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eHealth Is Going Mainstream: Why, How and When? 
Ville Koiste, Sitra. 4.9.2014 
ville.koiste@sitra.fi 
@villekoiste
“eHealthis about improving the flow of information, through electronic means, to support the delivery of health services and the management of health systems” World Health Organization 
Sitra • Ville Koiste • 04.09.2014 • 2
Sitra • Ville Koiste • 04.09.2014 • 3 
eHealth 
Remote consultation 
Communication with professionals 
Health information management 
Online booking 
Lifestyle coaching & decision support 
Sensors & monitoring tools 
Virtual health checks & surveys
eHealth is going mainstream: Why? 
Sitra • Ville Koiste • 04.09.2014 • 4
•Overall health spending accounts for approx. 9 % of GDP in OECD countries (e.g. Finland 9,1 & USA 16,9 %) 
•Global health spending growth will be 5-6 % / p.a. between 2014-2017 
•Healthcare systems are facing challenges such as 
•aging population 
•chronic diseases 
•uneven quality 
•imbalanced accessto care etc. 
Sitra • Ville Koiste • 04.09.2014 • 5 
Healthcare costs are rising –cost-effective solutions are needed 
”Silver tsunami” 
Source: http://www2.deloitte.com/content/dam/Deloitte/dk/Documents/ life-sciences-health-care/Global-health-care-2014.pdf
•staffed by board certified nurse practitioners 
•a personalized diagnosis, a treatment plan and a prescription if you need it -all in about 30 minutes and all online 
•If symptoms or medical history suggest that online care is not appropriate, patient is redirected to doctor's office, test lab, physical exam etc. 
Source: http://www.businesswire.com/news/home/20140617005116/en/virtuwell-surpasses-100000-cases-treated#.U6LBG_mSx1Y 
Sitra • Ville Koiste • 04.09.2014 • 6 
Case ’Virtuwell’ -24/7 online clinic that treats everyday medical conditions (USA) 
So far Virtuwellhas had 100,000 completed visits: 
•an average savings of $88 per visit 
•one Virtuwellvisit can save up to 2,5 hours as indicated by Virtuwellcustomers 
•98 % of customers recommend the service
McGinnis, et al., Health Affairs; 21(2), 2002 
Health Care 
Environmental& social factors 
Genetics 
Behaviour & lifestyle 
Many factors combine together to affect our health
Sitra • Ville Koiste • 04.09.2014 • 8 
Big data in healthcare: Data traffic jams or improved value and preventive care? 
Health data 
Research data 
Genomics 
Wearables & behavioral data
Citizens are ready for eHealth 
Sitra • Ville Koiste • 04.09.2014 • 9
In 2013, Sitra conducted an interview survey that included 1085 Finnish citizens: 
•70 % think eHealth services are beneficial for them 
•74 % want more eHealth services 
More than 2,400 Canadians participated in PwC’s research: “What does the future of health care delivery look like? 
•79% of Canadians indicate that they are comfortable with virtual monitoring for chronic conditions 
•54% of Canadians indicate that virtual visits, home monitoring, and virtual wards are good care delivery options 
Source: https://coachorg.com/en/communities/resources/ATA_Fall_Forum_Presentations/ATA_Toronto_Falk_Sept_10_2013_Final.pdf 
Sitra • Ville Koiste • 04.09.2014 • 10 
Attitudes among Finnish and Canadian citizens
The Accenture online survey of 1,110 U.S. patients (06/2012): 
•90 % want to self-manage their healthcare leveraging technology, such as accessing medical information, refilling prescriptions and booking appointments online 
•90 % prefer web-based access to health information and education to help manage conditions 
Similarly, Cisco study (2013) that includes 1,547 responses across ten countries, 
reveals that 74 % of consumers are open to virtual doctor visit 
Sources: http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Is-Healthcare-Self-Service-Online-Enough-to-Satisfy- Patients.pdf; http://newsroom.cisco.com/release/1148539/Cisco-Study-Reveals-74-Percent-of-Consumers-Open-to-Virtual- Doctor-Visit 
Sitra • Ville Koiste • 04.09.2014 • 11 
Most patients want to self-manage healthcare online
Sitra • Ville Koiste • 04.09.2014 • 12 
Why eHealth? 
Faster access to care 
Saving money & time, 
e.g. less travel 
Health monitoring is easy 
Sources: PwC 09/2013 & Sitra 03/2013 
Communication with professionals
80 % of US physicians believe virtual assistants will drastically change healthcareby 2018 
(Nuance Communications survey 02/2013) 
80 % of Spanish health professionals would be willing to use telemedicine if it were available to them 
(Telefonica 2013) 
59 % of Canadian physicians believe that the use of mHealth tools and virtual care is inevitable, but adoption will take time 
(PwC’s survey 09/2013) 
Sitra • Ville Koiste • 04.09.2014 • 13 
And the professionals…?
eHealth is going mainstream: How? 
Sitra • Ville Koiste • 04.09.2014 • 14
As eHealthempowers citizens to monitor their health, make more informed decisions, interact with the healthcare system, receive more personalized services… 
Sitra • Ville Koiste • 04.09.2014 • 15 
Pic source: Oliver Wyman; The Volume-to-Value Revolution, 2012
Sitra • Ville Koiste • 04.09.2014 • 16 
“Citizens become active healthcare consumers, rather than passive participants” Six Trends in an Era of Consumer-Driven Healthcare. Becker's Hospital Review
Sitra • Ville Koiste • 04.09.2014 • 17 
eHealthis transforming healthcare and potentially saving lives, especially in low- income countries
Sitra • Ville Koiste • 04.09.2014 • 18 
New business models, new institutions?
Source: http://www.pwc.com/us/en/health-industries/healthcare-new- entrants/assets/pwc-hri-new-entrants-chart-pack.pdf 19 Sitra • Ville Koiste • 04.09.2014 • 
Health sector is attracting new playersPwC 04/2014: Who will be the industry’s Amazon.com?
Sitra • Ville Koiste • 04.09.2014 • 20 
Sources: The Verge 15.10.2013; WSJ 28.5.2014; Forbes 22.8.2014
Source: http://www.fastcompany.com/3031385/most-innovative-companies/inside- apple-the-mayo-clinics-new-partnership 21 Sitra • Ville Koiste • 04.09.2014 • 
Partnershipsacross industries
Source: Rock Health 2014. http://www.slideshare.net/RockHealth/digital-36395071 
Sitra • Ville Koiste • 04.09.2014 • 22 
Digital health startups are getting more funding than ever
NY Times 16.11.2013: 
”One area getting increased attention, both from private and state investors in Finland, is health care” 
The Next Web 19.11.2013: 
“A wider push for health at Slush 2013: 120 health and wellness startups… Come Slush 2014 we think health will be the headline act” 
Sitra • Ville Koiste • 04.09.2014 • 23 
Photo: Tuomo Lampinen 
SLUSH 2013 
Health & life sciences was the largest industry category with 127 startups
Virtual clinic 
• Data integration and mining 
• Decision support 
Sitra • Ville Koiste • 04.09.2014 • 24 
Research and reference 
database 
• Cohorts 
• Biobanks 
• Research articles 
Electronic health records 
• Patient information – 
”sickness data” 
Citizen’s interface, 
e.g. webpage/mobile 
application 
eService portal & 
online booking 
tool 
Virtual health (e.g. palveluvaaka.fi) 
check 
Mobile & walk-in 
service channels, 
remote consultations 
Pic. sources: Intel Free Press, flickr.com/photos/neven/, Healthspot.com 
Personal health records 
• Health & wellness data 
• Genetic data 
Health 
information & 
personal risk 
assesment
eHealth is going mainstream: When? 
Sitra • Ville Koiste • 04.09.2014 • 25
Sitra • Ville Koiste • 04.09.2014 • 26
•Telefónica, one of the largest telecom companies in the world, has over 2 million eHealthservice customers in Latin America in the B2C segment 
•The number of eVisitswill climb to 100 million this year -potentially saving over $5 billion, according to Deloitte’s research (2014): e.g. Kaiser Permanente’s ’HouseCalls’ virtual service had 15 million eVisits in 2013 
•The share of large employers, with more than 5,000 workers, who offer telemedicine services increased to 17 % in 2013, from 12 % the year before (Survey of nearly 3,000 large employers by the global consulting firm Mercer) 
•Finnish Student Health Service provides health services for around 135 000 university students in Finland –currently tests video consultations via MeeDoc, a Finnish real-time video app 
Sitra • Ville Koiste • 04.09.2014 • 27 
Facts, figures and case examples
Sitra • Ville Koiste • 04.09.2014 • 28 
“Devices will bolster care in ways previously unthinkable” 
The Economist
sitra.fi 
Facebook.com/SitraFund 
@SitraFund 
Building a successful Finland for tomorrow

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eHealth is Going Mainstream: Why, How & When? - Ville Koiste at the Nordic Digital Business Summit 2014

  • 1. eHealth Is Going Mainstream: Why, How and When? Ville Koiste, Sitra. 4.9.2014 ville.koiste@sitra.fi @villekoiste
  • 2. “eHealthis about improving the flow of information, through electronic means, to support the delivery of health services and the management of health systems” World Health Organization Sitra • Ville Koiste • 04.09.2014 • 2
  • 3. Sitra • Ville Koiste • 04.09.2014 • 3 eHealth Remote consultation Communication with professionals Health information management Online booking Lifestyle coaching & decision support Sensors & monitoring tools Virtual health checks & surveys
  • 4. eHealth is going mainstream: Why? Sitra • Ville Koiste • 04.09.2014 • 4
  • 5. •Overall health spending accounts for approx. 9 % of GDP in OECD countries (e.g. Finland 9,1 & USA 16,9 %) •Global health spending growth will be 5-6 % / p.a. between 2014-2017 •Healthcare systems are facing challenges such as •aging population •chronic diseases •uneven quality •imbalanced accessto care etc. Sitra • Ville Koiste • 04.09.2014 • 5 Healthcare costs are rising –cost-effective solutions are needed ”Silver tsunami” Source: http://www2.deloitte.com/content/dam/Deloitte/dk/Documents/ life-sciences-health-care/Global-health-care-2014.pdf
  • 6. •staffed by board certified nurse practitioners •a personalized diagnosis, a treatment plan and a prescription if you need it -all in about 30 minutes and all online •If symptoms or medical history suggest that online care is not appropriate, patient is redirected to doctor's office, test lab, physical exam etc. Source: http://www.businesswire.com/news/home/20140617005116/en/virtuwell-surpasses-100000-cases-treated#.U6LBG_mSx1Y Sitra • Ville Koiste • 04.09.2014 • 6 Case ’Virtuwell’ -24/7 online clinic that treats everyday medical conditions (USA) So far Virtuwellhas had 100,000 completed visits: •an average savings of $88 per visit •one Virtuwellvisit can save up to 2,5 hours as indicated by Virtuwellcustomers •98 % of customers recommend the service
  • 7. McGinnis, et al., Health Affairs; 21(2), 2002 Health Care Environmental& social factors Genetics Behaviour & lifestyle Many factors combine together to affect our health
  • 8. Sitra • Ville Koiste • 04.09.2014 • 8 Big data in healthcare: Data traffic jams or improved value and preventive care? Health data Research data Genomics Wearables & behavioral data
  • 9. Citizens are ready for eHealth Sitra • Ville Koiste • 04.09.2014 • 9
  • 10. In 2013, Sitra conducted an interview survey that included 1085 Finnish citizens: •70 % think eHealth services are beneficial for them •74 % want more eHealth services More than 2,400 Canadians participated in PwC’s research: “What does the future of health care delivery look like? •79% of Canadians indicate that they are comfortable with virtual monitoring for chronic conditions •54% of Canadians indicate that virtual visits, home monitoring, and virtual wards are good care delivery options Source: https://coachorg.com/en/communities/resources/ATA_Fall_Forum_Presentations/ATA_Toronto_Falk_Sept_10_2013_Final.pdf Sitra • Ville Koiste • 04.09.2014 • 10 Attitudes among Finnish and Canadian citizens
  • 11. The Accenture online survey of 1,110 U.S. patients (06/2012): •90 % want to self-manage their healthcare leveraging technology, such as accessing medical information, refilling prescriptions and booking appointments online •90 % prefer web-based access to health information and education to help manage conditions Similarly, Cisco study (2013) that includes 1,547 responses across ten countries, reveals that 74 % of consumers are open to virtual doctor visit Sources: http://www.accenture.com/SiteCollectionDocuments/PDF/Accenture-Is-Healthcare-Self-Service-Online-Enough-to-Satisfy- Patients.pdf; http://newsroom.cisco.com/release/1148539/Cisco-Study-Reveals-74-Percent-of-Consumers-Open-to-Virtual- Doctor-Visit Sitra • Ville Koiste • 04.09.2014 • 11 Most patients want to self-manage healthcare online
  • 12. Sitra • Ville Koiste • 04.09.2014 • 12 Why eHealth? Faster access to care Saving money & time, e.g. less travel Health monitoring is easy Sources: PwC 09/2013 & Sitra 03/2013 Communication with professionals
  • 13. 80 % of US physicians believe virtual assistants will drastically change healthcareby 2018 (Nuance Communications survey 02/2013) 80 % of Spanish health professionals would be willing to use telemedicine if it were available to them (Telefonica 2013) 59 % of Canadian physicians believe that the use of mHealth tools and virtual care is inevitable, but adoption will take time (PwC’s survey 09/2013) Sitra • Ville Koiste • 04.09.2014 • 13 And the professionals…?
  • 14. eHealth is going mainstream: How? Sitra • Ville Koiste • 04.09.2014 • 14
  • 15. As eHealthempowers citizens to monitor their health, make more informed decisions, interact with the healthcare system, receive more personalized services… Sitra • Ville Koiste • 04.09.2014 • 15 Pic source: Oliver Wyman; The Volume-to-Value Revolution, 2012
  • 16. Sitra • Ville Koiste • 04.09.2014 • 16 “Citizens become active healthcare consumers, rather than passive participants” Six Trends in an Era of Consumer-Driven Healthcare. Becker's Hospital Review
  • 17. Sitra • Ville Koiste • 04.09.2014 • 17 eHealthis transforming healthcare and potentially saving lives, especially in low- income countries
  • 18. Sitra • Ville Koiste • 04.09.2014 • 18 New business models, new institutions?
  • 19. Source: http://www.pwc.com/us/en/health-industries/healthcare-new- entrants/assets/pwc-hri-new-entrants-chart-pack.pdf 19 Sitra • Ville Koiste • 04.09.2014 • Health sector is attracting new playersPwC 04/2014: Who will be the industry’s Amazon.com?
  • 20. Sitra • Ville Koiste • 04.09.2014 • 20 Sources: The Verge 15.10.2013; WSJ 28.5.2014; Forbes 22.8.2014
  • 21. Source: http://www.fastcompany.com/3031385/most-innovative-companies/inside- apple-the-mayo-clinics-new-partnership 21 Sitra • Ville Koiste • 04.09.2014 • Partnershipsacross industries
  • 22. Source: Rock Health 2014. http://www.slideshare.net/RockHealth/digital-36395071 Sitra • Ville Koiste • 04.09.2014 • 22 Digital health startups are getting more funding than ever
  • 23. NY Times 16.11.2013: ”One area getting increased attention, both from private and state investors in Finland, is health care” The Next Web 19.11.2013: “A wider push for health at Slush 2013: 120 health and wellness startups… Come Slush 2014 we think health will be the headline act” Sitra • Ville Koiste • 04.09.2014 • 23 Photo: Tuomo Lampinen SLUSH 2013 Health & life sciences was the largest industry category with 127 startups
  • 24. Virtual clinic • Data integration and mining • Decision support Sitra • Ville Koiste • 04.09.2014 • 24 Research and reference database • Cohorts • Biobanks • Research articles Electronic health records • Patient information – ”sickness data” Citizen’s interface, e.g. webpage/mobile application eService portal & online booking tool Virtual health (e.g. palveluvaaka.fi) check Mobile & walk-in service channels, remote consultations Pic. sources: Intel Free Press, flickr.com/photos/neven/, Healthspot.com Personal health records • Health & wellness data • Genetic data Health information & personal risk assesment
  • 25. eHealth is going mainstream: When? Sitra • Ville Koiste • 04.09.2014 • 25
  • 26. Sitra • Ville Koiste • 04.09.2014 • 26
  • 27. •Telefónica, one of the largest telecom companies in the world, has over 2 million eHealthservice customers in Latin America in the B2C segment •The number of eVisitswill climb to 100 million this year -potentially saving over $5 billion, according to Deloitte’s research (2014): e.g. Kaiser Permanente’s ’HouseCalls’ virtual service had 15 million eVisits in 2013 •The share of large employers, with more than 5,000 workers, who offer telemedicine services increased to 17 % in 2013, from 12 % the year before (Survey of nearly 3,000 large employers by the global consulting firm Mercer) •Finnish Student Health Service provides health services for around 135 000 university students in Finland –currently tests video consultations via MeeDoc, a Finnish real-time video app Sitra • Ville Koiste • 04.09.2014 • 27 Facts, figures and case examples
  • 28. Sitra • Ville Koiste • 04.09.2014 • 28 “Devices will bolster care in ways previously unthinkable” The Economist
  • 29. sitra.fi Facebook.com/SitraFund @SitraFund Building a successful Finland for tomorrow