sullivan. You can follow her on Twitter: @jwhippy.

A New Era in Health Data Analytics: The Key to Health Care Transformation

Nancy Fabozzi — Mon, 13 Aug 2012 21:27:56 GMT

Health IT Needed to Transform Patient Care

The provision of health services is an exceptionally data-intensive endeavor. Of course, other industries are also very data-intensive but the health care industry has notably lagged in making use of advanced information technology (IT) solutions to manage and process vast troves of data. Health care data includes clinical medical information collected at the point of care, financial information resulting from highly complex billing and claims processing, and voluminous administrative and demographic data required as a result of significant legal and compliance requirements--all of which provides a rich resource for gaining knowledge and insight into best practices. Unfortunately, in health care, disjointed data is collected across highly fragmented systems that are still often predominately paper-based or, if electronically-based, are not usually amenable to interoperability with electronic systems used by various payers, providers, or government agencies. The whole thing is mess and everyone knows it but the good news is that this situation is rapidly changing today with the new emphasis on all things health IT, particularly advanced EHRs and new methods of health information exchange. Over the past decade, especially during the last five years, health care providers, including hospitals, have considerably accelerated their use of clinical IT systems such as EHRs. Thanks in no small part to the strong push from the federal government in the form of financial incentives provided by the HITECH Act, hospitals are focused on installing new EHR systems and digitizing clinical information that has traditionally been locked in paper-based silos. The growing adoption of health IT is key to the government's goals to transform our health care system, as laid out in the ONC's Federal Health IT Strategic Plan for 2011-2015 and summarized in the following chart -

Growing EHR Adoption Drives Analytics Evolution to Next Phase

The growing use of EHRs is a very positive development on the road to health system transformation. In the next phase, newly digitized clinical data will be combined with financial and administrative data to yield new insights that will improve the quality, efficiency, and safety of patient care. Over the past 20 years or so, hospitals have steadily increased their knowledge and capabilities around digitally gathering and analyzing financial and administrative information. Thus, the digitization of financial and administrative data is further along in the hospital setting than is clinical data. Furthermore, the use of business analytics or business intelligence has been in place in most hospitals to some degree. Unfortunately, most hospitals have yet to adopt sophisticated analytic approaches to the data generated from their new EHR systems, and they particularly have not yet integrated clinical data with financial and administrative data.

Installing EHRs so that clinical data can be digitized and shared is the first step towards transformed health care. As EHR adoption grows, hospitals will need to aggressively move towards new processes and strategies to leverage clinical, financial, and administrative health data for the benefit of individual patients, patient populations, and the nation as a whole. Health care reform, the move to accountable care, and the prospect of bundled payments, or value-based reimbursement, are key drivers for the need to derive advanced insights from all forms of digital health data. Gaining value and insight from health data requires advanced, cloud-based data analytics solutions that pulls in data from all sources to provide both real-time and predictive insights, unlike the traditional retrospective, business intelligence approach of the past that mostly focused on financial analysis. Health data analytics is really a whole new approach to the analytics process that will impact every aspect of hospital operations.

It is clear that the future of health care will be increasingly driven by advanced health data analytics utilized at every point of care. We believe that the urgent need to transform our health care system will require hospitals to increasingly invest in advanced data analytics solutions to monitor end-to-end care delivery across a variety of settings as well as to provide comprehensive reporting on performance and quality measures to a variety of stakeholders. Understanding the key imperatives driving this phenomenon is essential. We take an in depth look at this issue in our new report, U.S. Hospital Health Data Analytics Market, 2011-2016: Growing EHR Adoption Fuels A New Era in Analytics, part of Frost & Sullivan’s Healthcare & Life Sciences IT Growth Partnership Service program.

Paradigms, Parents, and Podcasting

Katherine Burns — Fri, 03 Aug 2012 14:12:15 GMT

Every once in a while, you read something that really blows your hair back. Few things are better than having a moment of enlightenment – having a new idea presented to you that helps you make sense of your world in a better, simpler, way.

That’s what happened to me when I came across a book from the 1960s entitled The Structure of Scientific Revolutions. This book’s author, Thomas Kuhn, argued that periodically practitioners of a shared discipline find that the framework (or paradigm) in which they operate has been undermined by a series of events that cannot be explained by the prevailing paradigm. If they continue to accumulate, these incidents combine to create a state of crisis. Out of the crisis and the chaos come a revolution and out of that an altogether new paradigm – a new way of looking at the world, a new framework for working, existing, and thinking.

What an incredibly simple, but sophisticated, concept: a period of stability, followed by a period of chaos, followed by a new order of things. I know the phrase “paradigm shift” is no longer new, but that didn’t make it any less earth-shattering to me when I first came across it.

This idea has deeply, fundamentally affected the way I look at things, and it certainly affected my approach to writing the growth process toolkit for technology strategy, which I have discussed in my two previous blogs. We are living through a paradigm shift right now – each of us trying to make sense of the chaos and searching for clues of what the new paradigm will be.

Funnily enough, my own life is in the midst of something of a paradigm shift itself. I’m already a mother to a wonderful two-year-old boy, and I am about to have a daughter. My stable world will soon, to quote myself, find itself in a state of chaos. What will the new paradigm look like?

And what is my daughter’s paradigm going to be? How will she look at the world? What truths will govern it? I’ve been thinking about this a lot lately – what do I want to teach her? What do I want her to like (hint: old movies, Esther Williams, sparkles)? What do I want her to not like (hint: scary movies, New York Giants, sugar)? What things do I really want her to believe? At the risk of falling into platitudes, I thought I’d share a few of my lessons with you all (no guffaws or eye-rolling allowed, I don’t care if it’s cyberspace).

Fred Astaire made it look easy. The lesson: the harder you work, the more effortless it will seem. There is no substitute for hours upon hours of practice, frustration, setbacks, and breakthroughs. Talent alone is one step above laziness.

Find your brilliance. My dad used to tell me, you’re probably not going to be a genius at everything. But you might be lucky enough to be a genius at one thing. Have the courage to run at that strength with everything you’ve got.

Use your words. The English language is a wondrous thing. Treat it with respect. Learn your grammar. Diagram sentences. Speak properly. Write beautifully. Read E.B. White and P.G. Wodehouse. Listen to Cole Porter.

Daddy’s wrong about Mommy’s movies. Just because it’s old doesn’t mean it’s outdated. I know there’s something to be said for special effects, but could any technology of today improve upon Gone With the Wind? I rest my case. The past is a treasure trove of awesomeness.

Every day is a happy day. Start every day believing that it will be better than the one preceding it. Never think you’ve peaked. What was the line from Anne of Green Gables? Each new day is a new beginning, with “no mistakes in it.” Isn’t that comforting?

Anyway, this is sort of my blogging swan song, at least until November. So with that, I leave you all with a few thoughts:

1) I just recorded a podcast revisiting the concept of technology strategy (its opportunities and risks, success stories and cautionary tales), and I’d love for you all to take a listen. Please forgive my voice – I’ve been battling laryngitis. My husband says I just talk too much.

2) If the toolkits seem interesting to you, take note: There are 10 of them! You can see them all here.

3) If you’re not a member of Growth Team Membership, and therefore can’t access these materials but would like to, let us know.

4) Enjoy the Olympics! Enjoy Halloween! I’ll see you at Thanksgiving!

As always, happy computing.

Katherine Burns

Katherine is the Director of Strategic Communications for Growth Team Membership, a premier best practices research group within Frost & Sullivan. You can follow her on Twitter: @KatherineSBurns.

How Wine Tasting and the Gestalt Principles of Perception Improve My Designs

Jannette Whippy — Tue, 24 Jul 2012 22:22:39 GMT

It’s rare for me to meet a Cabernet Sauvignon that I don’t like. My favorites are Cabs with backbone: big and full-bodied. I like my wines earthy (even a little herbaceous [taste and aroma of herbs]) with some tobacco flavor. And I love when the wine finishes dry. My wine preferences have matured and changed over the years (I have attended many, many tastings) I started off liking the more fruity, light reds and creamy, buttery chardonnay’s and now I really cannot abide either.

My design skills have also matured and improved through the years. I have designed many pages, some good, some great, some forgettable, and some truly insightful. I find that my best designs are conceived when I have a few key principles in mind. When keeping proximity, similarity, and order (a few of the Gestalt principles of perception) top of mind I produce clean, easily navigable pages.

Proximity occurs when elements are placed close together. While they are still separate objects they are perceived as unified because they are close to each other.
Similarity occurs when objects look similar to one another; they are then perceived as a group or pattern. Repetition of colors or objects is pleasing and aids in fast comprehension.
Order (or symmetry) occurs when the whole of a figure is perceived rather than the individual items that make it up. When designing to instruct, order and symmetry help the information to be consumed and comprehended quickly.

There are more principles, but these three are the ones that help me the most when designing guidebooks.

Chelsea Cappetta created this slideshow that showcases all the Gestalt Principles:

Gestalt Laws and Design from chelsc

Simplicity is beautiful, especially if your end goal is comprehension. Attending all those tastings allowed me to learn what I liked and didn’t like and have been the building blocks for me to be a more informed and happy wine drinker. The Gestalt Principles give me a great starting point when designing a page, as long as I know how things interrelate on the page, I can then design the page for maximum, full-bodied, consumption.

Jannette is the Senior Graphic Design Artist for Growth Team Membership, a premier best practices research group within Frost & Sullivan. You can follow her on Twitter: @jwhippy.

U.S. Supreme Court Upholds the Affordable Care Act; Health IT Market Will Accelerate Across the Board

Nancy Fabozzi — Fri, 13 Jul 2012 19:20:24 GMT

Summary of Supreme Court Ruling

On June 28, 2012, the United States Supreme Court, in a 5-4 decision, found that the Patient Protection and Affordable Care Act’s individual mandate is a tax and thus allowable under Congress’ constitutional power to levy taxes. Under the law, most people, save those who quality for exceptions based on financial or religious considerations, are required to purchase health insurance or be subject to a penalty payable to the IRS amounting to 1 percent of their income starting in 2014. The penalty will increase with time. The Supreme Court’s decision leaves the majority of the law in place, with the exception of the Medicaid funding formula. Specifically, the majority of the court agreed that the law's expansion of Medicaid to an estimated 16 million people by 2019 is unconstitutional as written and that the federal government cannot threaten to withdraw existing Medicaid funds from states if they choose not to expand Medicaid. It is expected that this aspect of the ruling will impact the extent to which some states participant in the Medicaid expansion called for under the law, at least initially. While the ruling is seen as a win for the Obama administration, the next hurdle facing the Affordable Act (ACA) will be the November Presidential elections, as the Republicans have vowed to repeal the law if they win the White House. Even in the event that the Democrats retain the Presidency, it is highly likely that certain provisions of ACA will likely be repealed and/or revised in the coming years, e.g., the controversial tax on medical device manufacturers.

Market Impact

Overall, we see the Supreme Court ruling on ACA as a very strong positive for heath IT. Despite the prospect of a Republican win in November, most industry experts believe that there is more clarity now about how health system transformation is shaping up--and the headwinds are strongly in favor of an even more aggressive adoption of EHRs and related technologies. Clearly, this trend has been accelerating for the past several years, due in no small part to The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009. But beyond that, we see that the culture and attitudues around health IT are changing as well. We firmly believe that the ACA ruling will result in an even more widespread acceptance of the inevitable changes that will reshape the financing and delivery of health care in the United States. Specifically, the health care system will be increasingly characteristed by a greater volume of patients, many of whom are new to the system; a greater number financially disadvantaged patients coming into the system; and, most importantly, more patients with complex, chronic illnesses, often exacerbated by years of no access or poor access to health care services. This situation requires that providers gain every advantage in terms of facilitating access to care for more patients while simultaneously driving comprehensive improvements in quality, safety, and cost-efficiency. Such improvements simply cannot happen without the greater use of health IT. As providers come to grips with the new reality, those health IT stragglers, namely small physician practices and some small hospitals, will increasingly come on board out of sheer necessity. Many of these providers will be required to merge with larger practices, join an ACO, or get bought out by a hospital/IDN.

Below is a summary of some potential near-term and long-term impacts of the ACA ruling on key health care market participants:

Providers

With regard to EHRs, the ruling will probably not have much of an impact for large hospitals and academic medical centers as they have been strongly focused on EHRs anyway due to HITECH. Projects are well underway; contracts have been signed. Large vendors with fully integrated systems for hospitals and ambulatory practices have been winning big and this will continue and accelerate. Growing consolidation presents operational challenges for health IT implementation, especially when providers are on separate EHRs. This could slow the path to Meaningful Use (MU) for some providers. As a result, there may be some push back on MU measures and timelines due to growing consolidation as well as the need to ramp up other IT systems in preparation for 2014, particulary financial systems for revenue cycle management (RCM). We see a big opportunity for hospital RCM. Hospitals need to quickly get very smart about managing financial risk and reducing bad debt. The onslaught of newly insured patients coming into the system will require robust RCM capabilities including patient engagment at the pre-certifcation stage. While the fact that patients will be insured is good, hospitals will need to be very efficient about collecting co-pays and deductibles because nothing can be left on the table due to Medicare cuts and the growing numbers of Medicaid patients.

Vendors

There will be vendor displacement because of consolidation for all sectors of the market; large hospitals to some degree, but especially for mid-sized and smaller hospitals. Smaller hospitals (under 150 beds or so) are most likely to get absorbed into larger systems. Financial imperatives will be overwhelming for many and vendors serving that market are likey at increased risk. In addition, some large legacy vendors, especially those with weakness on the ambulatory side, will continue to get displaced. Hardest hit vendors will likely be those serving the small ambulatory medical practices. These practices will increasingly need to partner with a larger provider and will eventually go onto the larger system’s EHR. The next six months are very risky for vendors serving this market as some providers delay upgrade/purchasing decisions waiting for outcome of elections and/or seek to partner or get bought out. Add that to the need to spend more money for Stage 2 MU certification and these vendors face very difficult market conditions that will undoubedtly cause many to go under. Looking out over the longer term, the distinction between ambulatory and hospital EHRs will largely disappear over the next decade. We will likely see a move to open, cloud-based platforms that are interchangeable among all providers and care settings. Provides will select applications and modules that are relevant to their practice, e.g., EHRs, patient portals, PHRs, etc. However, user interfaces/usability may be more standardized due to regulatory oversight due to patient safety concerns.

Payers

The short term impact will likely be somewhat negative for payers but they have been expecting this so and much of the downside has already been accounted for in their business plans. Long term, we believe ACA is a strong positive for the insurance industry. We will likely see an acceleration in payers interested acquiring health IT companies as they need to have more access to quality data and provider performance metrics. As for state health insurance exchanges, we do expect some uptick in activity to form exchanges over the next several months; however, some states will be waiting until 2013 (after the elections) to move fully forward on this. The issue of health insurance exchange is a very political issue in many states. Thus, the process will likely be contentious and characterized by fits and starts as the market settles, much like what has taken place over the past several years with public health information exchange organizations.

Improving Efficiency by Focusing on the Customer: Asia Pacific 2012 Marketing Priorities Survey Results

Holly Lyke Ho Gland — Mon, 09 Jul 2012 14:11:10 GMT

Marketers continue to be faced with the imperative tofind ways to appeal to specific customer needs, keep costs down, and drive higher ROI. This focus on the customer has marketers reassessing their value propositions and customer segments—to target the “right” audience with an engaging message. However, marketers are expected to take on this task with limited resources—budgets and staffing levels are expected to remain stagnant. To accomplish more with less, marketers are striving to improve the effectiveness of lead generation efforts and adoption rate collateral by Sales. More pointedly, marketers are striving to improve their channel strategies and collaborate closely with Sales on segmentation efforts.

To examine these challenges in more depth, the survey asked respondents to “root cause” their top internal challenges; indicating if they stem from issues with staffing, process, technology/systems, or strategic alignment. Respondents attribute their challenges to two primary causes: limitations in staff and a lack of common objectives.

When comparing Marketing’s 2012 resource allocations to forecasts made in 2011, the belief that budgets and staffing would remain static is inaccurate. In fact budgets have decreased since 2011. In regards to staffing, budgets have dropped by over a third. In contrast, marketers’ growing love affair with social media is readily apparent as social media activities are receiving twice the budget allocation they did last year. Additionally, marketers have allocated more budget to “content development”, which is critical for demand and lead generation activities.

This year’s survey included examined Marketing’s demand generation capabilities. Overall marketers are satisfied with their demand generation effectiveness—most respondents ranked their effectiveness as “Above Average”. Marketers are also satisfied with their effectiveness at specific demand generation tactics—with the exception of social media and mobile marketing.

Differentiating the Value Proposition: 2012 Asia Pacific Marketing Priorities Survey Report

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Holly is the Research Lead for the Growth Team Membership, a best practices research group within Frost & Sullivan. Follow her on twitter at @hlykehogland.

Second Time Around

Katherine Burns — Tue, 03 Jul 2012 14:23:30 GMT

I once read an article in the Wall Street Journal about how writing the pilot episode of a new series is usually easier than writing the second episode, which can be an excruciating process. Maybe it’s because writers use all their good material in the first attempt, and feel a bit empty for the second go-round.

I hope this isn’t the case with me and this blog. I so enjoyed writing the first one – I hope you enjoy reading the second one as much.

At least I teed up a few things to discuss in this one, so I’m not starting at ground zero. Wasn’t that savvy of me?

For instance, I promised you all a list of my favorite detective stories. The “Professional Communicator” in me thinks that it would be a good idea to close with this, rather than lead with it…so scroll to the end if that’s why you’re here. I also promised to tell you more about something that I just wrote – a new growth process toolkit on technology strategy.

There can’t be a more satisfying feeling in the world that finishing a large project, especially one that took a great deal of personal blood, sweat, and tears (and no, for a writer, that’s no exaggeration: writing is a blood sport, played sitting down). I love to finish writing something, and then not look at it for a few weeks. That way, when I read it again, I see it with fresh eyes. Sometimes this means I’m disappointed in something that I previously had thought was terrific—and other times, I feel nothing but pride in what has been produced.

I’m happy to say that in this case, my re-reading of this toolkit produced the latter sentiment. Maybe it’s obnoxious of me to say that, but trust me – my standards are high, and this isn’t praise I would give myself, or anyone else, lightly. Furthermore, I think it’s probably a good thing for a writer to believe in her work. If you don’t, who will?

And if I didn’t believe in it, I wouldn’t be blogging about it right now. I wouldn’t be telling you how I think there’s something in it that will strike a chord with many of you. As I mentioned in my previous posting, technology is such a complex, moving target that it’s nearly impossible for anyone to make sense of the chaos. Patterns are fleeting, and moments of normalcy or consistency even more so. What this toolkit is designed to do is to help you stay calm in the storm. To take a systematic approach to understanding your business, identifying market opportunities, and evaluating them. To nurture creativity within your organization, because without it, you’re a sitting duck. These are really important ideas—and perhaps not entirely new, but still meaningful, and difficult to execute. The toolkit’s purpose is to aid that execution to the greatest extent possible. If you’re interested in reading the entire thing, and you are a member of Growth Team Membership, you can click here.

If you’re interested in reading the entire thing, but you’re not a member of Growth Team Membership, you can still read an excerpt by clicking here.

Enough about that. I mentioned at the start of this blog that I would close with a list of my favorite detective stories. In the interest of brevity, because brevity is the soul of wit, I shall keep the list to five (starting with my favorite).

1) Some Buried Caesar, by Rex Stout

2) Black Orchids, by Rex Stout (I realize it would be more interesting not to repeat an author, but…my blog, my rules)

3) Murder on the Orient Express, by Agatha Christie

4) The Big Sleep, by Raymond Chandler (read this, and then watch the movie: Bogie and Bacall at their most snazzy)

5) The Maltese Falcon, by Dashielle Hammett (read this, and then watch the movie: Bogie at his most Bogie, sans Bacall)

For a more in-depth book discussion, or to share your thoughts on technology strategy and its myriad challenges (none of which really existed in the lovely 1930s, “stuff dreams are made of” world I’ve just recommended for you), please take to the comments.

As always, happy computing.

Katherine Burns

Katherine is the Director of Strategic Communications for Growth Team Membership, a premier best practices research group within Frost & Sullivan. You can follow her on Twitter: @KatherineSBurns.

Pursuit of Productivity and Social Selling: 2012 APAC Sales Leadership Priorities Survey Results

Holly Lyke Ho Gland — Mon, 02 Jul 2012 17:27:38 GMT

This year’s survey results indicate sales executives’ 2012 challenges are shaped by their need to increase productivity. Specifically, sales executives need to pinpoint the highest-value sales activities, streamline their sales processes to match, and invest in new tools and practices for team collaboration. The other prominent challenges are enhancing the ability to monitor the business environment for shifts in pricing pressures and customers’ purchasing behaviors and needs.

To further explore this year’s challenges, respondents were asked to “root cause” their top challenges—whether they derive from issues with staffing, process, technology/systems, or strategic alignment. Sales executives attribute their challenges to the gamut of process, tools, and people. While respondents foresee little to no increase in staff, budgets are on the rise.

Given social media’s increasing role in companies’ strategies and activities, the survey asked respondents about the sales force’s use of social media. An overwhelming majority (98%) of the respondents are using social media in their daily sales activities. Specifically, respondents employ social media to identify needs, build awareness, and nurture ongoing client relationships. Unsurprisingly, LinkedIn is the primary social media platform sales executives use—primarily joining special interest groups to enhance their understanding of customer needs. Fewer respondents are actively participating in or creating special interest groups, which forgoes opportunities to demonstrate topical expertise.

Regarding the use of virtual and social media tools in sales activities, respondents employ tele-presence and/or live streaming video and predictive analytics—the analysis of customer behavioral data to identify patterns and insights for customer interactions. However, few respondents are using social media monitoring tools (e.g., Radian 6), dashboards (e.g., Hootsuite or MediaFunnel), or CRM systems (e.g., Nimble). Consequently, sales executives are not realizing the full benefits these tools offer for improving customer focus, collaboration, and productivity.

2012 Asia Pacific Sales Leadership Priorities Survey Report

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Holly is the Research Lead for the Growth Team Membership, a best practices research group within Frost & Sullivan. Follow her on twitter at @hlykehogland.

Visualize This!

Jannette Whippy — Thu, 28 Jun 2012 17:42:36 GMT

Inspiration hits at the strangest times: morning walks with my greyhound, a quiet moment sipping wine, or a busy and hectic day of running errands. It turns out solutions come more easily when I stop thinking about the problem. However, a key component of my ability to visualize solutions is having an understanding of the broader view.

Telling someone else’s story can be challenging. As a designer of Best Practice Guidebooks, I am not involved in the primary research and robust storyboard discussions required to create our guidebooks. When a guidebook is passed to me the researcher must explain everything, in extreme detail and I am responsible for visualizing the story. However, I often find the details distracting and, while it is good to have them, I need the big picture. Working with researchers who have a superior understanding of the subject manner and are able to step back and explain the overall view helps me to create meaningful structures and visuals. When I step back from the details, clarity often ensues.

Understanding the big picture helps me to better visualize graphical solutions to complex ideas. Once I design the concept, the details tend to slip into place within the larger, coheseive structure.

Visualizing text can make presentations more interesting and help your audience grasp the core concept quickly. If you are looking to make your work more visual, more exciting, details are nice to have but if you don’t understand how they all work together, visualizing your text will not be easy. Take a step back from your page and think about what you are trying to communicate.

Mastering the Social Media Universe

Austin Pullmann — Fri, 22 Jun 2012 16:32:41 GMT

It’s always nice to have your work enjoyed and shared by others. This is a primary reason for getting excited about my job, which is to document best practices executed by companies against a variety of challenges. Recently we created an infographic to tell the story of our research that covers a variety of approaches to leveraging social media effectively, entitled “Mastering the Social Media Universe” – for the record I came up with that title while sitting in a fast food restaurant with my kids. :) See a pasted version below:

[INFOGRAPHIC] Mastering the Social Media Universe

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So I mentioned that this infographic has been shared far and wide. Indeed, it has been retweeted and posted in various blogs, dissected and interpreted. All of this is great news in that we were able to connect with others using this visual format, and address challenges that others are commonly facing. Wonderful. As in many aspects of social media, the benefit generated is simultaneously hard to dispute, yet hard to calculate. Wouldn’t it be great to know how this research materially changed the thinking of the reader, and by extension generated value for that reader’s business? We would love to know. So now’s your chance – reach out to us with any kind of feedback, positive or negative on how the infographic has influenced your thinking. We will welcome it with open arms!

Kudos to our graphic designer, Jannette Whippy, who is the artistic genius behind this infographic.

Austin Pullmann
Austin is the North American Program Manager for the Growth Team Membership, a best practices research group within Frost & Sullivan.

Managing Resources and Idea Generation: 2012 Asia Pacific R&D Priorities Survey Results

Holly Lyke Ho Gland — Thu, 21 Jun 2012 18:42:44 GMT

The survey reveals that R&D executives in Asia Pacific are focused on challenges surrounding two topics: (1) managing the product portfolio and (2) integrating inputs from an array of sources outside of R&D. In regards to the first topic, R&D executives are struggling to generate an accurate technology map—that outlines customer needs, the current technology landscape, and gaps. Developing an accurate technology map is the first step to addressing R&D’s other portfolio management challenges—prioritizing and funding projects within the portfolio. A technology roadmap allows R&D executives to develop a portfolio strategy—that pinpoints which needs match company capabilities for development. Furthermore a formal portfolio strategy is necessary for an effective portfolio management process and measuring project ROI.

Customer-facing functions such as Sales and Marketing are a rich source of innovation information on everything from customer needs to feedback on current products. However, R&D executives struggle with establishing a method to consistently capture and integrate this information with their product development process. Some solutions to this dilemma include establishing regular cross-functional exchanges of ideas, or interacting with customers directly—via crowdsourcing or a formal open innovation process.

In view of open innovation’s (OI) growing prominence and potential to systematically capture ideas from a broad network, the survey asked respondents about their use of OI. The majority of respondents include OI in their product development processes. Open innovation is largely employed for idea generation and concept testing and customers are the primary source of ideas. Most of the respondents have a dedicated OI team within R&D.

Even though companies are committed to using OI—a concept that is founded on tapping into multiple sources for ideas—respondents still cite struggles with gathering and integrating insights from Sales and Marketing and customers. This may be attributed to respondents’ challenges with the fundamentals of establishing an OI program: overcoming the fear of lost IP, establishing a framework for collaboration, and garnering the resources needed to test incoming ideas and technologies.

2012 APAC Portfolio Management and Open Collaboration

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Hospital Merger Mania Continues Unabated Signaling Permanent Market Shift

Nancy Fabozzi — Mon, 18 Jun 2012 15:59:20 GMT

The New York Times recently reported news of a proposed merger between two of New York City’s largest hospital systems—New York University’s Langone Medical Center, which has 1,069 beds, and Continuum Health Partners, which includes Beth Israel and two campuses of St. Luke’s-Roosevelt and has a total of 2,180 beds. (New York Hospitals Look to Combine, Forming a Giant. A. Hartocollis, New York Times, June 6, 2012) Although not a done deal by a long shot—the hospitals must first receive federal and state regulatory approval—the proposed merger has garned a great deal of attention as it would create one of the largest health systems in New York City. Large health system deals like the prosed marriage between NYU Langone and Continuum as well as numerous others that have recently taken place across the U.S. have the power to significantly influence the market for health services. Thus, these deals are attracting increased scrutiny from the media, the public, and, of course, regulatory authorities.

Why Hospitals are Merging Now

There are numerous reasons why these deals are accelerating at this time. Like most mergers, the ultimate goal is to gain competitive advantage and increase market share among a dynamic and rapidly change marketplace. However, health care providers are usually reluctant to directly speak to such blatant business motives and generally prefer to play up the “integration drives quality” angle of these deals, which is certainly not untrue and must be considered in today’s environment where federal health reform law encourages greater integration and coordination. Yet, it is important to note that some studies by health economists show that hospital mergers actually have no effect on the quality of care, but do have a significant effect on the price that hospitals charge. According to a recent article by Avik Roy in Forbes (Goal of the NYU-Continuum Hospital Mega-Merger: Raising Prices), despite the fact that hospitals often claim that the reason for mergers is to improve care quality and integration while simultaneously reducing costs by creating economies of scale, the real driver behind most mergers is to force insurers and patients to accept higher prices. The potential for higher prices due to fewer market choices isn’t the only issue causing angst. Mergers in any industry are often accompanied by considerable disruption including staff layoffs, management and governance restructuring, and even changes in the organization’s basic mission and purpose. In the case of health care providers, proposed changes in womens’ health, reproductive services, and end of life care when religious-run health care systems acquire or form joint ventures with non-secular hospitals and health systems have resulted in public protests in several U.S. communities and have also given rise to public advocacy organizations like the New York-based MergerWatch, whose motto is “protecting patients when hospitals merge”.

Mergers Drawing Increasing Scrutiny

The health system consolidation trend has come come under scrutiny from the Federal Trade Commission (FTC), an independent agency of the U.S. government tasked with monitoring anti-competitive business practices that could potentially lead to monoplies. The FTC has recently taken a renewed interest in hospital consolidation and has ramped up efforts to look into how these deals might potentially lead to higher prices for patients and payers. The American Hospital Association (AHA), however, took a stand against the FTC in a recent letter to a House Judiciary subcommittee hearing on hospital consolidation. In essence, the AHA letter claimed that consolidation is the preferred method to build a necessary continuum of care and that anti-trust laws are outdated when applied to the reality of today’s health care market.

Potential Market Impact

Health system change and ongoing financial pressures are resulting in an increase in consolidation across the provider landscape. While we’ve seen this sort of merger mania among providers take place before—namely, around a decade ago at the height of the managed care trend--this time it’s different and we believe that provider consolidation is a signficant megatrend that will ultimately reshape the entire market landscape. According to Irving Levin Associates, there were a total of 86 hospital merger and acquisition deals in 2011, representing a 14.6 percent increase over the 75 deals that took place in 2010. In terms of total deal value, an article in HealthLeaders Media (Hospital M&As Continue Apace in 2011) puts the number at $7.3 billion, out of $236 billion of total health care-related M&A activity in 2011. There has been no sign of a let up in deal activity this year with a total of 23 deals reported in Q1 2012, an increase of 5 percent over Q1 2011, according to Irving Levin Associates. Thus, we think it is safe to presume that, whatever happens with the Supreme Court in June, the next two to three years willl be significant in terms of provider deal activity as hospitals and physicians brace for inevitable market transformation and increased cost pressures. In today’s “merge or die” environment, struggling non-profit and small hospitals and many physician practices, particularly small practices consisting of solo/partner and groups of five and under, are becoming more amenable to sacrificing their independence in order to come under the umbrella of a larger organization. Larger hospitals and medical groups generally have more robust capabilities with regard to overall clinical and financial operations, including financing options and capital spending, range of clinical services, IT infrastructure and facilities, staffing, and, especially, the purchase and management of advanced technology including health information technology (IT) systems.

How Mergers Affect Health IT Implementation

With regard to health IT, there are pros and cons to provider consolidation. In terms of the cons, the merges are coming on at a time of unprecedented pressures. Due to health IT requirements stipulated by MU as well as the prospect of the Patient Protection and Affordable Care Act (PPACA), both of which result in numerous complex IT projects with tight timeframes, most hospitals are well underway with IT projects regardless of whether a merger is in their future or not. Thus, hospital IT staff are completely tapped out trying to get their electronic health record (EHR) systems up and running to meeting Meaningful Use (MU) requirements. In order to quality for MU, some hospitals are doing system upgrades including installation of new applications and others are facing complete rip and replace including substantial IT infrastructure overhaul. At the same time, hospital CFOs, administrators, and HIM staff are struggling with ICD-10 implementation and changes in revenue cycle due to the prospect of value-based purchasing and bundled payments with widespread implications for IT applications and workflow processes. Add mergers to the mix and you have a situation that can substantially complicate the transition to EHRs and new RCM systems when two or more organizations with different vendors, IT infrastructures, cultures, workflows, and so on, come together in a merger. Hospital mergers seeking to create true integration and cost efficiencies often seek a single-vendor strategy, thus complicating IT system implementations and even potentially disrupting EHR upgrades and or even new installations resulting in wasted time and efforts. On the plus side, as previously stated, for some hospitals, the prospect of more resources to help rationalize and drive all of the various IT initiatives is a signficant benefit. This is particularly the case with small community non-profits and rural hospitals.

Disruptive market forces guarantee a bumpy ride for health care providers and the vendors who serve them. We believe that it is unlikely that the FTC and/or other disgruntled stakeholders will be successfully in significantly stemming the tide of hospital mergers. Ownership changes are inevitable and will result in considerable healht IT vendor displacement in the next few years.

Better Communication, Better Business

Holly Lyke Ho Gland — Tue, 12 Jun 2012 13:09:56 GMT

One of my roles in my household is mediator between my son and husband. Like many a father and son, they are so much alike that sparks fly on a fairly regular basis. Not surprisingly, nine times out ten, their frustrations stem from a lack of communication. Needless to say, pointing this out results in an emphatic eye roll from my son and gruff sigh from my husband. However, once they do talk, there is peace in the house for at least 24 hours.

So what does this have to do with business?

Part of my job is to conduct annual priorities surveys, to pinpoint role-related challenges for executives in Marketing, R&D, Corporate Strategy and Development, Market Research, Competitive Intelligence, and Sales. Some challenges that come up year after year include:

How do we get buy-in at all levels of the company for strategy adoption?
What’s the best way to get support for that promising innovation?
How can we get the strategy team to integrate our insights into the annual planning process?
Why won’t Sales use the collateral we developed?

Any of these sound familiar?

In addition to picking their top challenges, the surveys also ask respondents to pinpoint the root cause of each challenge. In addition to limited resources, there are three recurring culprits—ineffective processes, a lack of common objectives, and inadequate communications.

Another key part of my job involves creating best-in-class case studies (Best Practice Guidebooks) that address the challenges identified in the surveys. In almost every case study our team produces, the best practices require developing communication mechanisms—to generate buy-in, break down silos, tap into out of the box ideas, and create transparency and trust between stakeholders. Here are two common methods we have found for creating sustainable communications:

Formal cross-functional committees—these committees tend to meet monthly and include representatives from all the relevant stakeholder groups/functions. These committees are useful to discuss resources, create transparency on project milestones, and supply information on project status prior to hand-off.
Informal monthly meetings—these meetings tend to include staff from related functions (such as Marketing and R&D) and are particularly useful for sharing best practices, breaking down silos, and brainstorming long-range or disruptive ideas.

Much like with my son and husband, when left to their own devices, business communications tend to break down or be shifted aside for more pressing priorities. Communications are vital to ensuring the health of any project or process and require commitment and nurturing equal to the multitude of benefits it offers.

Holly is the Research Lead for the Growth Team Membership, a best practices research group within Frost & Sullivan. Follow her on twitter at @hlykehogland.

A First Time for Everything

Katherine Burns — Wed, 30 May 2012 16:08:29 GMT

Well, it’s my first blog. Not just my first one for Frost & Sullivan – my first blog ever. As a professional writer, and professional communicator, I guess this means I’m somewhat old-fashioned. I’d rather write something longhand than type it, and I wish we’d all put the Postal Service back in business by sending each other some letters. (Remember letters? No “you’ve got mail” ding, dong, ping, or gong could ever be better than the silent anticipation of opening an envelope.)

Anyway, I’m old-fashioned in most aspects of my life. I love old movies. I love old music. A few weeks ago my husband asked me to name a famous Grunge band, and the best I could do was Aerosmith (apparently they are NOT “Grunge”). Somehow this makes me eccentric, whereas the fact that he couldn’t tell me the difference between Ella Fitzgerald and Julie London just means he’s cool. Whatever.

And so I’ve skipped through life, mostly paying homage to things that happened before I was born, and all to a Cole Porter soundtrack. I’ve watched Singing in the Rain more times than I could count; I’ve memorized all of Fred Astaire’s movies. I’ve devoured books on the Golden Age of Hollywood. Mid-20^th Century detective stories are my vice (I’ve read them all, but Nero Wolfe’s brownstone is my absolute ideal…and if that doesn’t mean anything to you, do yourself a favor and pick up Some Buried Caesar, or maybe Champagne for One).

Speaking of mid-20^th Century detective stories: One of the lovely things about them is the way the detecting is done. There’s no scanning of Twitter pages, no research of Facebook posts. The hero might read back issues of the New York Times, or he might pay a trip to the library. He might even go really high-tech and type something, on a really snazzy machine like an Underwood. In all, a decidedly low-tech (but always successful) way of arriving at whodunit.

Imagine my anxiety, then, when I was asked to write about technology. Not the technology of yesteryear—but the technology of tomorrow! Technology that hasn’t even happened yet, and how we can predict it and prepare for it! Did I mention I’ve barely started to blog? As I like to remind my boss, I have only to look at a computer to fry its insides past the point of hope or redemption.

Perhaps I should explain why I was so chosen. I’m responsible for writing a series of Growth Team Membership deliverables called the Growth Process Toolkits. These toolkits are essentially primers – how-to-manuals—on key topics that drive a company’s top-line growth. For example, we’ve published toolkits on M&A, new product launch, distribution channel optimization, and more. We needed to write a toolkit on technology strategy, and as the author of the series, the responsibility fell to me. I was, as I said, somewhat hesitant to begin. What could I possibly teach on this subject, when I was so ill-informed myself?

And then I realized two lovely things all at once:

I’m not the only one who’s overwhelmed by the rapid, nearly disorienting pace of technology evolution today. It’s OK to acknowledge this feeling, and to empathize with others who may also be struggling to make sense of the chaos. That’s why I decided to open the toolkit with a quotation from historian Henry Adams (for you history buffs out there, Mr. Adams was a direct descent of John, who was his great-grandfather). I came across this passage while reading David McCullough’s wonderful new book The Greater Journey: “Every day opens new horizons and the rate we are going gets faster and faster till my head spins and I hang on to the straps and shut my eyes.” He wrote those words in 1900 – but how apt they seem today! Maybe not everyone reading this would self-describe as “old-fashioned,” the way I have, but I think everyone can relate to that sentiment and sometimes feels powerless to keep up with…well, anything today. We live in a crazy time. That’s probably why we need a toolkit on technology strategy in the first place. And that leads me to my second realization:

The ideas don’t have to be mine; I just have to present them clearly. One of the great things about my job, and about writing these toolkits, is that it’s made easier by working with extremely smart people. I may not know a lot about technology, but I know who in our company does, and I know how to seek them out, ask them questions, and see how they’ve helped others think through technology-related challenges. All I have to do is collect the goods and translate them into a single, cohesive story. I might not be good at blogging (am I?), but I can certainly do that.

And so there was no need for trepidation—and in fact, this was a good chance for me to learn about something that I’ve avoided, perhaps to my detriment, for a very long time. I’m happy to say that the production of this new toolkit has been a learning experience for me; I hope reading it will be one for you as well.

That last sentence probably makes it sound like the toolkit is finished. It’s not. But it will be soon, and we’ll share it with you as soon as it is. Check back in with us next month, and we’ll provide some more detail on it (that, and my favorite detective stories).

Until then, happy computing.

Katherine Burns

Katherine is the Director of Strategic Communications for Growth Team Membership, a premier best practices research group within Frost & Sullivan.

2012 European R&D/Innovation and Product Development Priorities Survey: Open Innovation for Idea Generation

Holly Lyke Ho Gland — Tue, 29 May 2012 18:20:25 GMT

Frost & Sullivan’s Growth Team Membership™ (GTM) recently completed its 2012 survey of R&D/innovation and product development executives throughout Europe. The executives were asked to identify their most pressing challenges for 2012.

The survey reveals that R&D executives continue to struggle with doing effective portfolio planning and leveraging a wide network for idea generation. Moreover, respondents are challenged by how to generate an accurate technology map—outlining customer needs, available solutions, and technology gaps—to guide portfolio planning and project prioritization. The other prominent challenge is a perennial one, identifying the next breakthrough idea.

To examine these challenges in more depth, the survey asked respondents to “root cause” their top challenges by indicating if they stem from issues with staffing, process, technology/systems, or strategic alignment. R&D executives attribute their challenges to two primary causes: limitations in staffing and processes. R&D executives are unlikely to see additional staff in 2012; most respondents expect staffing level to remain static. On a positive note, budgets are expected to increase in 2012. Despite the emphasis on breakthrough innovation, most of the budget increases will be allocated to short-, medium-term, and incremental innovation projects.

In view of open innovation’s (OI) growing prominence and potential to help R&D develop emerging or disruptive technologies, the survey asked respondents about their use of OI. Surprisingly, given its prominence in the last two years’ survey results, the majority of respondents do not leverage OI in their product development processes. This may be attributed to respondents’ challenges with establishing partnerships and measuring the ROI of OI efforts. In regards to creating OI partnerships, respondents struggle with identifying partners with the right IP, establishing clear communication channels, and building sustainable trust. The R&D departments that are embracing OI tend to use it for idea generation and screening during product development life cycle and customers are their primary source of ideas. In terms of staffing for open innovation activities, most respondents employ part-time technology scouts.

Open Innovation for Idea Generation - 2012 R&D Innovation Priorities Survey Results

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Feedback: The Good, The Bad, and The Irrelevant

Jannette Whippy — Thu, 24 May 2012 18:32:45 GMT

As an in-house designer who works alone, I require constant feedback. It’s the only way to know if I am on the right track. Recently, I had an epiphany: I have ignored my best design resource available, my fellow designer. I could have kicked myself for the oversight. I was working on a poster that was just not fitting together well. I ignored my first instinct to send it to a friend, and instead sent it to a fellow designer in a different department. Her insightful comments and suggestions helped me to see the holes in my design and the fixes we discussed made the poster better.

Feedback is only as good as the reviewer. If your reviewer doesn’t know your intended audience or have much experience in your subject, their feedback (while interesting) is not as meaningful as another, more appropriate, reviewer. Take care in gathering feedback. Your work will get better if the feedback gathered is from someone who understands/is part of the audience you wish to engage. As Seth Godin says: “Shun the non-believers.”

What's the best email subject line you've ever seen?

Austin Pullmann — Wed, 23 May 2012 21:25:27 GMT

Or rather, what is an example of a subject line you simply could not resist opening? I can think of a few – “How you can do what xx did”, or “Does this version work for you?”. Sometimes no subject line is the most effective of all.

The airlines could stand to improve at this. I’m subscribed to perhaps every domestic airline’s email list, and the emails (judging by subject line) have virtually nothing to say. Subject lines consist of “Austin, check out these great offers”, or “Take advantage of our (insert month) sale”. The airlines must also get data from the same source on the best time/days to launch an email, since they tend to dump into my inbox at roughly the same time.

In an effort to uptick open rates and increase email campaign effectiveness, here are 3 tips:

Spike curiosity – This can be achieved in a number of ways. Introducing an incomplete thought that can only be completed by opening the email is very effective. For example, “Do you believe it?” virtually requires a reader to open it and learn more.
Get to the point – Every word chosen either adds or detracts from the message. Limit subject lines to 50 characters or less, and ideally just 4-5 words maximum. The goal of the subject line is to get the reader to open the message. Once that’s been accomplished, the message itself can convey your objective.
Don’t shoot yourself in the foot – There are certain terms that recipients are reluctant to open (such as “Free!”, or “Reminder”, or “Help”). Even worse, some terms are set to be blocked by spam filters. Choose wording that will grab the reader and entice them to open the message.

Use these tips in your next email campaign and compare the results with previous campaigns. Post tips of your own if I'm missing anything critical!

2012 Global R&D/Innovation and Product Development Priorities Survey: Pursuing Emerging Innovation

Holly Lyke Ho Gland — Wed, 23 May 2012 15:17:56 GMT

Frost & Sullivan’s Growth Team Membership™ (GTM) recently completed its 2012 survey of R&D/innovation and product development executives globally. The executives were asked to identify their most pressing challenges for 2012. GTM will focus its best practices research to address the prominent issues identified in the survey.

This year’s survey indicates R&D executive struggle with two chronic challenges: (1) managing the product portfolio and (2) finding the next disruptive idea. In regards to portfolio management challenges, respondents struggle to develop accurate technology maps for planning, to prioritize innovation projects, and measure their portfolios’ success rate. Overcoming these challenges requires R&D executives to map out their portfolio strategy and develop key performance indicators to guide project prioritization and monitoring.

Identifying the next breakthrough idea rarely involves a “Eureka” moment, but does require time and resources. While companies understand the need to develop emerging technologies, they are reluctant to commit substantial resources to high-risk projects. This risk aversion appears to be impacting R&D budget allocations—budgets for incremental innovations are increasing, while disruptive technology budgets remain stagnant.

The survey asked respondents to “root cause” their top challenges by indicating if they stem from issues with staffing, process, technology/systems, or strategic alignment. R&D executives attribute their challenges to two primary causes: understaffing and processes (ineffective or nonexistent process). On a more positive note, R&D executives foresee additional resources—both staffing levels and budgets are expected to increase in 2012.

Given the pressure on R&D executives to tap into new ideas and emerging technology, survey respondents were asked about their use of open innovation. The majority of respondents employ some form of open innovation team (OI)—typically a small, dedicated sub-group within R&D. It comes as no surprise that OI’s primary role in the product development life cycle is idea generation and that customers are the primary source of ideas.

Even though companies are committed to using OI to increase their ability to develop emerging or disruptive technologies, respondents struggle with the fundamentals of establishing an OI process: securing internal buy-in, getting resources for idea testing, and creating a collaborative framework with external partners.

Idea Generation and Portfolio Management - 2012 R&D Innovation and Production Development Priorities Survey Results

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2012 Americas R&D/Innovation and Product Development Priorities Survey: From Portfolio Management to Open Innovation

Holly Lyke Ho Gland — Tue, 22 May 2012 18:35:17 GMT

Frost & Sullivan’s Growth Team Membership™ (GTM) recently completed its 2012 survey of R&D/Innovation and product development executives in North and South America. The executives were asked to identify their most pressing challenges for 2012. GTM will focus its best practices research to address the prominent issues identified in the survey.

According to the 2012 survey results, R&D executives continue to wrestle with portfolio management. Specifically, R&D executives need to prioritize innovation projects, balance the value and risk of the portfolio, and allocate budgets across a wide range of project categories. Respondents also struggle with two other persistent issues: (1) identifying breakthrough ideas and (2) integrating inputs from internal stakeholders (e.g., Sales and Marketing) with portfolio planning.

The survey reveals differences in challenges between different business models. For example, the key challenges for R&D executives in B-to-B companies are generating technology roadmaps for portfolio planning and managing an open innovation process. In contrast, their peers in B-to-C companies are challenged by securing buy-in for promising innovations with senior management and streamlining the product development process to reduce costs.

The survey asked respondents to “root cause” their top challenges by indicating if they stem from issues with staffing, process, technology/systems, or strategic alignment. By and large, R&D executives attribute their challenges to understaffing. Fortuitously, staffing and budgets are expected to increase in 2012. Ironically, though respondents stress the importance of driving breakthrough innovations, short-term or incremental projects account for the majority of the 2012 budget increase.

Given the potential of open innovation (OI) to tap emerging technologies, survey respondents were asked about their use of OI. The majority of respondents (58%) apply OI approaches to their product development process. When asked about the role OI plays in product development, respondents report using OI for ideation generation and screening. However, respondents in B-to-C companies are more likely to use OI throughout the product development process than their B-to-B peers. The composition of respondents’ OI teams varies by business model. Respondents within B-to-B companies employ small, dedicated open innovation teams, while R&D executives in B-to-C companies use part-time technology scouts.

While most R&D organizations engage in OI activities, R&D executives still struggle with implementation: establishing an effective OI process, garnering resources, and collaborating with partners. Respondents in B-to-B companies are focusing on developing a method to measure the ROI of OI activities, while their peers in B-to-C companies are endeavoring to establish a structured process to test the feasibility of idea submissions.

From Portfolio Management to Open Innovation - 2012 R&D Innovation and Product Development Priorities Survey Results

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Progress and Continuing Challenges in the Adoption of Electronic Health Records

Nancy Fabozzi — Wed, 16 May 2012 17:33:07 GMT

The CMS EHR Incentive Programs

The adoption of health information technology like electronic health records (EHRs) and health information exchange (HIE) has been a top priority of the United States federal government since the administration of George W. Bush. The Obama administration has accelerated the push towards health IT with approximately $30 billion in incentive payments earmarked for various initiatives as part of two key pieces of legislation - the American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act (PPACA) of 2010. The CMS EHR Incentive Programs, part of AARA, will provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate “meaningful use” (MU) of certified EHR technology. Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. Incentive payments for eligible hospitals and CAHs may begin as early as 2011 and are based on a number of factors, beginning with a $2 million base payment.

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Tracking the Progress of Health IT Adoption

Given the potential for health IT to significantly improve some of the most glaring inefficiencies and quality concerns that plague the health system today, health policy analysts are keeping a close watch on how providers are progressing in the move to digital technologies. In addition, the large amount of tax-payer funds involved with health IT drives the need to collect robust metrics and pinpoint potential areas of concern. The nonprofit Robert Wood Johnson Foundation (RWJF), which is the largest philanthropy in the nation devoted exclusively to public health issues, works with the Office of the National Coordinator for Health Information Technology (ONC) to report on various health IT issues, including tracking progress toward the universal adoption of EHRs. A series of reports have been issued by RWJF since 2006 and ONC will use a portion of this year’s study (Health Information Technology in the United States: Driving Toward Delivery System Change, 2012) to report to Congress on the status of health adoption. The newest report expands on previous analysis on health IT trends by investigating providers’ (hospitals and physicians) readiness to meet the requirements of the CMS EHR Incentive Program and also explores the role of health IT in other health care reform initiatives. Included in the report is a look at EHR adoption data from surveys of U.S. hospitals and office-based physicians; recent data on the progress and challenges of HIE at both the state and federal levels; the importance of health IT to health reform initiatives including patient-centered medical homes and accountable care organizations; and several other issues relevant to health IT.

Adoption Trends as Reported by RWJF

The authors found steady increases in the level of EHR adoption for physicians and hospitals throughout the United States. For physicians in ambulatory practice, the authors report on data collected by the CDC's National Center for Health Statistics (NCHS) as part of its National Ambulatory Medicare care Survey (NAMCS): Electronic Medical Records Supplement (funded by ONC). The most recent survey was sent to 10,301 physicians in 2011 and had a response rate of 64 percent. The NAMCS surveys show that the proportion of physicians reporting the use of any EHR (defined as either all electronic or part paper/part electronic) increased from 17.0 percent in 2002 to 57.0 percent in 2011 while the proportion of physicians with at least a basic system rose from 12.0 percent in 2007 to 34.0 percent in 2007. In terms of the rate of EHR adoption relative to physician characteristics, the data showed primary care physicians are increasing EHR adoption at a faster rate than specialists and that physicians in practices with more than two physicians and those in the Northeast are adopting at a faster rate than others. As for intentions to qualify for EHR incentive funds (either Medicare or Medicare), data from the NACMS showed that 51.3 percent of physicians reported that they intended to apply. However, only 10.5 percent of those intending to apply actually have an EHR system with the appropriate functionality to meet MU requirements as stipulated by the EHR Incentive Program. The data also showed that those physicians working in physician-owned practices were significantly more likely to apply for EHR incentive funds. As for hospitals, the authors report on data collected by the American Hospital Association (AHA) Health Information Technology Supplement (also funded by ONC). The AHA survey of health IT adoption is sent as a supplement to AHA's Annual Survey. Data for the 2011 survey was collected from October through December 2011 from 2,646 hospitals, approximately 50 percent of all acute care hospitals in the United States. For this survey, EHRs are characterized as basic or comprehensive depending on various functions and extent of use. The AHA survey found that hospitals’ use of basic EHRs rose from 11.5 percent in 2010 to 18.0 percent in 2010 and the use of comprehensive EHRs rose from 2.6 percent to 8.7 percent. Of concern, the authors report that the gap between the use of EHRs in larger, urban teaching hospitals and smaller, rural hospitals is growing. Data show that adoption among lager hospital increased by 17.3 percentage points compared to 10.1 percentage points among smaller hospitals. The authors also point out concerns around hospitals' ability to fully meet MU based on key functionalities required (e.g., drug-drug and drug-allergy checks, quality reporting and CPOE).

Progress is Impressive but Providers Need Hands On Assistance to Meet Meaningful Use

As the RWJF report clearly shows, the adoption of EHRs has been on an upward swing for some time but has significantly accelerated since the passing of AARA and PPACA. The latest data being reported from CMS (March 2012) shows that a total of 225,765 providers have registered for the CMS EHR incentive programs - 222,282 eligible professionals (physicians, nurse practitioners, dentists, etc) including 148,476 under the Medicare program and 73,806 under Medicaid, and 3,483 hospitals. Payments, which began in May 2011, have totaled approximately $2.4 billion. While things are certainly moving in the right direction, albeit somewhat slowly, data from the RWJF report and CMS verify some key trends and potential concerns around EHRs that we have been tracking for some time. First, many physicians and hospitals are moving to digital technologies because they simply must in most cases. This is due to a number of factors in addition to incentive funds including growing complexities in reimbursement from both government and commercial payers; the need to drive cost efficiencies and streamline operations; the proliferation and growing familiarity with information technology; an explosion of data and information due to technological and scientific advances; and, most imperative, the need to improve the quality and safety of patient care. However, the adoption of EHR technology does not automatically translate into MU - that is, meeting the government’s core objectives around specific functions designed to improve patient care. This is due to technical issues around EHRs (i.e., some providers have EHRs that are not equipped with core MU functions like clinical decision support, etc) as well as logistical issues that providers face in actually adapting to workflow changes, some of which are quite daunting.

Technology Vendors Must Be Highly Proactive in Helping Clients Achieve Meaningful Use

As we are seeing more and more, getting to MU, and ultimately sustaining the process, is complex and multi-dimensional entailing significant changes in technology use, workflow, communication, and culture on both organizational and personal levels. MU is a living, breathing entity that must be continuously nurtured as the government adopts ever more stringent requirements to qualify for incentive funds. The drumbeat round MU complexities is growing louder, particularly since CMS released the proposed requirements for Stage 2, set to begin in 2014. While the government may continue to be flexible around timelines and some aspects of MU requirements, it is unlikely that requirements will significantly relax. What this means from a market perspective is that those vendors who have technologies and services that are particularly adept in helping clients meet and sustain MU will continue to gain. It will come as no surprise that the need is particularly acute for ambulatory providers and small hospitals. Vendors must be extremely proactive about understanding and meeting client challenges around MU, both technical and logistical. Selling the EHR technology is not enough – ongoing communication and support are critical for survival in this increasingly competitive market. Technology vendors must be willing invest time and resources in helping their clients succeed.

Sales and Marketing Collaboration

Holly Lyke Ho Gland — Wed, 16 May 2012 16:11:02 GMT

The Growth Team Membership™ (GTM) program recently surveyed marketing executives to identify their principal challenges for 2012. The survey found that marketers struggle to (1) cultivate a differentiated value proposition that resonates with clients, and (2) ensure Sales adopts the appropriate messaging and materials.

Survey respondents indicate that understaffing and a lack of strategic alignment across Sales and Marketing’s leadership are the primary causes of Marketing’s struggles. By joining forces with Sales, Marketing can address the strategic alignment issue and tap into additional staff. However, successful collaboration requires taking a closer look at the following three areas:

1. Goal Alignment—Since revitalizing the value proposition requires a substantial commitment in time and resources, it is essential that Marketing and Sales agree on the reason for the revitalization at the outset. To achieve this goal, marketing and sales executives need to build consensus on answers to the following questions:

Are our assumptions about how we are perceived by our customers accurate?
Can we quantitatively prove any of our assumptions?
How does our value proposition differentiate us from the competition?
Does our current messaging tell the story we want?
How consistently is our messaging being used?

2. Sales Involvement—No matter how necessary, or how compelling, the redesigned value proposition may be, the sales force may still resist it. Successful marketers understand that sales reps want some measure of control over the way they communicate with their customers and are prone to resenting outside influence. Marketers therefore involve the sales force throughout each stage of the new value proposition’s development (including messaging creation). This inclusion builds cross-functional ownership of the new messaging and limits the likelihood that Sales will reject it later on. Furthermore, it speeds new messaging roll-out, since the sales force will already be familiar with the value proposition and how to tailor its message for various segments.

3. Continuous Engagement—Trust and transparency are crucial to any long-term successful collaboration between Sales and Marketing. One way to maintain this openness is through regularly scheduled meetings between senior management in Sales and Marketing. Growth Team Membership researchers have found that a monthly cadence works best for keeping the conversation flowing, collecting feedback, and addressing collaboration challenges. Monthly meetings also allow marketers to track value proposition adoption and identify opportunities for improvement.

While sales and marketing collaboration is a perennial challenge, some companies have found ways to unite these often-at-odds functions. Take the experience of Kronos, a workforce management software solutions company. For many years, Kronos considered itself a market leader, in spite of its flat product revenue growth. This disconnect stimulated Marketing and Sales to collaboratively revise and differentiate Kronos’ value proposition and messaging. Kronos’ sales and marketing teams followed the practices outlined above—alignment, inclusion, and engagement—to overcome key barriers to collaboration. Successful collaboration has resulted in 92% of the sales force consistently using the messaging. Kronos’ new value proposition has also led to a 36% increase in its earnings before interest, taxes, and amortization (EBITA).

In conclusion, Growth Team Membership survey data suggest that marketers are committed to differentiating their companies through redesigned value propositions. However, Marketing’s efforts are constricted by a lack of coordination and buy-in from Sales. By including Sales in the development process, Marketing can ensure its efforts are adopted and strengthen its relationship with Sales for long-term success.

Want to learn more about best practices for sales and marketing integration?

Sales & Marketing: Revitalizing the Value Proposition

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Scenario Planning: Making Better Decisions about Tomorrow, Today

Jessica Jeffcoat — Mon, 14 May 2012 21:57:23 GMT

The future is inherently unpredictable, forcing companies to conduct strategic planning in the face of great uncertainty. As a result, many companies struggle to develop strategies that take into account long-term threats and opportunities, while balancing short-term priorities. Scenario planning is a structured methodology you can use to test existing strategies against varied future states or scenarios. Scenario planning is not meant to predict the future. Instead, it allows you to explore a series of high-impact, uncertain—yet plausible—future states. This knowledge, in turn, enables you to recognize the “signposts” of scenarios as they unfold and react accordingly.

Frost & Sullivan’s Growth Team Membership (GTM) profiled Merck & Co., Inc. (the global pharmaceutical company) and how it applied scenario planning. Merck’s objective was to better anticipate how different strategies would hold up against the state of the global healthcare environment looking out 10 years. What follows are some of the key insights the team gleaned in understanding Merck’s approach.

Garner Internal/External Insights and Buy-In

To establish plausible scenarios for the future, it is important to involve a cross-divisional team to garner the full range of views within the company. It is equally important to tap into external perspectives on the industry, and outside scenario-planning consultants, to lend credibility and objectivity to the effort. Finally, C-level buy-in and participation in the initiative must be secured.

Challenge Assumptions about the Future

Before you can start exploring future scenarios, you must first understand your existing assumptions about the future. What is the conventional wisdom about where the industry and economic, political, and regulatory factors are headed over the next 10 years? What assumptions about the future underpin this outlook? Once this information has been brought to light, you need to challenge your underlying assumptions to explore alternative future scenarios. It can be helpful to pose this question: What if, and how could, your assumptions about the future turn out differently? The answers to this question uncover they key uncertainties you have about the future and allows you to start envisioning different future scenarios that could emerge.

Explore Future Scenarios’ Implications

After considering a range of alternative future scenarios, it is important to focus on a digestible number of scenarios—generally no more than four—to explore in depth. It is essential to filter the scenarios by plausibility and impact to select the most significant, relevant scenarios for your company and industry.

Identify signposts of the future: A critical step in evaluating the final group of scenarios is to identify early indicators that would signal each scenario is coming to pass. A company should continually monitor this list of indicators to look for early warning signs so it can determine what, if any, strategic shifts are necessary. This enables you to hedge your bets against future risks and gain a first-mover advantage.
Test current strategies against divergent futures: It is important to think about how your company’s current strategies would perform in the context of each scenario. What challenges and opportunities would you face? What actions should you consider taking now to prepare for each scenario?

Revisit Investment Decisions

Once you have identified and explored the most plausible scenarios, the next step is to present your findings to executive management and help them internalize the scenarios’ implications. It can be beneficial to run an investment exercise with executive management that compares their current long-range resource allocations with the allocations they would make in the context of each future scenario. If a particular scenario were coming to fruition, how might your company change its resource allocations toward existing and new business areas? This type of exercise can translate scenario planning into strategic discussions and decision-making about the future.

Learn from Merck’s Approach to Scenario Planning

Scenario planning enabled Merck to embed longer time horizons in its strategy planning, gain a deeper understanding of its internal capabilities and the competitive landscape, and prompt scenario-based resource allocation decisions.

Register for a complimentary webinar on May 22^nd featuring the Merck case and learn how Merck used scenario planning to explore long-term threats and opportunities.
Download a three-page sample of the Merck Best Practice Guidebook, Scenario Planning: Fostering Long-Term Strategic Thinking.
If you have questions regarding the Growth Team Membership™, contact us at GTMResearch@frost.com, follow us on Twitter @Frost_GTM, or visit us at www.gtm.frost.com.

[Mobile Photos] Live from ATA - San Jose

Daniel Ruppar — Tue, 01 May 2012 15:15:26 GMT

MarketWatch talk Q&A in the Business session track, Speaker: Zachary Bujnoch - Senior Industry Analyst, Connected Health

[Survey] Visit Frost & Sullivan at ATA 2012 and Provide Your Input on Telehealth

Daniel Ruppar — Fri, 20 Apr 2012 04:46:00 GMT

Posted the ATA link the other day, but wanted to post this as well along with our pre-event survey link for interested parties....

The telehealth industry can be convoluted and confusing despite significant efforts by the industry. As a result, success in telehealth hinges upon proper understanding and identification of the markets, as well as an awareness of voice of the customer basic questions, such as who are the customers and what are their needs?

Meet Frost & Sullivan’s leading Connected Health analysts at ATA 2012 at

Booth 1703

To share and explore the

Top 20 Telehealth Markets

Click Here to Participate in Frost & Sullivan’s Pre-ATA 2012 Survey

We also invite you to participate in the above survey. Current users and vendors’ perspectives are welcome. The survey should take only about five minutes of your time. Resulting research will be shared with all survey participants.

We look forward to meeting you at ATA 2012.

Come see us at the American Telemedicine Association meeting in San Jose! April 29-May 1, 2012

Daniel Ruppar — Mon, 16 Apr 2012 15:16:49 GMT

Multiple people from our Connected Health group will be at the American Telemedicine Association (ATA) meeting in San Jose, as Frost & Sullivan is a Media partner for this event. We also will be at booth 1703 in the Expo and surveying on trends in telehealth. Hope to see you there. Feel free to contact Daniel Ruppar for scheduled meeting opportunities through our main number 210-348-1000.

[VIDEO] Panel Discussion at Digital Health Summit CES 2012

Daniel Ruppar — Mon, 09 Apr 2012 20:09:00 GMT

Is technology changing the doctor-patient relationship?

As preventable medical conditions such as obesity continue to grow so does the need for patient involved healthcare. The doctor-patient relationship is critically important to bridging the gap between passive patients and informed medical consumers. Innovative technologies are the enabling factor for this, but are they succeeding — and how long will it be before we start seeing significant changes?

Moderator: Zachary Bujnoch, Senior Industry Analyst, Frost and Sullivan
Panelists: James White, Vice President, Connected Hospital, Alcatel-Lucent
Gene Frantz, TI Principal Fellow, Texas Instruments
William Reid, FACHE, VP, Product Management, Numera
Alexandra Von Plato, Executive Vice President, Chief Creative Officer, Digitas Health and Razorfish Health

Intro: Jill Gilbert, Producer, Digital Health Summit

Frost & Sullivan Medical Device Event - Take Aways from Panel on mHealth

Daniel Ruppar — Fri, 06 Apr 2012 13:54:57 GMT

There was great attendance and discussion at our event in San Diego around telehealth and mobile health solutions in healthcare. The panel session “mHealth: Are You Ready to Be a Driver of the Future?” featuring executives from Airstrip, Blue Highway, Welldoc, and the Global Hospital Virtualization Program was an exciting one for the conference addressing mobile health, which is of high interest and visibility in the industry currently.

One point of discussion was - why is this now a key point for mHealth in medicine? Airstrip Technologies CEO Alan Portela discussed how with the shift to outcomes based medicine, the shortage in physicians, and increased patients with needs for chronic disease management, physicians must become mobile professionals. With that they need immediate access to needed information and decision support regardless of location in order to be able to manage their patient load. Essentially mHealth has become a mission critical technology to bring data to the caregivers wherever they are, versus physicians having to go to one certain place in order to be able to access information for patient care.

From the panel, another key point in mHealth is getting the health system to fully understand and realize the ROI of the use of mobile technology in the practice of medicine – which is not just about dollars but more importantly is about outcomes. Portela discussed how the real time transfer of EKG information from an ambulance to the hospital through their solution can enable a cardiologist to diagnose and ready the cath lab before the patient presents, and therefore through that faster cycle time, result in better outcomes, less ICU time, and other direct benefits to the patient and system. Blue Highway CEO Al Di Reinzo gave the example of a seizure patient where first responders can have an EEG read remotely, and therefore be able to make more informed medication decisions on-site prior to transfer, resulting in lower patient risk, and better outcomes.

Regarding the continued changes in consultation through mHealth, Danny Petrasek, Director - Global Hospital Virtualization Program, discussed that 50-80% of medical problems can be diagnosed through a conversation, thus presenting an opportunity of a massive volume of care which could be taken on remotely through new options in IT enabled approaches. A shift in increasing remote consultation, especially with the ability to bring diagnosis further in terms of penetration in to the home, brings with it both direct and indirect cost savings.

Overall, the panel did an exemplary job addressing major critical issues in mHealth. Due to the advancements in IT and mobile technology over the last several years, telehealth is now at a point of evolution where it can make a transformative difference in the practice of medicine, as well as business models, to deliver an overall continuum of care through connected health solutions.

Customer-Centric Shortfall: 2012 Global Sales Leadership Priorities Survey

Jessica Jeffcoat — Thu, 05 Apr 2012 18:20:22 GMT

By Jessica Jeffcoat, Research Analyst, and Holly Lyke-Ho-Gland, Research Lead, Growth Team Membership™ (GTM)

Frost & Sullivan’s Growth Team Membership™ (GTM) recently completed its 2012 survey of sales executives globally. The executives were asked to identify their most pressing challenges for 2012. GTM will focus its best practices research to address the prominent issues identified in the survey.

Sales Leadership in 2012—A Snapshot

Implementing lead generation strategies is the primary challenge of sales executives.
A lack of personnel is the root cause of the primary challenge.
In comparison to 2011, staffing levels will remain static while budget levels are expected to increase moderately in 2012.
Companies attribute 20 percent of their sales to distribution channels and partnerships.
In the main, Sales uses social media to identify and qualify leads.
LinkedIn is the primary social media platform used by Sales, and is typically used to improve sales reps’ knowledge of customer needs and to boost brand recognition.

2012 Sales Leadership Survey Executive Summary

The 2012 survey reveals that sales executives continue to wrestle with a perennial issue: improving customer focus. Specifically, sales leaders must employ more effective tactics to generate high-quality leads, map their sales cycle to customers’ purchasing behavior, and incorporate customer feedback into their sales strategies.

To examine these challenges in more depth, the survey asked respondents to “root cause” their top internal challenges by indicating if they stem from issues with staffing, process, technology/systems, or strategic alignment. Sales executives attribute their challenges to two primary causes: limitations in staffing (limited resources and lack of knowledge) and processes (ineffective processes and inadequate communication). Sales executives are unlikely to see staffing improvements in the next year, as most respondents anticipate staffing levels will remain static in 2012. Budgets, however, are expected to increase moderately in 2012. Despite concerns over inadequate staffing and processes, nearly half (49 percent) of the survey respondents rate their function’s effectiveness as “above average.”

Given social media’s prominence and its ability to give sales executives an additional window into customer needs and behaviors, the survey asked respondents about their use of social media. The majority of respondents (54 percent) indicate they participate in social media as part of their sales approach. More specifically sales reps are employing social media to identify and qualify prospects, collect information on customer needs, and maintain customer relationships. Sales executives predictably are using LinkedIn as their primary social media platform and are conducting individual searches and joining special interest groups to enhance their understanding of customer needs. While the majority of respondents actively participate in LinkedIn’s special interest groups, few sales executives moderate their own groups and thus do not take full advantage of LinkedIn’s ability to help boost brand recognition.

In response to questions about their use of virtual and social media tools in sales activities, respondents indicate universal use of tele-presence and/or live streaming video to increase sales productivity. However, the majority of sales executives indicate they are not employing social media CRM systems (e.g., Nimble), monitoring platforms (e.g., Radian 6), or dashboards (e.g., Hootsuite or MediaFunnel). This is unfortunate given that these tools magnify the benefits of social media activities by collating customer information, which helps facilitate the creation of customer insights. In addition, more than half of the respondents do not use predictive analytics—the analysis of customer behavioral data to identify patterns and provide insights for customer interactions—which is a key customer analysis tool. It is noteworthy that most sales executives are not using these tools despite citing the need to improve their understanding of customer needs and behavior.

Respondent Demographics

There were 564 respondents.

The respondents work predominantly for privately held (56%) rather than public (34%) companies.
The majority of the respondents (69%) work in a business-to-business environment.
Most of the respondents (39%) come from firms with revenues below $100 Million (USD).

For a more detailed analysis of the survey results, including analyses by business model, please see the attached report.

If you have questions regarding the survey, or are interested in learning more about GTM’s marketing best practices, please contact us at: GTMResearch@frost.com, follow us on @Frost_GTM, or visit us at www.gtm.frost.com