The document provides an overview of Andy Wilkins' background in healthcare consulting and digital health. It discusses the large size of the global healthcare market and rising costs driven by chronic disease, aging populations, and new medical technologies. It also outlines some of the key challenges in digital healthcare adoption, including modifying patient behaviors and overcoming barriers across the healthcare ecosystem. Finally, it identifies opportunities in areas like aged care and improving the outpatient experience through better support for patients outside of clinical settings.

1. Digital Health: Understanding the
healthcare and technology challenges
Andy Wilkins
Independent healthcare consultant
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2. My health Background Highlights
NHS
• Co-authored “Digital First” report for NHS England
• Co-authored “The Future’s Digital” mental health report for NHS Confed + NHS England
• Co-authored mHealth report for NHS England
• Innovation model recommendations for NHS/private sector collaboration
• Patient Experience research & innovation report for Royal Free Hospital
Private Sector
• Diabetes Patient & clinical needs research & report for Sanofi Aventis
• Health market assessment & recommendations for O2 Health
• Interim head of eHealth strategy for Bupa
– Corporate employee health & wellbeing service design (behaviour change) - Bupa
– Market needs analysis for pregnancy and early stage motherhood – Bupa
– Market opportunities analysis for aged care – Bupa Care Homes
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3. Agenda
1. Background
2. Healthcare market size and trends
3. Digital healthcare challenges
4. Key opportunity areas
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4. Healthcare $6.5tn – welcome to biggest show on earth!
Total spend on healthcare is almost 10% of OECD GDP!
• Around 70% of health costs are due to preventable conditions
• Controlling healthcare costs is one of the biggest challenges for 21C!
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5. Why are health costs continuing to rise?
1. Rise in Chronic disease
(Lifestyle related)
• Obesity (26%)
• Diabetes (5.5%)
• Heart disease (4.4%)
• Cancer
• Mental health
2. Aging populations
• Longer life spans
• Changing demographic mix
3. Rise in medical costs
• Medical technology
• New treatments
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6. Today most healthcare spend is focused on sickness..
Healthy/low
risk At risk
High risk
Chronic Disease
early stage
Acute Disease
Chronic
Disease
Progression
End of Life
care
Healthcare Cost
CostValue
20% of population generate 80%
of healthcare costs
Healthcare Status
Preventing sickness Treating sickness
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7. Wholescale business model change is required…
350m consults/yr
£50/consultation
£25/consultation
Nursing care
Innovation needed to transfer diagnostics &
treatments to lowest cost point of delivery
Increasing cost & finite resources
42.5k GPs 358 NHS hospitals356k Nursing/
Healthcare visitors
80m consults/yr
£250/consultation
60 Million People
Traditional
healthcare Primary care
Secondary care
Digital
healthcare
mHealth Opportunity• Telehealth
• Monitoring
• Personalised
medicine
• Preventative care
Smartphones & IoT
Monitoring Devices
Electronic Health Records & Care Pathway workflow
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8. “You‘ve got to start with the customer
experience and work back toward the
technology - not the other way around.”
Steve Jobs
Technology as an enabler not a solution - Apple
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9. Understanding what patient experiences to create is not easy….
What?
Who?
When? 9

10. Designing Digital healthcare solutions
Understand the ecosystem context
• Who are the players and what does good look like for them?
• How will they measure success?
Understand the Patient’s context
• What value will they get from the solution (could be different from clinician’s)
• In what contexts will this be used?
• Do you understand the patient journey – physical, cognitive and emotional
• What usability issues need to be considered
Understand the clinical context
• What are the outcomes that define success?
– Clinical outcomes
– Care pathway measures
– Economic
– Technical
Wellness Prevention
(at risk)
Diagnosis Treatment
Healthcare providers & Regulators
Healthcare Payers & Insurers
Lifestyle, Fashion & Wellbeing
brands
Health Service Providers
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11. Modifying behaviour is harder than the technology!
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Mental
Physical
Environment
Financial
Social
Life
satisfaction
Intellectual
BehaviourChangeStrategies
Personal
Wellbeing
• Diet & nutrition
• Exercise
• Substance abuse
• Disease management
• etc
• Mental health
• Stress
• etc
There is now compelling evidence to show that people do not make rational decisions
to improve their health & wellbeing…. mHealth providers need to use new techniques
MINDSPACE
Messenger
We are heavily influenced by
who communicates information
Incentives
Our responses to incentives are
shaped by predictable mental
shortcuts such as strongly
avoiding losses
Norms We are strongly influenced by
what others do
Defaults
We go with the flow or preset
options
Salience
Our attention is drawn to what
is novel & seems relevant to us
Priming
Our acts are often influenced by
sub conscious cues
Affect
Our emotional associations can
powerfully shape our actions
Commitment
We seek to be consistent with
our public promises and
reciprocate acts
Ego
We act in ways that make us
feel better about ourselves
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12. The explosion of wearable sensors will create a revolution through
passively recording and monitoring health & physiological data
Primary Care
A&E
Secondary Care
Nursing Care
Health information
Public Health
Pharmacists
Social Care
Health Insurance
3rd Sector Support
Fragmented data held by health system silos
The transactional patientThe quantified selfHealth & Wellbeing
Behaviour Tracking
Physiological
Tracking
EHR
My
data
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13. There are ecosytem barriers to widescale adoption…
Wellness Prevention
(at risk)
Diagnosis Treatment
Medical device, pharma &
content providers
Developers & ICT industries
Digital Health
Solutions
Healthcare providers & Regulators
Healthcare Payers & Insurers
Lifestyle, Fashion & Wellbeing
brands
Lack of mHealth
skills
Health Service Providers
Constraints & Enablers
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14. Opportunity Areas
Andy Wilkins – Health 2.0
1. Aged Care
2. Outpatient care
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15. Senior person
Their family &
support network
Aging Journey End of life
Their medical
provider
Self sufficiency
Reliance on supporting services
Living at home Support at home Assisted living Care home
Digital & Telehealth service opportunities
Market opportunity – 10m 65+
2. Medical Support – managing my condition
3. Wellbeing Support – living well
1. Care Support – looking after myself
There are huge opportunities in aged healthcare
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16. • The Royal Free Hospital serves 500k outpatients per year
• They new their patient experience was poor
• We were asked to research the patient journey & make recommendations
The Royal Free Hospital in
NW London
The Royal Free has an ambition to become a world class hospital
Players in the healthcare system are now aware they
need radical change in order to achieve their objectives
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17. Deep dive patient research which enabled us to identify
over 400 needs along a structured customer journey
Backstory Appointment
journey
How they felt
about their
experiences
What else could
make a
difference
Patient Interviews1. Conduct patient interviews &
observations
Contexts
Functional
needs
Emotional
needs
Wider support
needs
2. Interview analysis to extract
needs & experiences
Contexts
Functional
needs
Emotional
needs
Widersupport
needs
Contexts Functional
needs
Emotional
needs
Wider support
needs Contexts Functional
needs Emotional
needs Wider support
needs
Contexts
Functional
needs
Emotional
needs
Wider support
needs
Contexts
Functionalneeds Emotionalneeds Wider supportneeds3. Collate multiple interviews to
build end to end outpatient
experience journey
4. Analyse patient experience needs
to create solution ideas
Over 400 needs
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18. Research revealed that the patient journey is broken with
many disconnected experiences – lots of opportunity!
PRE-CONSULTATION POST CONSULTATIONCONSULTATION
Referral DischargePre-appt Travel Arrival Clinic
time
travel Post-appt
Visit a GP due to
health issue
Obtain a referral Find out more about
my condition
Prepare for my appt Travel to my appt Arrive at hospital
Determine location,
proceed to clinic
Arrive at clinic,
register for appt
Wait for appt
Meet doctor for
appt
Test / procedure
Obtain advice /
follow on appt
Onward travel Manage condition Obtain a discharge
Significant numbers of
patients are being
referred unnecessarily
clogging up the system
Patients need and want
more information to help
them plan & prepare for
their appointment visits
There are multiple issues
around directions, travel
planning & parking that
cause significant
frustration & difficulty to
patients who are ill
First impressions are
chaotic and unwelcoming
and hospital navigation is
confusing
Waiting is key frustration
for patients with many
clinics offering a dingy,
overcrowded & poor
experience
Testing & consultation
procedures often
involves more waiting &
queuing
Consultation templates of
fixed lengths often lead to
rushed appointments &
patients feeling unable to
express themselves or
unclear on doctor
explanations & instructions
Limited information &
support for ongoing
patients leads to poorer
condition management &
outcomes + greater
readmission rates
Inconsistent discharge
procedures lead to
unnecessary follow ups
that further clog the
system
Overbooking leads to
significant delays in
availability and appointment
choices impacting patient
outcomes and convenience
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19. Research from Kaiser Permanente shows that outpatients
spend 0.01% of their time with doctors & 99.99% on their own
PRE-CONSULTATION POST CONSULTATIONCONSULTATION
Referral DischargePre-appt Travel Arrival Clinic time travel Post-appt
My Life
1. Visiting the hospital
2. Managing with a
medical condition
Patients receive minimal support
at the time they most need it!
This is where health happens!
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20. PRE-CONSULTATION POST CONSULTATIONCONSULTATION
Referral DischargePre-appt Travel Arrival Clinic time travel Post-appt
My Life
1. Visiting the hospital
Understanding
& ownership of
my condition
• Understanding my condition/ treatment
• Personalising my care plan
• Taking ownership of my condition/
self management
Managing my
treatment & my
condition
• Support for managing my condition
• Obtaining support from family for managing my condition
• Support from other patients for managing my condition
• Monitoring my condition
Obtaining
support from my
doctor & care
team
• Communication
access to my doctor
& clinic teams
Carrying out
tests &
obtaining
supplies
• Undertaking repeat tests
& procedures
• Obtaining repeat medical
supplies
Support for
medical queries
and emergencies
• Medical queries
• Emergency support
Managing &
coordinating my
appointments• Coordinating & managing
my hospital appointments
Huge “white spaces” exist in the patient’s world where personalised
info & tools would provide significant help & improved outcomes
2. Managing with a
medical condition
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21. I will leave you with an important medical tip…
“Never under any circumstances take a sleeping
pill and a laxative on the same night.”
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22. 2222
Thank you…..
Andy Wilkins
+44 (0) 7713 266626
andrew.wilkins@btinternet.com
Andy Wilkins – Health 2.0