Q optum 3 SEASON 2 CASE STUDY (B-SCHOOLS) Bisa Wacol m1} (0 (ea CoM MET La Ma eI L nee} UNITEDHEALTH GROUP”|_| Qoprtum i Background (on UnitedHealth Group & Optum) Ranked Fortune #7 and with over $240 billion of annual revenue, UnitedHealth Group (UHG) is the largest health care and wellness solutions company in the world. Optum, the fast-growing part of UnitedHealth Group, is a leading information and technology-enabled health services business. Our teams are dedicated to modernizing the health care system and improving the lives of people and communities. Serving virtually every dimension of the health system, we work with a diverse set of clients such as those who diagnose and treat patients to those who pay for care, manage the delivery of health services, and those who supply treatment and disease management solutions in the form of medications and devices. Optum provides technology and tools that enable unprecedented collaboration and efficiency across various levels of healthcare delivery. As a result, we can tap into valuable health care data to uncover insights and develop strategies for better care at lower costs. At Optum, our mission is to help people live healthier lives and to help make the health system work better for everyone. We are tackling the biggest challenges in health care by designing multifaceted solutions, creating actionable insights and partnering with stakeholders across the entire ecosystem, Together, we are transforming health care for a better future for everyone we serve. Business Context In 2020, the global market size of Internet of things in healthcare (loHT) has been estimated at $ 72.5 billion and it is estimated that the loHT market size will grow to $188.2 billion by 2025 at a CAGR of 21.0% (1). In the context of the US Healthcare system, the adoption and business application of IoHT spans the innovation, early adopters and early majority phases of the technology adoption lifecycle with several |oHT applications being at the cusp of innovation and early adoption. loT Adoption Life Cycle in US healthcare System ’ Innovators Early Early Late Laggards Adopters Majority Majority Presently, loT in healthcare systems include remote care system for patients, warning systems for emergencies, fitness programs, specific use cases in chronic disease management, monitoring of temperature, air quality and other social determinants of health, metabolism and elderly care such as heart rate measuring system, blood pressure monitoring machine, health check systems, artificial heart rate provider and hearing aids.|_| Qoprtum i With these applications and more advanced applications being developed, loHT has the potential to improve patient management by reducing costs, maintaining or enhancing quality of care, and im- proving healthcare user experience. loHT can also enable healthcare providers to reduce service downtimes, identify optimum times for supply and refill of medication supplies, and enable effi- cient allocation of limited resources. Innovation is at the core of Optum’s mission to help people live healthier lives and make the health system work better for everyone. Optum invests $3.6 billion annually in research and development in order to employ the latest developments in technology and push the boundaries in achieving de- sired healthcare outcomes for all stakeholders. Optum brings its deep knowledge into play while bringing together disparate strands of emerging technology and iterate, adapt or invent approach- es that are tailored to meet the specific needs of patients, health care practitioners, providers, payers and all other stakeholders across the health care spectrum. In Optum, loT is being used to enable a new Continuous Care model that supports chronic disease management, medical adherence and care transitions. For this, Optum has been developing plat- form infrastructure and services that support IoT technical requirements around continuous care. Platform infrastructure is being used to form an ecosystem of partners around Patient Generated Health Data (PGHD) to deliver an e-Consult service, accelerate the use of PGHD in patient care and build premium benefits plans around this model. With wearable devices and smartphone applica- tions that deliver on-demand health data and insights, loT enables patient-generated health data (PGHD) for fitness or medical purposes and empowers providers and patients to better manage medical conditions, prevent future diseases and personalize care delivery. Problem Statement As the global spending is expected to increase to $18.28 trillion in 2040, healthcare is more focused towards delivering preventive and personalized care under value-based models. [2] Today, connected devices facilitate proactive care by ensuring that information is always at our fingertips, sensors track our behaviours and biometrics, and online communities and rewards provide positive reinforcement. This has great potential within the scope of primary healthcare in reducing risks, improving physicians-patients and patients-patients communication, and revealing hitherto unseen patterns or sensory features in a ubiquitous, personalized and continuous manner. Shifting to a preventive paradigm requires a holistic and patient-centred approach that involves participation from individuals, healthcare professionals, policy makers, insurers, employers and other stakeholders along the length and breadth of the healthcare system. Another aspect that adds to the complexity of healthcare, preventive care involves lifelong engagement and requires the designing of tailored programs and services to be designed to meet the healthcare needs from the young to the elderly and thus requires involvement from different stakeholders throughout the span of a person’s life. [3] Some key challenges include: * Health information exchange barriers including use of proprietary smart communication protocols * Disparate platforms and standards for inter-realm authentication * Apprehensions about users’ (patients’) security and privacy * Collection and management of heterogenous data with varying requirements across therapeutic areas such as cardiology, endocrinology and neurology|_| Qoprtum i Key Question(s) to be addressed While presenting your proposed solution, your team needs to consider the following key question(s): * Design probable solutions/business models based on (but not limited to) technological solutions, adoptable care models, learnings from other industries etc for Optum to address the gaps in adoption of loT-based healthcare solutions, for stakeholders like payers, providers, clinical pharmacies etc. Points/questions to be considered as part of your solution * Discuss the timelines and financial implications with respect to your team’s solution, and the potential executional roadblocks and risk mitigation considerations that need to be managed How would you ensure regulatory compliance, reliability and scalability of the proposed solution/s? Explore the future possibilities of healthcare delivery using Smart loT and the key role that Optum can play in the immediate future (consider a 3-year time horizon). With its current standing and existing capabilities, how should Optum accelerate its IT capabilities and derive synergies through partnerships to meet requirements for a comprehensive IoHT implementation and address potential roadblocks in the technical solutioning? How should Optum as an organization prepare its leadership to meet the evolving requirements and capabilities of loHT strategically? Outline the adoption and communication strategy for the healthcare population segments (such as Medicare & Medicare Advantage population with members who are 65 years and older; privately insured population with commercial healthcare plans for members who are less than 65 years old) to target and position your loT solutions You will be evaluated on following criteria: 1. Your understanding of the US healthcare system and related issues 2. How realistic the proposed solutions are, considering the 3-year time horizon, while exploring future possibilities of healthcare delivery using Smart loT 3. Holistic approach proposed to tackle the situation at the level of users (patients), healthcare providers, payers and internal stakeholders 4, Uniqueness and innovativeness of your solutions Coherence and Structure of presenting your thoughts 6. Relevance to the Health Care Industry Reference 1. MarketAndMarkets. loT in Healthcare Market by Component (Medical Device, Systems & Software, Services, and Connectivity Technology), Application (Telemedicine, Connected Imaging, and Inpatient Monitoring), End User, and Region - Global Forecast to 2025 2. https:/www.marsdd.com/news/transforming-health-shifting-from-reacti dictive-care/ 3. https:/fhealthcare-communications.imedpub.com/analytics-and-telehealth-emerging-technologi es-the-path-forward-for-smart-primary-care-environment.php?aid=20802 -to-proactive-and-pre