EMPOWERING THE NEW

HEALTHCARE ECOSYSTEM
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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

Today, the healthcare industry finds itself on the threshold of a

new era in which key stakeholders, empowered by technology,
are breaking down barriers and redefining what’s possible in
medical care. Find out how IT is shaping this new healthcare
ecosystem.

A NEW ERA

Never before has the healthcare industry offered so much hope amid
so much uncertainty. In the last decade, we have seen the unlocking
of the human genome, which has put personalized and predictive
medicine within reach for the first time in history. Advances in
biomedicine and pharmaceuticals are achieving unprecedented
success against formerly intractable diseases. And the next generation
of information technology is sparking innovation across the
healthcare value chain.

Yet we are also living in a time of great economic and social upheaval,
with healthcare businesses and organizations contending with
extraordinary new financial, demographic, and regulatory pressures.
A challenging global economy continues to strain the bottom lines of
providers, payers, and pharmaceutical companies - not to mention
the businesses and taxpayers who ultimately foot the bill. What’s
more, the economics of healthcare are set to become even tougher in
the years ahead as aging populations in industrial countries place new
demands on both private and public healthcare systems.

Tighter finances and thinning margins have made cost cutting and
operational efficiency a top priority across the healthcare supply
chain. It has also fueled innovation, with stakeholders ranging from
hospitals and insurance companies to drug companies and
pharmacies learning to exploit “Health IT” to become leaner and
more agile without compromising the end goal: patient care. Indeed,
Health IT is quickly turning into a competitive differentiator,
helping healthcare organizations attract new patients and plan
members with more personalized services and rich health-
information resources.

In the U.S., the convergence of medical advances, technology

innovations, and policy shifts are rewriting the rules of a $2.5 trillion
industry that makes up an astonishing 17.3% of the nation’s
economy.1 When President Obama signed the Patient Protection and
Affordable Care Act in March 2010, an entire industry was mobilized
by the prospect of serving 32 million newly insured people. A year
before, the Health Information Technology for Economic and
Clinical Health (HITECH) Act-part of the 2009 economic stimulus
program2 - poured billions of dollars into the development of
electronic medical records (EMRs).

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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

In the U.S., the convergence of medical advances,

technology innovations, and policy shifts are rewriting the rules
of a $2.5 trillion industry that makes up an astonishing 17.3% of
the nation’s economy.

These new programs come with sticks as well as carrots, and the new
era of healthcare will be marked by a ratcheting up of regulatory
rules, mandates and penalties designed to cut fraud and waste and
jumpstart new solutions such as health information exchanges.
Similar government initiatives are reshaping the healthcare landscape
of Europe, Asia and other developed economies around the world.

What does this all mean for industry stakeholders? At a minimum,

stakeholders will need to prepare for a world of escalating complexity
and volatility. Navigating this new environment won’t be easy. It
will call for flexible strategies that can evolve in step with the
changing economic, technological, and regulatory landscape. It will
call for smart investments in technology - ones that emphasize
interoperability, scalability, and cost-effectiveness. And it will call
for strategic partnerships to help stakeholders thrive in the new
healthcare ecosystem.

Navigating this new environment won’t be easy. It will call

for flexible strategies that can evolve in step with the changing
economic, technological, and regulatory landscape.

THE NEW HEALTHCARE ECOSYSTEM

Who are the stakeholders in the new ecosystem? At the highest level,
we all are. Anyone who seeks medical care as a patient has a vested
interest in the healthcare system. So the architecture of the new
healthcare ecosystem begins with the patient—the first “P” in what
we call the “6 Ps” of healthcare, as shown in the figure on the next
page.

The following key stakeholders populate the rest of the ecosystem:

?Providers - doctors, nurses, therapists, hospitals, physician

groups, clinics and other medical professionals and
organizations that provide medical care to patients.
?Payers - health insurance companies that cover the cost of
medical care, as well as businesses, organizations, and
individuals who either directly pay for care, or pay for
insurance coverage.
?Pharmaceutical companies - makers of drugs prescribed by

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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

doctors and healthcare providers; pharmaceutical companies

sell approximately $300 billion worth of products in the
U.S., and $650 billion worldwide.
?Pharmacies - a sometimes overlooked player in the
healthcare ecosystem, pharmacies represent a $277 billion
industry in the U.S., often providing critical guidance to
patients.
?Policymakers - government agencies and industry
organizations that set healthcare policy, write and enforce
regulations, and oversee industry standards.

THE 6 PS OF THE NEW HEALTHCARE

ECOSYSTEM

UNIQUE ROLES, SHARED INTERESTS

In the past, these stakeholders occupied distinct niches in the overall
healthcare ecosystem. Their roles were completely clear, in part
because interfaces between stakeholders were either weak or
nonexistent. Payers before the advent of managed services, for
example, stayed largely uninvolved in medical management;
pharmacies, lacking the enterprise software and networks to link to
providers and payers, served as passive dispensers of medicine;
providers, for their part, occupied “silos” of their own, lacking the
means to track patients from place to place, or automated systems to
offload the burden of paperwork.

The new paradigm reflects a “systems thinking” view of an industry

where the walls separating stakeholders are steadily crumbling -
where the success of one depends on the success of others, and where
new business models of coexistence and co-development are rapidly
becoming the norm. That’s partly due to new government

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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

regulations that have opened up vast flows of information between

patients, providers and payers - and throughout the ecosystem; and
partly the result of runaway medical costs, which have spurred the
entire complex to live within its means. That priority demands more
collaboration, more information sharing, more interoperability, and
more integration. In short: more convergence.

This new ecosystem presents tremendous opportunities for creating

value when stake-holders learn to grasp the full potential of
technology- and policy-driven convergence. In this new era, we see
stakeholders coalescing around a common goal: delivering better
care, to more people, at a reasonable cost. Getting there will require
vision, skill, and the confidence to invest in innovation. What is clear,
also, is that information technologies, services, and solutions will
play a central role in this value-creation process.

THE TECHNOLOGY EDGE

Historically, healthcare has been slow to embrace information

technology. “The healthcare industry…is where most of corporate
America was a decade or more ago in adopting Internet-style
computing,” writes Steve Lohr in the New York Times. “There are
innovators, intriguing experi-ments and lots of interest, but the
technol-ogy hasn’t yet gone mainstream.” But the situation is rapidly
changing, he adds, and “only the pace of the shift is in question.” 3

In truth, information technology has been transforming healthcare

organizations for more than a decade, albeit in low-profile venues
like hospital back offices, where enterprise resource planning (ERP)
systems have been installed to automate billing and other revenue-
cycle functions. Today, healthcare organizations large and small are
equipping themselves with enterprise systems and solutions to
optimize tasks ranging from claims processing and patient
admissions to workforce management and regulatory compliance.
Pharmaceutical companies, meanwhile, are investing heavily in IT to
speed drug development and testing programs.

Far from a trivial development, the growing adoption of Health IT

has generated enormous value for organizations. Among other
initiatives, strategic outsourcing and selected business-process
partnerships are generating immense value to healthcare
stakeholders, translating into billions of dollars in bottom-line
savings across the industry. The move is letting healthcare
organizations spend less on tasks that fall outside their core
competency and transfer more resources to areas that matter most,
such as clinical care, scientific research, and healthcare education.

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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

Beyond the administrative streamlining, Health IT has now moved

to the forefront of medical best practice, giving providers the
knowledge and tools to head off disease before it strikes, while
empowering patients with the resources to take charge of their
healthcare and make smarter decisions from both a medical and cost
perspective.

In these areas, Health IT’s strength lies in its power to distill massive
amounts of data from disparate sources, to provide mechanisms for
faster, better decision-making, and to open up new channels of
communications between patients, providers and payers. At the end
of the day, enabling the predictive, preventive and participatory
approaches to healthcare made possible by IT is expected to yield the
most meaningful and lasting returns to the industry and society as a
whole.

EMERGING TRENDS

The tech-enabled future is already visible in several key trends

emerging now. Chief among them may be the accelerating adoption
of electronic medical records that share data across networks. EMRs -
along with the closely affiliated EHRs (electronic health records) and
PHRs (personal health records) - will soon become pervasive,
boosted by nearly $20 billion dollars in government incentives as
well as advances in information security and portability that have
addressed initial concerns about the concept. Nearly 200,000
providers have already adopted EMRs, yet its potential for
improving patient health remains largely untapped.

Healthcare will be more coordinated in the future, continuing a trend

of “patient-centric” care that emphasizes preventive primary care and
close partnerships between patients and providers. Guided by shared
information, patients will move seamlessly between all types of care -
givers in an integrated fashion, with each provider staying fully
informed of the patient’s overall progress. Care coordination will
drive savings by improving medical outcomes and focusing care more
effectively.

Increasingly, evidence-based medicine will become the norm for the

healthcare profession. This methodology depends on analyzing
massive stores of data, including genomic and epidemiological
databases, to refine diagnoses and set the best course of treatment for
each individual. The approach is one of the most reliable ways to
improve treatments and outcomes, which makes it an attractive
option for every stakeholder in the industry.

Information technology will enable healthcare to be delivered on a

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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

more constant basis in the years ahead. Telemedicine will support

that trend, enabling expert care to be delivered wherever the patient
lives via broadband multimedia networks. Such technology bridges
vast distances in an instant, giving patients new options for home
healthcare and extending the specialized skills of experts to more
people and geographies.

Guided by shared information, patients will move

seamlessly between all types of caregivers in an integrated
fashion, with each provider staying fully informed of the
patient’s overall progress.

CONCLUSION

In the new healthcare industry, stakeholders will continue to be

challenged by tough choices as they seek to deliver the highest level of
patient care with limited economic and human resources. For that
reason, information technology will remain at the center of the new
healthcare ecosystem, helping stakeholders harness the power of
collaboration and knowledge sharing to improve care, stretch
budgets, and spark innovation. Convergence will be a dominant
trend in this world, and the most successful stakeholders will be those
that exploit the tremendous value potential of cross-boundary
integration and innovative technology partnerships.

ABOUT AUTHOR
For more information about how HCL is enabling the future of
healthcare, contact Pradep Nair, Senior Vice President -
Healthcare Practice, HCL, at pnair@hcl.com.

REFERENCE
1 http://prescriptions.blogs.nytimes.com/2010/02/04/us-health-
care-spending-rose-at-record-rate-in-2009/

2 Also known as the American Recovery and Reinvestment Act

(ARRA)

3 “Health Care Industry Moves Slowly Onto the Internet,” Steve

Lohr, New York Times, April 5, 2009.

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EMPOWERING THE NEW HEALTHCARE ECOSYSTEM

ABOUT HCL
HCL Technologies

HCL Technologies is a leading global IT services company, working

with clients in the areas that impact and redefine the core of their
businesses. Since its inception into the global landscape after its IPO
in 1999, HCL focuses on ‘transformational outsourcing’, underlined
by innovation and value creation, and offers an integrated portfolio
of services including software led IT solutions, remote infrastructure
management, engineering and R&D services and BPO. HCL
leverages its extensive global offshore infrastructure and network of
offices in 26 countries to provide holistic, multi-service delivery in
key industry verticals including Financial Services, Manufacturing,
Consumer Services, Public Services and Healthcare. HCL takes pride
in its philosophy of ‘Employees First’ which empowers our 77,046
transformers to create real value for customers. HCL Technologies,
along with its subsidiaries, had consolidated revenues of US$ 3.5
billion (Rs. 16,034 crores), as on 30 June 2011 (on LTM basis). For
more information, please visit www.hcltech.com

About HCL Enterprise

HCL is a $6 billion leading global technology and IT enterprise
comprising two companies listed in India - HCL Technologies and
HCL Infosystems. Founded in 1976, HCL is one of India’s original
IT garage start-ups. A pioneer of modern computing, HCL is a global
transformational enterprise today. Its range of offerings includes
product engineering, custom & package applications, BPO, IT
infrastructure services, IT hardware, systems integration, and
distribution of information and communications technology (ICT)
products across a wide range of focused industry verticals. The HCL
team consists of 85,000 professionals of diverse nationalities, who
operate from 31 countries including over 500 points of presence in
India. HCL has partnerships with several leading Global 1000 firms,
including leading IT and technology firms. For more information,
please visit www.hcl.com

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