مقاله انگلیسی رایگان در مورد ارزیابی مدل B2C برای بیماران CHF – اسپرینگر 2017

Abstract

Background: The purpose of this study is to assess the Business-to-Consumer (B2C) model for telemonitoring patients with Chronic Heart Failure (CHF) by analysing the value it creates, both for organizations or ventures that provide telemonitoring services based on it, and for society. Methods: The business model assessment was based on the following categories: caveats, venture type, six-factor alignment, strategic market assessment, financial viability, valuation analysis, sustainability, societal impact, and technology assessment. The venture valuation was performed for three jurisdictions (countries) – Singapore, the Netherlands and the United States – in order to show the opportunities in a small, medium-sized, and large country (i.e. population). Results: The business model assessment revealed that B2C telemonitoring is viable and profitable in the Innovating in Healthcare Framework. Analysis of the ecosystem revealed an average-to-excellent fit with the six factors. The structure and financing fit was average, public policy and technology alignment was good, while consumer alignment and accountability fit was deemed excellent. The financial prognosis revealed that the venture is viable and profitable in Singapore and the Netherlands but not in the United States due to relatively high salary inputs. Conclusions: The B2C model in telemonitoring CHF potentially creates value for patients, shareholders of the service provider, and society. However, the validity of the results could be improved, for instance by using a peer-reviewed framework, a systematic literature search, case-based cost/efficiency inputs, and varied scenario inputs.

Background

Populations globally are aging, chronic diseases are becoming more prevalent and healthcare budgets are strained. Telehealth, i.e. telecommunication technologies used in healthcare, are emerging rapidly to help cope with the ever-increasing number of people suffering from chronic diseases. In the current healthcare climate, where a quarter of countries worldwide have a telehealth policy in place [1], the dominant financial strategy is based on reimbursement schemes. This is also referred to as the Business-To-Business model (B2B). However, there are many barriers to the uptake of telehealth under the B2B model [2]. In a previous publication we designed a Business-toConsumer (B2C) model for telemonitoring patients with Chronic Heart Failure (CHF), by extending the existing B2B model. In order for CHF patients to have access to this service, healthcare providers, equipment manufacturers, regulators/payers, and promoters/distributors must come together via the establishment of a telemonitoring centre in a jurisdiction. The B2B model needs to be extended toward the B2C to create synergies between these players in the healthcare ecosystem. However, it is not known if this model creates value for the proposed venture and society. The venture is based on patient-driven demand for telemonitoring of cardio-vascular disease in the future. The targeted customer is: 1) a person aged 55+ at risk of or suffering from CHF, 2) with smartphone and mobile internet, and 3) able to procure the service and the telemonitoring devices. Care coordination is performed by telemonitoring nurses based in a telemonitoring centre. A physician, pharmacist, and informal caregiver are included in the care process, and each stakeholder can set up and invite other stakeholders to join the care-coordination team. The patient is still a part of the healthcare system, which pays for the physician time and service, but is able to receive telemonitoring service irrespective of the spacetime restrictions (e.g. on the road, during the weekend). The procurement of the drugs, and the reimbursement for healthcare system utilization, goes via the regular pharmacies and insurance companies/ national health systems. Figure 1 describes the flow of data, voice communication, money, and medication between the stakeholders. From an execution perspective, B2C telemonitoring involves: 1) informing patients via the media that the telemonitoring service exists, 2) patients and other stakeholders downloading the app, 3) patients registering and paying the installation charge and monthly fee, 4) connection of the peripheral monitoring devices, 5) technical assistance to resolve any installation issues, and 6) a telemonitoring nurse making an initial call to the patient. Figure 2 presents the Care Experience Flow Map [3] with the estimated number of minutes each action requires.