1
Business Modelling Panel
Lisette van Gemert-Pijnen (mod) Maarten van Limburg
February 12, 2010
PANEL Digital Society Trends:
Business modelling for design & implementation of Healthcare Technology
Lisette van Gemert-Pijnen
University of Twente The Netherlands
Maarten van Limburg University of Twente The Netherlands
Liezl van Dyk Stellenbosch University South Africa
Marike Hettinga Windesheim The Netherlands
Lambert
Nieuwenhuis
Hans C. Ossebaard
University of Twente National Institute for Public Health and the Environment
The Netherlands The Netherlands
Panel procedures
Self-Introduction of panelists
Short propositions
Discussion-statements
Response from the audience
Response from the panel
Interaction between/among panel and audience
Business models and eHealth (Maarten)
A Business model is ‘the rationale of how an organization creates, delivers and captures value’.
Going from ‘traditional healthcare services’ to
eHealth services requires health organizations to reinvent themselves.
Business modelling facilitates that step!
19-3-2010
A business model
19-3-2010
Presentatie 5
Infrastructure Value Customer
Proposition Finances Value proposition Customer relationship Distribution channels Target customers Partner network Value configuration Core capabilities Cost structure Revenue model Osterwalder, Pigneur (2004)
Business modelling is a collaborative process with clients as most relevant stakes (Lisette)
Different from business casus, models
Different from cost benefit analysis
Multi-perspective focus
Service (intangible) oriented
Clients as drivers
Co-creation of values
Consensus-driven
Examples business models other industries
3 successful, different business models:
Philips Senseo (co-creation)
Ryan Air (collaboration of stakeholders)
Apple (user-centered innovation) And in eHealth ???
Statement #1 (Maarten)
The process of business modelling is just as important as the business model itself.
High # of stakeholders
Conflicting interests
Complex money flows
19-3-2010
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 9
Process is equally important as the numbers (Bart)
actor types ─ insurance company ─ general practitioner ─ pharmacist ─ home care ─ physiotherapist ─ nursing houses ─ mental health care ─ hospital – specialists ─ hospital – logistics ─ insurer ─ network provider ─ clearing house aspects
─ prevention, diagnostics, therapy, quality, medication,
medical aid, personnel, reimbursement, payment
business
processes
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 10
Process to analyze impact of a new service more/less work more/less failures more/less quality … … actor effect actor effect process process effect process effect owner process volume process effect value actor effect value period
Statement # 2 Upside down approach (Bart)
approach is important!
Business modelling in an early design phase
Calculation on costs in an early phase, upside down approach Up sid ed ow n
Early stage in a project
Stakeholders participate from start
Formative evaluation of alternative role divisions (switch presentation)
Statement # 3 Emphasize organisational design (Marike)
Aap
not
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 13
Statement # 4 “it’s about economy, stupid” (Bart)
Costs health Care 1998 - 2005
€0 M €5.000 M €10.000 M €15.000 M €20.000 M €25.000 M €30.000 M €35.000 M €40.000 M €45.000 M 1998 1999 2000 2001 2002 2003 2004 2005*
Verstrekkers ondersteunende diensten Verstr. geestelijke gezondheidszorg Tandartsenpraktijken
Specialistenpraktijken
Paramedische-/verloskundigenpraktijken Overige verstrekkers gezondheidszorg Leveranciers therapeutische midd. Leveranciers geneesmiddelen Huisartsenpraktijken Gemeentelijke gezondheidsdiensten Categorale ziekenhuizen ARBO-diensten Algemene ziekenhuizen Academische ziekenhuizen
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 14
Size of population in nl in 2007
Source: Centraal Bureau voor de Statistiek, Voorburg/Heerlen 2007
Size of population in The Netherlands in 2007
K 50 K 100 K 150 K 200 K 250 K 300 K 0 10 20 30 40 50 60 70 80 90 Age N u m b e r 2007
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 15
Size of population in nl in 2007 and 2020
Source: Centraal Bureau voor de Statistiek, Voorburg/Heerlen 2007
Size of population in The Netherlands in 2007 and 2020
K 50 K 100 K 150 K 200 K 250 K 300 K 0 10 20 30 40 50 60 70 80 90 Age N u m b e r 2007 2020
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 16
Illness related costs/capita in nl - 2003
0 10.000 20.000 30.000 40.000 50.000 60.000 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95+
Niet toew ijsbaar / Niet ziekte gerelateerd Ongevalsletsel en vergif tigingen Onvelledig omschreven
Aandoeningen perinatale periode Congenitale afw ijkingen
Bew egingsstelsel en bindw eefsel Huid en subcutis
Zw angerschap, bevalling en kraambed Urogenitaal systeem
Spijsverteringsstelsel Ademhalingsw egen Hartvaatstelsel
Zenuw stelsel en zintuigen Psychische stoornissen
Bloed en bloedvormende organen Endocriene, voedings en stofw . ziekten Nieuw vormingen
Infectieziekten en parasitaire ziekten
Copyright RIVM, 2006. Slobbe LCJ, Kommer GJ, Smit JM, Groen J, Meerding WJ, Polder JJ. Kosten van Ziekten in Nederland 2003 (www.kostenvanziekten.nl)
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 17
Health costs during the last years of life
€ -€5.000 €10.000 €15.000 €20.000 €25.000 €30.000 €35.000 €40.000 €45.000 €50.000 9-14 15-24 25-44 45-64 65-74 75-84 85+ x x - 1 x - 2 x - 3 x - 4 x - 5 x - 6 x - 7 x - 8
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 18
PUBLIC AND MARKET SERVICES
Labor productivity developments
cost reduction due to re-use of medical information
cost reduction due to decrease of medication errors
reduction of costs required for additional health care
cost reduction due to improved labour productivity
increased cost/benefit ratio due to increased quality
Feb 12, 2010
Bart Nieuwenhuis - School of Management and Governance 19
Statement #5 Patients complicate business modelling (Maarten en Marike)
Patients have a delicate role in healthcare
Patients are no real customers
Patients are not the deciding or paying stakeholder
Asymmetric relationships, heavily dependant on trust
‘What do patients want’ vs. ‘We know what’s best’
19-3-2010
Statement #6 Business modelling implies a holistic approach (Maarten, Hans)
Collaborating health organizations
Collaborating with patients
Empowering patients
Iterative process stimulating reconsideration of deep-rooted assumptions
19-3-2010
•Telemedicine is a multidisciplinary effort
(Switch presentation)
Statement # 7 Cooperation a multidisciplinary effort, but… (Liezl)
Statement #8 Business modeling is overlooked or poorly understood in health care (Maarten)
Existing business models are “simple sums”-models
Based on fuzzy assumptions
Skewed Critical Design Issues
Borrowed Business models
19-3-2010
Thank you
Merci beaucoup
Baaie dankie
Why
to use Business Modeling for
Design and Implementation of
Healthcare Technology
Telemedicine:
A multidisciplinary effort
Liezl van Dyk
(Stellenbosch University)
•“Bedryfsingenieur”
•Operations Research (Mathematical
Modeling for Decision Making)
•Systems/ Business/ Enterprize
Engineering
•2005-2008 – E-learning Advisor •From 2009: Engineering Management
•Engineering Faculty Telemedicine
project S
Business (Process) Modeling
≠
Business Model
Management
business
processes
Operational
processes
Supporting
processes
Telemedicine:
Technology push Needs pull
Bottom-up Top-down
Telemedicine:
Regional Systems of Innovation
External Influences Knowledge generation and diffusion subsystem
Knowledge generation and diffusion subsystem Knowledge application and exploitation subsystem
Customer Collaborators Contractors Competitors Industrial CompaniesIndustrial Companies Workforce mediating organizations Workforce mediating organizations Educational organizations Educational organizations Technology mediating organizations Technology mediating organizations Public research organizations Public research organizations
Knowledge, resource and capital flows and interactions
Regional socio-economic and cultural setting
• Individual patient? Family of individual patient? • Doctor? / Nurse? / Doctor-in-training
• Hospital (hospital group)? / Pharmacy? / Drug developer? • Government (public health)? Private Healthcare provider? • Medical School? / Medical Student? / Government?
Who is
the
customer?
Who is
the
customer?
Open Business Models as answer to
eTELEMED initiatives?
Telemedicine:
“How to” Open Innovation
Telemedicine:
•
Is Open Innovation and Open Business Models
the answer to getting things work in a
multi-disciplinary environment?
•
Is Web 2.0 an answer to the need for Knowledge
Networks within context of eTELEMED?
Telemedicine:
Organisational design as
requirement for sustainable
embedding of telemedicine
Panel contribution e-Telemed, February 12, 2010 Marike Hettinga, Timber Haaker, Sikke Visser
Windesheim University of Applied Sciences, Zwolle, the Netherlands & Novay, Enschede, the Netherlands
gap between project and practice is too deep:
• too often: end-of-project equals end-of-telemed-innovation
• too late during project: anticipation on sustainable embedding of innovation in regular care practice
opportunity using business model method:
• perspective switch: telemed-innovation as a service instead of a solely technological innovation
Viable Telemedicine!
Business model
Services
e.g., Value proposition, Target group
Organisations
e.g., Division roles, Network strategy
Technology
e.g., Service delivery system
Financial
e.g., Revenue model
Value for customers
Value for providers
Creating successful ICT-services, practical guidelines based on the STOF method, Edward Faber en Henny de Vos (2008) See also: www.stofmethod.com
An example:
Organizational arrangements for a
Personalized Dementia Directory
in an
early stage
of the project:
- draw an inventory of all activities
needed to offer this service
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