The document discusses leveraging consumer-facing technologies to improve health outcomes. It describes how healthcare information technology (HIT) can help reduce medical errors, improve adherence to guidelines, and enable more effective disease management and remote patient monitoring. HIT includes electronic health records, computerized physician order entry, and other integrated data sources. The document also covers benefits of telehealth/telemedicine, which can improve access to care and reduce costs through reduced travel, hospitalizations, and mortality rates. Overall, the document advocates that HIT and telehealth can help improve quality of care while increasing efficiency and reducing costs.

1. Leveraging Consumer-Facing Technologies
to Improve Health Outcomes
By applying advanced analytics, healthcare organisations can not only
achieve healthy revenue gains but improve patient care.
Executive Summary
Healthcare spending will continue to rise, not only
because of inflationary drivers but as a result of
growing recognition by policymakers, worldwide,
that improved health is inextricably linked to
greater national wealth. Keeping the universal
healthcare model throughout the European Union
(EU) will require rationing of services and consoli-
dation of healthcare facilities, as public resources
fall short of demand. Consumer technologies,
and consequently healthcare technologies, are
becoming ubiquitous worldwide, changing the
way we communicate, conduct commerce and
provide care and services.
Some of the most compelling benefits of
healthcare technologies are in the areas of
disease prevention, chronic disease management
and improving healthcare delivery. In addition to
these benefits, innovative medical technologies,
by providing more cost-effective patient care, can
also contribute to a more efficient and targeted
use of resources in healthcare. This also means an
increase in productivity.
Difficult Times
The pharmaceuticals industry is going through
a time of dramatic transformation. The pressure
to cut costs while maintaining effectiveness has
never been higher. The prescribing behaviour of
physicians is increasingly being influenced by
integrated delivery networks (IDNs), account-
able care organizations (ACOs) and government
prescribing guidelines. These external influenc-
ing factors are amplified by internal constraints,
such as maturing portfolios, decreasing product
margins, competition from generics, etc.
European healthcare systems are the pillars of
the continent’s social infrastructure. Although
they differ in terms of operational and financial
structure, they share common goals and
priorities such as universality, access to quality
care, equality and solidarity. More importantly,
European states also share common challenges.
The first is an ageing population that is having
a direct impact on the overarching dependency
factor and pathological map of Europe.
It is also important to consider the rise of chronic
diseases(forexample,diabetesandcardiovascular
conditions) that are directly related to unhealthy
lifestyles. At the same time, citizens as a whole
are receiving better information on healthcare
issues, indirectly pushing national health systems
to provide them with better quality and safety.
• Cognizant 20-20 Insights
cognizant 20-20 insights | august 2013

2. 2
European Healthcare
Systems Challenges
European governments face a growing number of
major health challenges that place unprecedent-
ed pressures on public health systems. As main
actors responsible for the delivery and financing
of healthcare, generally based on the principle of
social solidarity, national governments need to
define policies to best address these challenges
and mandate the relevant
non-health sectors to
implement them.
Despite limited compe-
tencies with regard to
health, the EU can facili-
tate change by encourag-
ing cooperation among
member states to fund
health programs and rein-
force internal market rules.
The ageing population,
health inequalities and
the social determinants of
health, however, present significant challenges to
healthcare systems that in many cases go beyond
medical ailments. Ensuring a multilevel and
holistic government response will be important
in tackling these challenges. The consideration of
quality in healthcare requires an examination of
the different dimensions of quality, the impact of
rationing devices, professional organisations and
new models of healthcare delivery.
Equity of access remains
a central tenet of Euro-
pean healthcare systems
but raises complex ques-
tions on equity, compre-
hensiveness and financ-
ing, as well as placing the
principle of social solidar-
ity under increasing pres-
sure. Healthcare costs
have steadily increased
in recent years — e.g.,
UK spend as % of GDP
increased from 3.4% 50
years ago to 8.2% now,
and is predicted to con-
tinue to increase,1
although this is not necessar-
ily driven by increased need. Cost-effectiveness,
value-for-money considerations, pharmaceuticals
pricing, new technologies and diversity of provi-
sion are all important elements in exploring ways
to reduce health costs.
While states remain the main actors in healthcare
policy in Europe, EU policies and law can influence
healthcare delivery, particularly when considered
in terms of the interrelation between health
and other sectors. While internal market rules
ensuring the free movement of people and
services can challenge domestic health sectors,
there are also tangible benefits and opportunities
for collaborating at the EU level, not the least of
which is the potential for coordinated policy.
Patients are increasingly a major cost driver of
healthcare systems. This occurs in two ways. First,
access to online information about every aspect of
health makes individuals more savvy healthcare
consumers and more inclined to demand the
latest (and likely expensive) medical innovations.
Patients make these demands because they
suspect that cash-strapped healthcare systems
are unreasonably denying them the medical care
they need.
Second, the spread of unhealthy lifestyles is
driving up medical costs. For example, a high-
calorie, fast-food culture has fed an epidemic of
obesity, which in turn provides fertile ground for
other diseases to develop, such as type-2 diabetes.
The Foresight Report (2007), a government
study in the UK (where levels of obesity are
already among the highest in Europe), predicted
an increase in excess of 60% in obesity-related
diseases between 2005 and 2030.2
Preventive measures will become more important
as a way of promoting healthy behaviour. The
World Health Organization (WHO) noted in 2005
that at least 80% of all cases of heart disease,
stroke, and diabetes are preventable. This requires
lifestyle changes, which can be influenced
through a combination of public education,
pricing, taxation, and various incentives and
disincentives. In terms of prevention and early
detection, most countries are trying to combat
chronic conditions by experimenting with various
programs. These approaches aim to reduce the
burden of chronic disease through activities
that avoid impairment to health, or make it more
unlikely. Overall, prevention and early detection
programs are promising, but far from well-devel-
oped in most countries. Given the severe medical,
social and economic consequences of chronic
diseases, more effort and resources need to be
invested in prevention.
cognizant 20-20 insights
The consideration of
quality in healthcare
requires an examination
of the different
dimensions of quality,
the impact of rationing
devices, professional
organisations and new
models of healthcare
delivery.
The spread of unhealthy
lifestyles is driving
up medical costs. For
example, a high-calorie,
fast-food culture has
fed an epidemic of
obesity, which in turn
provides fertile ground
for other diseases to
develop, such as
type-2 diabetes.

3. Healthcare Information Technology
Healthcare information technology (HIT) can
be defined as ‘technology used to collect, store,
retrieve, and transfer clinical, administrative, and
financial health information electronically’. Brailer
and Thompson explained that HIT can be defined
as ‘the application of information processing —
through computer hardware and software — to
the storage, retrieval, sharing, and use of health
care information, data, and knowledge for com-
munication and decision making’.3
In accordance with the increased attention to
patient care, new devices and technologies
have provided more accurate information about
patients for better healthcare delivery. Informa-
tion technology plays a significant and evolving
role in managing information.
During the last decades, various aspects of
quality management have been introduced into
healthcare organizations, and the notion of
HIT has arisen as a way to dramatically change
the entire healthcare landscape. Healthcare
providers have applied diverse technological
innovations that have influenced both clinical and
administrative aspects of the delivery of medical
services. HIT includes a variety of integrated
data sources and has been shown as a solution
that improves patient safety and reduces inef-
ficiencies. Therefore, HIT has great potential to
improve the quality of care, to support healthcare
IT infrastructure and to save administrative costs.
A recent NHS England report, ‘The NHS Belongs
to the people: a call to action’, discusses a
potential £30bn funding gap by 2020/21.4
This
report cites the need to focus on prevention, and
asserts that to be successful the NHS will need to
focus on harnessing transformational technology,
exploiting the potential of transparent data as
other industries have.
Benefits of HIT
In recent years, greater attention has been paid to
the quality of healthcare. Numerous complaints
have been aired (publicly and privately) that
patients often do not receive proven therapies
or preventive measures, and that the rate of pre-
ventable medical errors remains high. Healthcare
organisations are now focusing on understand-
ing how providers, patients and policies, and
the factors they influence, can affect the quality
of care. This includes the training of healthcare
personnel, improving delivery system processes,
and attention to systemic level factors such as
technologies and medical records. The specific
benefits of HIT are detailed below.
Medical Error Reduction
The Agency for Healthcare Research and Quality
(AHRQ) noted that insufficient or improper point-
of-care treatment information is a frequent
and significant cause of medical errors.5
Com-
munication problems and a lack of access to
information can cause most medical mistakes.
Therefore, new information
management technologies
must be implemented and
smoothly integrated within
the existing healthcare
infrastructure. According to
studies, HIT also decreased
medical errors by improving
medication dosing with such
treatments as antibiotics
and anticoagulants.6,7
Adherence Support
HIT can improve the quality of care by increasing
adherence to guideline-based care. Decision
support functions that were embedded in
electronic health records (EHRs) and computer-
ised physician order entry (CPOE) are parts of
adherent studies that show the effect of HIT on
enhancing preventive healthcare delivery.
Effective Disease
Management
In addition to the ben-
efits mentioned above, HIT
systems also offer enor-
mous potential in improving
clinical decision-making and
disease management. Effec-
tive disease management
provides healthcare services
with analysis of relevant
data and cost-effective tech-
nology to improve the health
outcomes of patients with
specific diseases. According
to one article, for example,
the use of HIT systems was found to increase
documentation advice and recommendations for
laboratory testing and treatment.8
Efficiency Saving
The pursuit of efficiency has become a central
objective within most healthcare systems.
Efficiency mandates aim to achieve equivalent
performance with fewer resources. Through
3cognizant 20-20 insights
HIT includes a variety
of integrated data
sources and has been
shown as a solution
that improves patient
safety and reduces
inefficiencies.
Decision support
functions that were
embedded in electronic
health records (EHRs)
and computerised
physician order entry
(CPOE) are parts of
adherent studies that
show the effect of HIT
on enhancing preventive
healthcare delivery.

4. cognizant 20-20 insights 4
the adoption of HIT, healthcare organizations
can potentially reduce healthcare professionals’
administrative time such as documentation-relat-
ed nursing time, the delivery of treatment through
CPOE and reduced hospital stays resulting from
increased patient safety and the coordination of
patient care.
Remote Patient Monitoring
An increasing number of adults over 60 years
of age are challenged by chronic and acute ill-
nesses and/or injuries. A Center for Technology
and Aging report explains that ‘chronic disease
management, post-acute
care management and
safety monitoring are three
important applications of
remote patient monitor-
ing (RPM) technologies for
the older adult population’.9
RPM technologies have an
important role to play in
chronic disease manage-
ment, slowing chronic disease progression and
ensuring continued recovery after the patient is
discharged from an acute care setting. RPM tech-
nologies could be utilised with alert systems, to
prompt intervention from the patient’s physician
when preset disease management criteria are
met. For example, if a patient’s blood pressure is
above a predetermined dangerous threshold for
three days running.
The five steps of a remote
patient monitoring system
are: collect, transmit, evalu-
ate, notify and intervene.
RPM technologies are
devices enabled with wire-
less communication that
are able to collect and send
a patient’s clinical data.
This may be an individual
device, one that monitors
blood glucose levels for example; an individual
device that is able to monitor multiple physiologi-
cal parameters, blood glucose levels and blood
pressure for example; or a series of integrated
devices, each able to record a different aspect
of a patient’s physiological parameters. Data is
then packaged, delivered and received by patient-
selected providers, family caregivers and clini-
cians via different modes of communication.
Once the clinicians have evaluated the data and
made decisions as to the actions needed, notifica-
tion of those decisions and actions to be taken is
transmitted to those who need to act. That may
include the patient, other clinicians, family, pro-
fessional caregivers or other parties. They can
then take action if an intervention is needed.
The Wonder of Telehealth
and Telemedicine
Telehealth is a healthcare service, consultation
and expertise delivered via a telecommunica-
tions medium, over any distance. Telehealth adds
a new paradigm in healthcare, where the patient
is monitored between physician office visits.
According to a paper by Noel et al., telehealth has
significantly reduced hospitalizations and visits
to the emergency room, while improving patients’
quality of life.10
And the Whole System Demon-
strator Programme showed that telehealth can
deliver a 15% reduction in A&E visits, a 20%
reduction in emergency admissions, a 14%
reduction in elective admissions, a 14% reduction
in bed days and an 8% reduction in tariff costs.
More strikingly, they also demonstrate a 45%
reduction in mortality rates.11
Telehealth also
benefits patients where traditional delivery of
health services is affected by distance and lack of
local specialist clinicians to deliver services.
The advantages of telehealth services include
improvements in patient access to medical data,
patient health outcomes and decision-making,
and reductions in healthcare costs, travel time,
redundant diagnostic procedures or tests and
patient waiting time and eventually heightened
early diagnostic, administrative, and communi-
cation capabilities. Implementation of telehealth
could have other non-health-related beneficial
impacts. For example, telehealth can lead to
reduced travel from both patients and physicians,
thereby delivering a greener solution.
The function of a telehealth network is to establish
the link between the individual telehealth device
and the decision-making unit. This will involve the
electronic patient interfaces, repositories that will
be required to store generated medical reports,
the patients themselves and an amalgam of
healthcare personnel, services and providers. For
some time now, technologically advanced devices
are increasingly being deployed for telehealth.
Telehealth increasingly utilises technologi-
cal advancements in physiological and clinical
recording equipment, wireless communications
and mobile phone capabilities (both hardware
and software apps). Each advancement has led to
enhanced telehealth services.
The five steps of
a remote patient
monitoring system
are: collect, transmit,
evaluate, notify and
intervene.
Telehealth has
significantly reduced
hospitalizations
and visits to the
emergency room, while
improving patients’
quality of life.

5. 5cognizant 20-20 insights
Emerging Healthcare Technology:
Supporting Patients Beyond the Pill
Adherence to prescriptions is critical to optimal
treatment and outcome. However, taking the right
dose of the prescribed medication at the right
time can be a challenge, particularly for older
patients taking multiple medications. The World
Health Organization (2003) defines adherence as
‘the extent to which a person’s behaviour — taking
medication, following a diet, and/or executing
lifestyle changes — corresponds with agreed rec-
ommendations from a health care provider’.12
Poor medication adherence can have negative
consequences for individuals, families and society
because it significantly increases the cost and
burden of illness.
Wood highlighted that medication non-adherence
contributes to 33% to 69% of medication-related
hospital admissions and 23% of all nursing home
admissions.13
McDowell and Barnett highlighted
that in the UK medication contributes to 5% to
8% of hospital admission and readmissions, of
which almost half (approximately 4%) are pre-
ventable.14
A 2010 Department of Health report
postulated that poor adherence to medicines
contributed a significant amount of the estimated
£150m wasted medicines cost the NHS each year.
Moreover, the New England Healthcare Institute
(NEHI) estimates that $290 billion of healthcare
expenditures could be avoided each year if medi-
cation adherence were improved.15
Medical and health experts have recognised the
importance of improving medication adherence
in delivering improved patient welfare and in
decreasing health costs. Increasingly poor medi-
cation adherence is often attributed to an ageing
population with a parallel increasing occurrence
of chronic conditions, and with many patients
being treated for more than one condition. New
healthcare technologies are seen as having a key
role in improving adherence, leading to improved
patient quality of life.
Quick Take
From a traditional baseline of transaction
monitoring using basic reporting tools, spread-
sheets and application reporting modules, an
IBM Executive Report20
highlights that analytics
in healthcare is moving toward a model that will
eventually incorporate predictive analytics and
enable organizations to ‘see the future’, creating
more personalized healthcare and predicting
patient behaviour.
Medication Adherence
Propensity Model
• Business case: As earlier noted, data shows
that as many as 50% of all patients do not
adhere faithfully to their prescription-medi-
cation regimens. The result is that significant
money is spent on avoidable hospitalizations.
Engaging and supporting patients to increase
their adherence is critical for improving health
outcomes and reducing cost. In today's system,
however, there are neither the incentives nor
the support systems to do so. Investments
can be made to create a model that predicts
the likelihood of patients not adhering to
medication. Based on this, a personalised
outreach program can be created that helps
such patients.
Predict Future Medication for Better
Health Outcomes and Costs
• Business case: Alerts are sent to a physician
to inform him about a series of studies to dem-
onstrate a connection between multiple rare
mutations found in 10% of people and the
likelihood that they might convert to type 2
diabetes. The physician has electronic medical
records with the genome sequence of all his
patients and runs a quick search (back-end
analysis) and finds about 80 who are at risk.
To 50% of patients, the physician sends a
strong reminder and advice on diet and lifestyle
choices they can adopt to avoid the disease. To
the other half, whose medical records reveal
pre-diabetic symptoms, he sets up appoint-
ments to consider more proactive treatment
with drugs that can prevent the onset of
disease. Such accurate diagnosis, prognosis
and treatment can save lives.
Representative Analytical Use Cases

6. cognizant 20-20 insights 6
In a review of 102 articles, Jin et al.16
show that
patients have many reasons for not taking medi-
cations, such as cost, side effects, forgetfulness,
cultural and belief systems, not feeling the need
for medication, lack of concern for their condi-
tion, poor family/social
support and more. The
NEHI report cited above
states that reaching the
improved health outcomes
offered by medications
depends on patients fol-
lowing their prescription
regimens. Patients with
chronic conditions are
especially vulnerable if
they don’t adhere closely
to these regimens. This is
a huge concern for family
member caregivers, who
are charged with admin-
istering and monitoring
medications.
Mobile-Enabled Diagnostic and
Monitoring Devices
Many diagnostic and monitoring devices are
mobile-enabled — i.e., they communicate with
mobile devices or have mobile capabilities them-
selves. These peripheral devices can include
sensors, accelerometers,
remote patient monitoring
technologies and environ-
mental monitoring tech-
nologies. Among other
devices, mobile-enabled
diagnostic and monitoring
devices have more recent-
ly been incorporated as
part of current mobile
devices (e.g., cell phones)
or have been given the
capacity to communicate
with mobile devices.
The Center for Technol-
ogy and Aging highlighted
that m-health devices and
technologies with mobile
components may aggre-
gate multiple forms of patient health data or may
provide a platform to access this data.17
These devices may also be used to send alert noti-
fications based on patient health information or
treatment needs. As health data and programs
continue to move toward cloud-based systems,
these mobile devices will become even more
capable and convenient ways to view, access and
enter health diagnostic and monitoring informa-
tion, promoting anytime, anyway healthcare.
The recent expansion of mobile and communica-
tions technologies within health service provision
has created a plethora of opportunities to deliver
innovative, interactive health services to patients,
clinicians and patient-caregivers alike. These
technologies can assist all users with obtaining
proper medication information, patient education,
medication organisation, dispensing and dose
reminders and notification when doses are missed.
Technology Trends Influencing
the Pharmaceuticals Industry
Shifts in the behaviour of patients and healthcare
professionals and emerging technologies are
changing the relationship between pharmaceu-
ticals companies and their traditional customers
and creating new opportunities for collaboration
— which will have a fundamental impact on the
future success of businesses.
Pharmaceuticals companies will be able to utilise
emerging technologies — location-based capa-
bilities and wide-scale use of smart phones and
other 3G and 4G devices — to better engage
patients and provide services and solutions that
can improve their care and deliver better quality
of life. For example, Merck Sharp & Dohme, the
makers of Clarityn, created an application that
forecasts the pollen count in a user’s vicinity,
providing features such as an allergy calendar and
store locator for anti-allergy medication — all with
the aim of helping seasonal allergy symptoms.18
Beyond applications, technology can be used to
collect patient data in real time — such as a blood
glucose monitor that could detect dangerously
high blood glucose levels and send this informa-
tion to a smart phone. The devices could then
sync and automatically make an emergency call
to a specified healthcare provider, relative or
patient-nominated contact.
Fischer highlighted that there is a wealth of
tracking, monitoring and outcomes behaviour
that mobile devices such as smartphones and
tablets will increasingly be able to collect, convey
and aggregate.19
This data, coming in particular
from medical apps, will represent a prosperous
research resource that once anonymised can be
mined for efficiency and effectiveness data by
Merck Sharp & Dohme,
the makers of Clarityn,
created an application
that forecasts the
pollen count in a user’s
vicinity, providing
features such as an
allergy calendar and
store locator for anti-
allergy medication
— all with the aim of
helping seasonal allergy
symptoms.
As health data and
programs continue to
move toward cloud-based
systems, these mobile
devices will become
even more capable and
convenient ways to
view, access and enter
health diagnostic and
monitoring information,
promoting anytime,
anyway healthcare.

7. cognizant 20-20 insights 7
pharmaceuticals companies. Patients will be able
to provide real-time data, with minimal inconve-
nience that will aid patient care, research, efficacy
and compliance.
Increasingly, disparate streams of data, patient
records and real-time patient data, health
outcomes, financial infor-
mation, genetic disposi-
tion and at-risk factors will
be brought together to
deliver models and insights
that will enable healthcare
providers to make more
informed decisions on which
treatments deliver the most
efficient and effective mode
of care for both patients
and the healthcare services
that pay for the care.
This information will be especially vital under
healthcare reform and the current move to
clinical commissioning groups (CCGs) in the UK,
for example, which encourage better patient
outcomes by enabling healthcare providers to
commission services, based on quality outcomes
and measures of that service. Using EMR data
and e-prescribing information, physicians and
healthcare providers can better track patient
outcomes over the long term, a critical element
for providers to demonstrate their performance
and therefore the value they bring to the patient.
Pharmaceuticals companies will need to collabo-
rate on this front as well and use this targeted
data to improve areas such as drug develop-
ment, meet the needs of insurers and provide
compelling evidence of a drug’s benefits.
Opportunities for Pharma
As we have discussed, healthcare technologies
provide a number of obvious benefits for patients,
healthcare systems and healthcare professionals;
but what’s in it for pharmaceuticals companies?
Pharmaceuticals companies face numerous
challenges. Chief among them: increase revenues
in an era of fewer blockbuster products. They
also need to help governments reduce the cost
of providing healthcare, deliver more support to
healthcare professionals and demonstrate they
are fully patient focused.
If pharmaceuticals companies embraced new
healthcare technologies and advanced analytics
they could conquer all of these challenges.
Pharma companies should look beyond existing
patients and view the entire population as
potential patients; moving their focus from illness,
through wellness to well-being.
To do this, they should develop, in partnership
with specialist organisations, healthcare technol-
ogies and advanced analytics that deliver multi-
faceted benefits. These could help healthcare pro-
fessionals identify citizens at risk of developing
a disease; help these at-risk citizens manage
their health so they don’t need drug intervention;
ensure better compliance/health management
for those patients already undergoing drug
treatment, so the patient doesn’t need to be given
a higher dose or more expensive medication; and
provide healthcare professionals with real-time
updates on the wellbeing of their patients, high-
lighting potential needs for intervention.
For example, a pharmaceuticals company may
specialise in diabetes. Through the employment
of healthcare technologies and analytics it could
help keep at-risk citizens off diabetes medication
both by helping healthcare professionals identify
these citizens, and then by helping the citizens
take preventive actions to minimize their risk
of developing diabetes. It could ensure that
those already on less expensive products, such
as Metformin, don’t need to increase the dose
or move to more expensive medication, and
can reduce complications that would require
expensive hospital visits.
The above would meet all of the challenges
previously identified, apart from increasing
revenues for pharmaceuticals companies.
These companies would then need to work
with government healthcare agencies on ways
to obtain payment when they can prove they
have reduced healthcare expenditure — in other
words, ‘outcomes-based pricing’. This isn’t as
far-fetched as it might initially sound. Pharma-
ceuticals companies already receive payment for
certain drugs only when the drug has shown to
have a benefit for a patient. Cimzia in the UK is
one example. Under the Cimzia Patient Access
Scheme, UCB will not charge the NHS for the first
12 weeks of treatment. Available data for Cimzia
suggests that clinical response is usually achieved
within 12 weeks of treatment. UCB will not charge
the NHS for the first 12 weeks of Cimzia, so that
the prescribing clinician can judge if a clinical
response has been achieved and if continued
therapy is appropriate.
Pharma companies
should look beyond
existing patients
and view the entire
population as potential
patients; moving their
focus from illness,
through wellness to
well-being.

8. cognizant 20-20 insights 8
If pharmaceuticals companies adopt a stepwise
collaborative approach — involving government
agencies, healthcare professionals and patient
groups — they could, through embracing
healthcare technologies and advanced analytics,
deliver what can initially appear as a disparate set
of goals for all healthcare stakeholders.
Looking Ahead
Healthcare technologies are becoming ubiquitous,
changing the way we communicate, collate infor-
mation and provide care and services. A draft
proposition paper by the Center for Technology
and Aging17
proposes that some of the most
compelling benefits of healthcare technologies
are in the areas of disease prevention, chronic
disease management and improving healthcare
delivery. In addition to these benefits for patients,
through providing more cost-effective patient
care, innovative medical technologies can also
contribute to a more efficient and targeted use
of resources in healthcare, which also means
increases in productivity.
Other benefits of healthcare technology to the
healthcare industry include much simpler access
to data, and greatly enhanced storage capabilities
for that data, statistically enhanced modelling
and much greater insight driven by the ability to
see patterns between what have historically been
disparate data sources. Healthcare providers
should also see the key benefit — that the infor-
mation is patient-centric and should be accessible
to all providers within a patient’s care pathway.
Footnotes
1
Appleby, J. Spending on health and social care over the next 50 years. Why think long term?,
London: The King’s Fund, 2013, http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/
Spending%20on%20health%20...%2050%20years%20low%20res%20for%20web.pdf.
2
Foresight, Tackling obesities: future choices—project report. London: The Stationery Office, 2007.
3
Brailer, D., and Thompson, T. , Health IT strategic framework, Washington, DC: Department of Health and
Human Services, 2004.
4
NHS England, The NHS belongs to the people: a call to action, July 2013, http://www.england.nhs.
uk/2013/07/11/call-to-action/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+
NHSCBoard+(NHS+England).
5
Agency for Healthcare Research and Quality,’Reducing errors in health care: Translating research into
practice’, AHRQ Publication No. 00-PO58, April 2000.
6
Chertow, G. et al, ‘Guided Medication Dosing for Inpatients With Renal Insufficiency’, JAMA December
12, 2001, Vol. 286, No. 22, 2001, http://jama.jamanetwork.com/article.aspx?articleid=194455.
7
Evans, R. et al., ‘A computer-assisted management program for antibiotics and other antiinfec-
tive agents’, New England Journal of Medicine, 1998; 338:232-8, http://medicina.med.up.pt/im/
trabalhos05_06/sites/Turma21/artigos%20-%20WEB/tiburcio%2010.pdf.
8
Shekelle P., Morton S.C., Keeler, E.B., ‘Costs and Benefits of Health Information Technology’, Evidence
Reports/Technology Assessments, No. 132. Rockville (MD): Agency for Healthcare Research and Quality
(U.S.), April 2006, http://www.ncbi.nlm.nih.gov/books/NBK37984/.
9
Center for Technology and Aging, ‘Technologies for Remote Patient Monitoring for Older Adults’,
position paper, 2010, http://www.techandaging.org/RPMPositionPaper.pdf.
10
Noel, H.C., ‘Home telehealth reduces healthcare costs’, Telemed J E Health [Online] 2004
Summer;10(2):170-83, http://www.ncbi.nlm.nih.gov/pubmed/15319047.
11
Whole System Demonstrator Programme, ‘Headline Findings – December 2011’. Department of Health,
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215264/dh_131689.pdf.
12
World Health Organisation. (2003) ‘Adherence to Long-term Therapies: Evidence for Action’,
http://www.who.int/chp/knowledge/publications/adherence_report/en/. (accessed on 30 April 2013).
13
Wood, B., ‘Medication Adherence: The Real Problem When Treating Chronic Conditions’, U.S. Pharmacist
[Online] 2012; 37(4) (Compliance suppl): 3-6, http://www.uspharmacist.com/content/s/200/c/33457/.

9. About Cognizant
Cognizant (NASDAQ: CTSH) is a leading provider of information technology, consulting, and business process out-
sourcing services, dedicated to helping the world’s leading companies build stronger businesses. Headquartered in
Teaneck, New Jersey (U.S.), Cognizant combines a passion for client satisfaction, technology innovation, deep industry
and business process expertise, and a global, collaborative workforce that embodies the future of work. With over 50
delivery centers worldwide and approximately 164,300 employees as of June 30, 2013, Cognizant is a member of the
NASDAQ-100, the S&P 500, the Forbes Global 2000, and the Fortune 500 and is ranked among the top performing
and fastest growing companies in the world. Visit us online at www.cognizant.com or follow us on Twitter: Cognizant.
World Headquarters
500 Frank W. Burr Blvd.
Teaneck, NJ 07666 USA
Phone: +1 201 801 0233
Fax: +1 201 801 0243
Toll Free: +1 888 937 3277
Email: inquiry@cognizant.com
European Headquarters
1 Kingdom Street
Paddington Central
London W2 6BD
Phone: +44 (0) 20 7297 7600
Fax: +44 (0) 20 7121 0102
Email: infouk@cognizant.com
India Operations Headquarters
#5/535, Old Mahabalipuram Road
Okkiyam Pettai, Thoraipakkam
Chennai, 600 096 India
Phone: +91 (0) 44 4209 6000
Fax: +91 (0) 44 4209 6060
Email: inquiryindia@cognizant.com
­­© Copyright 2013, Cognizant. All rights reserved. No part of this document may be reproduced, stored in a retrieval system, transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without the express written permission from Cognizant. The information contained herein is
subject to change without notice. All other trademarks mentioned herein are the property of their respective owners.
About the Author
Graham Parkinson is an Associate Principal within Cognizant’s Analytics Practice. Over his 16 years in the
life sciences industry, Graham has led engagements related to promotional measurement; multichannel
optimization and campaign management; BI requirements, consulting and solution design; and sales and
marketing analytics. He holds an M.Sc. in operational research and management science. Graham can be
reached at Graham.Parkinson@cognizant.com.
Acknowledgment
The author would like to acknowledge the contributions of Hemalatha A, a Senior Manager within
Cognizant Analytics with over 10 years of experience in transforming data into meaningful and actionable
insights primarily focusing on the life sciences and healthcare industry.
14
McDowell, A. and Barnett, N., ‘How improved medication adherence can prevent costly medicine waste’,
HSJ [Online] February 2012, http://www.hsj.co.uk/resource-centre/best-practice/qipp-resources/how-
improved-medication-adherence-can-prevent-costly-medicine-waste/5041067.article.
15
‘Thinking Outside the Pillbox: A System-wide Approach to Improving Patient Medication Adherence for
Chronic Disease’, NEHI, 2009, http://www.nehi.net/publications/44/thinking_outside_the_pillbox_a_
systemwide_approach_to_improving_patient_medication_adherence_for_chronic_disease.
16
Jin, J. et al., ‘Factors affecting therapeutic compliance: A review from the patient’s perspective’,
Ther Clin Risk Manag. February 2008; 4(1): 269–286, http://www.ncbi.nlm.nih.gov/pmc/articles/
PMC2503662/.
17
‘mHealth Technologies: Applications to Benefit Older Adults’, Center for Technology and Aging, Draft
Proposition Paper, March 2011, http://www.techandaging.org/mHealth_Position_Paper_Discussion_Draft.
pdf.
18
Clarityn Allergy Pollen Forecast App, http://www.claritynallergy.co.uk/smartphone-landing.php.
19
Fischer, E., ‘Mobile revolution: how have drug developers embraced smart device technology?’, Phar-
maceutical-technology.com [Online] May 2012. http://www.pharmaceutical-technology.com/features/
featuremobile-revolution-drug-developers-smart-device-technology.
20
‘The value of analytics in healthcare: From insights to outcomes’, IBM Institute for Business Value
Executive Report, 2012, http://www-935.ibm.com/services/us/gbs/thoughtleadership/ibv-healthcare-
analytics.html.