My perspective of the healthcare industry

PRESENTATION TO

ABC BERHAD

My Perspective of the Healthcare Industry

By Dennis Ooi Kok Peow

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Agenda

The Environment A The Opportunity B

Complex Business Environment 1.

Navigating the Business Environment

2.

Major Trends – Changing Deliveries

Globalisation of Healthcare

5.

PESTLE Analysis

3.

4.

6.

.

Changing Demographics

Business Planning 1.

3.

4.

Expanding the Network

The Future

2. Transforming Pantai

3

Political &

Regulatory

Emerging Opportunities

Cultural

Growth Functions

Growth Team

Growth Process

Career Development

Non Customer

Demo- graphics

Behavior

Competitor’s Customers In-Direct

Competition

Competitive Strategy

Competitive Benchmarking

Emerging Competition

Country Risk

Economic Trends &

Issues

Economic Threats

Economic Trends

Emerging Technology

New Applications

Disruptive Technologies

Industry Expansion Potential

Industry Convergence

Industry Shifts

External Industry Impact

Industry Integration

ECONOMIC

BEST PRACTICES

CUSTOMER

COMPETITIVE

TECHNOLOGY

INDUSTRY

Complex Business Environment

LOCAL LANDSCAPE

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LOCAL LANDSCAPE

Maintain an effective Growth Plan for 3 - 5 years in the future; create and develop the Growth Team; ensure Growth Team members understand their functions and contributions to growth; leverage industry Growth Thought Leaders and best practices.

TECHNOLOGY

BEST PRACTICES

INDUSTRY CUSTOMER

ECONOMIC COMPETITIVE

Identify geographic expansion opportunities, monitor the political and regulatory effects of doing business in Malaysia; understand cultural implications and requirements Ensure a solid understanding of

emerging technologies: affects and opportunities; plan for potentially disruptive technologies; leverage new products and/or applications for growth

Maintain a solid grasp of key industries and the industries that could have an impact on Pantai’s business; identify factors that are causing new trends and changing buying behaviours; address industry convergence and integration; identify opportunities to expand within the market

Know any and all emerging competition; identify alliance partners; benchmark growth against the industry; refine competitive strategy; monitor market perceptions, changing processes, technologies, culture, etc.

Identify unmet needs; customise products and services to market needs; manage brand equity; identify emerging customer segments; keep track of changing cultural trends

Identify current and future economic trends; identify growing customer segments; take advantage of emerging opportunities; adjust for currency changes

Navigating the Business Environment

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Patient centred care

2010 2020 2015

Power Patient Generation

Major Trend

Major Trends – Changing Healthcare Deliveries

Patients Become Customers

Personalised Healthcare

Healthcare Globe Trotters

Hospitals Go Virtual

Smarter Drugs

Devices Become Monitors

Innovation vs. Knowledge

CyberDocs

Prevention Before Cure

1

2

3

4

5

6

7

8

9

10

Baby Boomer retirement starts

Patients became healthcare Kings and Queens

Patients gain access to health quality information

Consumerism

holistic health and well being

One stop shop Customised products Home services

Genetic testing

Targeted clinical trials

Information based medicine

Major diseases understood at molecular level

Wellness care Presymptomatic diagnostics & treatments

Immediate Treatment abroad becomes an option

"medical tourism" crosses the US$2 billion mark

Private companies invest in facilities and services abroad

All departments/buildings within hospitals are connected

Medical communities become interconnected

Regional/Country-wide connectivity

Non-invasive delivery Drugs will enhance productivity, memory, and physical performance

Disease management Remote patient monitoring Self-monitoring

War for medical talent Medical professionals keep up with knowledge growth

Baby Boomer retirement starts

Virtual face to face doctor- patient relationship

Perform routine diagnostics with predictive precision

Cheaper care available to more people in need

Early treatment Implementation of IT Precise therapy becomes reality

Source: Frost & Sullivan

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PESTLE Analysis

Increase influence by regulatory bodies POLITICAL Increasing harmonisation Growing Political Focus and

Pressure on Healthcare

Spend per capita on health globally grows

ECONOMIC Divide between the EU, US and rest of the world grows

Global ‘Not for Profit’ Pharma Supply for developing countries

Reduction in pharma growth (business model changes)

Patient Centric Healthcare

SOCIAL Increasing pressure from patient groups Health awareness (prevention)

Ageing population

Internet TECHNO-LOGICAL

Information Based Systems

LEGAL

Therapeutics>Theranostics (Rx/Dx)

ENVIRON-MENTAL

Mergers and Acquisitions

Personalised healthcare

Medical Ethics Health education Raised consumer expectations Increasing customer awareness

Pharmacogenomics

Drug Design

Genomic Drugs

Health card / Smart Cards Combined diagnostics and therapeutics

Customised treatments

Direct to Patient Advertising

Biogenerics/biosimilars

Privacy

Faster Drug Approvals Medical Errors / Safety

Genetic Discrimination

Biotech companies transition to Pharma companies

Development of specialist therapy providers

Impact of HIV and other pandemics

2010 2020 2015

Source: Frost & Sullivan

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Changing Demographics - Increase in Ageing Population

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$12,500 $9,200 $7,800 $14,500 $13,125 $33,000

Singapore Thailand India Costa Rica Mexico United States

Globalisation of Healthcare

$16,000 $9,500 $5,900 $11,500 $16,800 $27,500 Laparoscopic

prostatectomy

$4,500 $4,500 $2,238 $6,500 $4,275 $19,000 Laparoscopic

hysterectomy

$10,000 $8,500 $6,500 $9,500 $10,500 $21,000 Knee replacement

$9,000 $8,000 $6,500 $13,000 $9,400 $45,000 Hip replacement

$13,500 $11,000 $6,650 $13,600 $14,400 $37,000 Heart bypass

Angioplasty

Procedure

Source: PlanetHospital Note: Prices do not account for travel or accommodations costs. Expenses can also increase if there are complications with the procedure. United States rates reflect Medicare reimbursements for hospital services but not for medications or anesthesia.

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Transforming Pantai

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Current Approach “Find It and Fix It”

Future Approach “Health Adviser and Management” Care is based primarily on visits Care is based on continuous healing relationships

Professional autonomy drives variability Care is customized according to patient needs and values

Professionals control care The patient is the source of control

Information is a record Knowledge is shared and information flows freely

Decision making is based on training and experience Decision making is evidence-based

Do no harm is an individual responsibility Safety is a system property

Secrecy is necessary Transparency is necessary

The system reacts to needs

Cost reduction is sought Waste is continuously decreased

Preference is given to professional roles over the system

Cooperation among clinicians is a priority

Needs are anticipated

Transforming Pantai

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Patient appears (falls sick)

Patient is treated “find it and fix it”

Patient is discharged

Patient then disappears from the system

Current Approach

“Find It and Fix It”

Electronic Health Records (EHRs)

Chronic Disease Management Systems

Personal Digital Assistants

Disease Management Program

Home monitoring devices

Personal Health Records

Web- based education and support

Patient Scan

Good Chronic

Disease care

Patient Support

Tools

Telehealth for virtual

interactions

Sharable Personal Health Records

Web portals to EHR

Systems

Provider Support

Tools

System oriented to acute illness

Patient’s role not emphasised

Follow up sporadically

Prevention overlooked

Future Approach

“Health Adviser & Management”

Transforming Pantai

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Output

Week 0

• Data pack for first business planning day

Weeks 1 – 3

• Vision, strategic objectives and work plan agreed

Weeks 4 – 6

• Agree final work to be conducted

Weeks 8 – 12

• Finalised business plan ready for board review

Activities

Indicative timing

Pre-meeting preparation

• Compile available data on market trends, customers, suppliers, and competitors

• Compile information on financial performance

• Articulate preliminary vision statement and key strategic objectives

Business planning session

• Review market environment

• Review relevant external factors

• Review competitive position and key success factors

• Develop and agree focus topics (SAPs), defining objectives and key elements

• Develop draft milestones and targets for each SAP

Progress review meeting

• Review progress

• Reaffirm vision and strategic objectives

• Begin building financial models

Final business plan review

• Confirm vision and strategic objectives

• Present final business plan

• Review financials

Business Planning

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S

T

O

W

High service quality/personnel

Modern medical equipment

Well-managed operation

Strategic location

Strong shareholders

Friendly local government policy “Medical hub”

Ringgit weakening

Riding on the strength of Parkway Group

About 200k people from Indonesia and 50k from Malaysia are visiting Singapore for medical treatment

Energy cost increases

Shortage of doctors, nurses and specialists

Recognition of Thailand, Singapore, India as legitimate medical destinations and the players are fast improving

Shift from sellers market to buyers market

Emerging of new entrants in medical tourism business from other industries

Not JCIA approved

Comparing to leading players in Singapore, Thailand, and India; Pantai is lacking behind in terms of:

IT infrastructure

Track record in solving complicated cases

Foreign language translation services

International branding and marketing network

Business Planning

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Reasons for Engaging in Medical Tourism Overseas

• Relatively lower medical fees

• Long waiting list for medical services locally

• Inadequate medical facilities or techniques locally

• Advanced technology or facilities overseas

• Integrated medical and cultural experience overseas

• Comprehensive planning of insurance system

Critical Success Factors

• Enhanced trust level as there is no language barrier when seeking medical attention

• Low-cost

• Advanced medical techniques and state-of-the-art facilities

• Professional medical features

• Instant and applicable medical tourism package planning

• International marketing propaganda

• Lifting of restrictions on medical related laws and ordinances

Strategic Direction for Expanding Medical Tourism Business

• Obtain JCI accreditation

• Increase the number of alliances with

• international organisation that promotes medical tourism

• foreign-based healthcare insurers

• medical travel agencies

• world-renowned medical research institutions

• Set up elites club that entitles its members to lifetime privileges

• Expand foreign language translation services

• Expand wellness services

• Establish collaboration with hydrotherapy, spa, shopping center and beach resort in order to create global advertisement

• Offer customised diets to suit the need of patients of different cultural backgrounds

• Recruit skilled medical team who received training in the U.S. or Europe

• Offer comprehensive planning of instant medical packages that suit travelers’ needs depending on their lengths of stay

• Disclose medical and wellness services fees on the website

• Offer various competitive medical provisions, health checkup and surgery packages at fixed price

Business Planning

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Health Care Processes

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Adm

issio

n

Admitting

Scheduling

Pre-certification

Registration

Key

Requir

em

ents

Timeliness

Accuracy

Key

Measure

s

Ease of Getting Appointment (OP)

Number of Correct Registrations

Multid

iscip

linary

Care

Multidisciplinary Care

Initial Assessment

Planning

Intervention

Evaluation

Modification

Resolution Key R

equirem

ents

Timeliness

Accuracy

Reliability

Access

Responsiveness

Empathy

Competence

Key M

easure

s

Wait Times

Medication Errors

Patient Falls

Patient Identification Errors

Inpatient Clinical Care Index

Outpatient Clinical Care Index

Cost per Day

Length of Stay

Care

Support

Serv

ices

Care Support Services

Laboratory

Radiology

Pharmacy

Nutrition

Key

Requirem

ents

Timeliness

Accuracy

Competency

Appropriateness

Key

Measure

s

Turnaround Time

Stockout Rates

Nutrition Assessment

QA Measures

Business Planning

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Obstetric (OB) Service Balanced Scorecard

General Balanced Scorecard

Finance

Customer

Business Process

Learning and Growth

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Improve financial results

Remodel OB suite: Goal = complete by November

Increase net revenue of OB product line: Goal = 10%

Contract for emergency transportation: Goal = complete by November

Begin tours and survey: Goal = patient satisfaction >90%

Measure market share: Goal = 5% increase

Measure patient satisfaction (facilities): Goal: >90%

Measure patient satisfaction (perceived clinical quality): Goal: >90%

Measure patient satisfaction (high touch): Goal: >90%

Improve operations

Improve marketing and customer service

Provide employees with skills, tools, and motivation

Customer service training: Goal = complete by Sept

Business Planning

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• Knowing the cost and profitability of each illness category

• Knowing the per patient profitability (insurer)

• Knowing the profitability of each population segment

Informed profitability management

• Knowing the costs and profitability of each profit center

• Supervising profit center budget compliance

• Allows benchmarking for profit center improvements (corresponding period in previous year)

Decentralization of Organisational Subunits into Profit Centers

• Constructing and updating current budget

• Constructing and updating multi-annual budget

• Defining “What if” scenarios under uncertainty

Definition of future scenarios for simulation

Business Planning

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Wellness Centers

Retail Clinics

Wellness Centers

Healthy Food Centers

“One-stop shops” clinics offering private services

including dentistry, screening, a pharmacy and complementary therapies alongside GP practices.

Whole Food / Diabetes Recipes

Restaurants

Wellness retreat, spa, rehabilitation,

retirement, treatment

Acute Care Wellness/ Prevention

Chronic Care

Retail Focus Clinics

Offering wide range of health care services

(including: diagnostics; follow-up services for hospital; outpatient

surgery)

Renal Care Centers

Offering kidney dialysis and related services

Expanding the Network

Chinese Medicine Centers

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Wellness Centers

Retail Clinics

Wellness Centers

Healthy Food Centers

Acute Care Wellness/ Prevention

Chronic Care

Retail Focus Clinics Renal Care Centers

Expanding the Network

Chinese Medicine Centers

Based in local and foreign cities; and also responsible for: referring

patients; collecting and distributing patient health information; and

arranging travelling visas and accommodation.

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The Future: Patient Centric Health & Wellness Care

Web of Care

Smart eHomes

Mobile EHR

Health Robots

Implantable eCare

Wearable BioSensors

NanoCare

Decision Support

Doctors & Medical

Team

Coaches &

Advocates

Online Support

Communities

Friends &

Family

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Dennis Ooi Kok Peow Tel: 012 2082 789

E-mail: [email protected]