Modeling Values-Based Business with the Business Innovation Kit
Medicine2.0'10: Business Modelling to advance the development and implementation of eHealth technologies
1. Business Modelling to advance the development
and implementation of eHealth technologies
Maarten van Limburg, MSc, BEng
Elly Kloeze, MSc
30 November 2010, Maastricht
2. MAARTEN VAN LIMBURG, MSC, BENG
Background in Business IT and Innovation Management
MSc project: Business model for a Dutch PHR service
PhD Student: “eHealth Business Modelling”
Eursafety Health-net project
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3. IN THIS TALK
Why the implementation requires attention
Explanation on business models and business modelling
Why business modelling in eHealth
Introduction of CeHRes Roadmap
Example case: Business Modelling for a teledermatology project
Current projects and future research
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4. IMPROVING eHEALTH TECHNOLOGIES
More focus on how to improve eHealth technologies
User-/Human-Centered Design
Involving the users of the technology
Improving usability
eHealth technologies reflect users needs and behaviour better
Persuasive technology
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5. IMPLEMENTATION OF eHEALTH TECHNOLOGIES
Implementation of eHealth technologies still problematic:
eHealth technologies don’t catch on in practice
Lacking support from insurance companies, health professionals, etc
No self-sustaining revenue model
Fragmented – difficult to scale up
Too technology-driven
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6. STAKEHOLDERS
There are a lot more parties involved than just users
For the implementation the stakeholders are relevant
- health insurance companies
- healthcare organizations
- healthcare professionals
- government
- ...
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7. STAKEHOLDERS
Stakeholders aren’t neccesarily users of the technology
“Anyone who affects or gets affected by the technology” (Freeman)
Stakeholder types: policymakers, vendors, insurers, healthcare
organizations and providers, home care, employers and patients (Cain)
Every eHealth technology will have its own, specific stakeholder network
(sometimes also refered to as ecosystem)
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8. STAKEHOLDERS EXPECT VALUE
Stakeholders expect certain benefits in return for participating in the
eHealth technology.
“one good turn deserves another” (Proverb)
Something valuable
How can we make the implementation value-driven?
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9. BUSINESS MODELS
“a business model is the rationale of how an organization creates,
delivers and captures value” (Osterwalder)
Used in strategic management to assess innovations
Basis for implementing an eHealth technology:
Assessing the implementation a priori
Guideline for operationalizing the technology in practice
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11. BUSINESS MODELLING
Involving stakeholders in composing the business model, they need to
accept the implementation after all.
Discovering what value they want
Consensus, finding a fit (HOT-fit)
Co-creation
Continuous process
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12. SO WHY BUSINESS MODELLING IN EHEALTH?
As said, it can help the implementation:
Sustainability
Cost-effectiveness
Holistic approach
Value-driven
Co-creation and collaboration
Flexible and reflective
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13. DEVELOPING IS IMPLEMENTING
Makes the whole development process value-driven
If stakeholders find something valuable, make it, implement it
And if they don’t, don’t!
Implementation influences development
Development influences implementation
The environment determines, not only one party (outside-in)
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14. DEALING WITH MULTIDISCIPLINARITY
eHealth is multidisciplinary (Pagliari)
Brings different types of stakeholders together
Diverse values
“Value” can act as a common ground:
# of patients
$$$
Quality
Work to a consensus or fit
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15. STAKEHOLDER NETWORK BECOMES A PLATFORM
Multidisciplinary nature means that collaboration is important
Getting the group who need to eventually collaboration together whilst
implementing
If it doesn’t work now, it won’t work later either
Finding the context of the problem
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16. OPENNESS
Collaboration requires openness
Open business models (Chesbrough)
Disease Management -> Organizational barriers fade
Willingness to co-create
Using standards
Avoid problems from fragmentation
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17. FLEXIBILITY AND EVALUATION
Formative evaluation
A business model grows:
Discovery driven (McGrath)
Evaluate assumptions
Environment is dynamic
Summative evaluation
Technologies and implementations aren’t forever
Still feasible/sustainable/cost-effective? Or re-design?
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18. CEHRES ROADMAP
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19. CEHRES ROADMAP - INSTRUMENTS
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21. ELLY KLOEZE, MSC
Background in Health Science & Policy
MSc project: Business model for a Teledermatology project
Researcher on business modelling for diabetic foot care and Pal4.
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22. EXAMPLE CASE: Teledermatology
Using CeHRes Roadmap for a teledermatology (TD) eHealth technology
Tele-diagnostic device chronic wounds
Automated diagnosis
Wound evolvement
Problem Stakeholder Design Scenarios
identification analysis requirements Infrastructure
wound care
Stakeholder- Values Technical
mapping feasibility Business
Functional
model
requirements
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23. CONTEXTUAL INQUIRY
First indication stakeholders
Focus group
Problem statement (step 1)
General solutions (step 2)
Contribution of technology (step 3)
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24. VALUE SPECIFICATION
Definitive stakeholders project
Stakeholder interviews (n=11):
Determine values
A value = “something that is beneficially and desirable for a
stakeholder.”
Determine attributes (how to realize values?) and requirements
(specification of attributes)
Rank the values, attributes and requirements (1-5)
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25. ATTRIBUTES & REQUIREMENTS
Example of scored attributes and requirements
Nine overview schemes per stakeholder
Program of functional stakeholder requirements
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26. ATTRIBUTES & REQUIREMENTS
Example of scored attributes and requirements
Nine overview schemes per stakeholder
Program of functional stakeholder requirements
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27. Functional requirements
high performance quality camera and technical system
objectifying shape, surface, depth, color, total size
under leg, temperature, wound edge conditions
providing images
involve patient by technique and results
sharing a portal between health care providers
more alignment chain of care
transparency and uniformity of communication
financial support
integration with wound score sheets
store history and additional disorders patient
work on behalf of standard protocol
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28. DESIGN
More specific information about the characteristics of the design and
format of the TD device
Examples: handy, disinfection option, stand alone device etc.
Match stakeholder requirements with technical requirements
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29. OPERATIONALIZATION
Different scenarios:
Role of the TD service provider
Scenario 1: the General Practioner (GP) takes an image of the wound
and sends the image to the dermatologist
Scenario 2: the home care nurse takes an image of the wound and
send the image to the GP
Interaction networks
Who pays for which service? Who benefits? Who have a contract with
whom?
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30. WHICH SCENARIO SUITS BEST?
Validation of the interaction
networks:
Different stakeholders
Brainstorm session technology
provider TD device
Scenario 2 is preferable:
the economics of scale
wound care structure
improves:
nice tool for communication
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32. BUSINESS MODEL FOR SCENARIO
How technology fits in
business model of partner
(Openness)
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33. SUMMATIVE EVALUATION
Can take place after the TD device is deployed
Test first prototype in clinical setting
Test advanced prototype
Results unknown for now
Robustness roadmap
Reflect on participatory development process
Cost effectiveness
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34. CURRENT PROJECTS AND FUTURE RESEARCH
Different case settings:
Eursafety Health-net
Personal Assistant for life (PAL4)
Diabetes Interactive Education Program (DIEP)
Refine and test roadmap, improve robustness
Added value for the development of eHealth technologies
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35. THANK YOU
E-mail : a.h.m.vanlimburg@utwente.nl
: e.kloeze@utwente.nl
www : www.ehealthresearchcenter.org
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