Six Winning Roles For Medtech To Thrive In The Future Of Health

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Six winning roles formedtech to thrive inthe future of health

Six winning roles for medtech to thrive in the future of healthWe are living in an era of exponential change in medicaltechnology, with developments so fast and nonlinearthat they are at the point of limiting our ability to see overthe horizon. Numerous trends, many of them driven bydigital transformation (figure 1), are accelerating the paceof disruption and propelling us toward a future of healththat will be significantly different from our current medtechmarketplace.By 2040, we expect that the consumer willbe at the center of all things health-related.Health will be defined holistically as anoverall state of well-being encompassingmental, social, emotional, physical, andspiritual health. Interoperable, always-ondata will promote closer collaborationamong industry stakeholders, andinnovative combinations of products andservices will be offered by incumbents andnew entrants. Interventions and treatmentsare likely to be more precise, morepersonalized, less complex, less invasive,and less expensive.What role will medtech companies playin the future of health? Conventionalmedtechs traditionally have focused theirbusiness operations and investments onmanufacturing and selling technologicallyadvanced medical products such asdiagnostic equipment, implantable devices,monitoring devices, or other medicalsupplies. However, as evolving consumerhealth needs and increasing data availabilitydrive development of new solutions that gobeyond the device, the implications for thesecompanies’ future market viability couldbe considerable. For example, innovativemedical solutions will be enhanced bynontraditional consumer technology anddigital health disruptors, creating datacentric offerings and clinically differentiateddevices. Flexible consumption modelsare emerging in which companies offerservices on a per-patient, per-use basis,providing alternatives to traditional capitalintensive models. Health will be monitoredon a continuum of care, with providersfocusing on devices and equipment thathelp improve patient outcomes. Decreasingreliance on traditional product-centricsolutions will be offset by increasing needfor consumer preventive wellness solutionsand postprocedure monitoring capabilities.Figure 1. Future of health trends are driving medtech marketplace changes02Data-sharingStrong participation indata-sharingInteroperable dataData archetype and analysisis radically transformedAccessSocioeconomics and geographydo not dictate accessEmpowered consumerConsumers demand convenienceand transparencyBehavior changeConsumers influenced viadigital toolsScientific breakthroughBreakthroughs will happen atan exponential pace

Six winning roles for medtech to thrive in the future of healthMany medtech companies are alreadybeginning to incorporate always-onbiosensors and software into devicesthat can generate, gather, and share data.That’s an important step forward, but tocreate sustainable clinical and businessvalue, medtechs will need to evolve fromtheir current product supplier role anddefine where they want to play and howthey want to win in the future of health viathese new roles.In particular, we envision six future rolesthat will enable medtech companies todeliver meaningful and differentiated valueand thrive in tomorrow’s consumer-centric,digitally powered health care marketplace(figure 2).Figure 2. Six future medtech roviderDiseaseownerEcosystemdata rentiatingthroughmeaningful andsustainable costadvantageBest-in-classR&D capabilitiesto deliver gholistic solutions,includinghardware,software, andservices, toenable optimizedcareProviding endto-end solutionsacross patientjourney todiagnose, treat,and monitorspecific diseasesIntegrating dataand generatinginsights andecosystemwideanalytics acrossentities, devices,and diseasesEnablingconsumers toself-manage andimprove healthvia connectedsensors andvirtual doctorsValuedriversCommoditydevices at lowestcostsClinicallydifferentiateddevicesHolistic medicalsolutions tooptimize careEnd-to-endsolutions forspecific diseasesData, analytics,and algorithmsSmart healthdevices andplatforms forconsumersCustomersProviders, othermedtech rolesProviders, othermedtech rolesProvidersProviders, payers,consumersProviders, payers,other medtechrolesProviders, payers,consumersSimilar to existing modelMore transformative03

Six winning roles for medtech to thrive in the future of healthAs they evolve to these roles, medtechs willneed to: Strengthen core capabilities tospecialize either as a low-cost, highlyefficient supplier or a premium supplier ofinnovative and differentiated products; Expand offerings to create holisticsolutions by either combining products,software, and services to help providersachieve clinical and operational excellenceor integrating all products and servicesrequired to treat a selected disease viapartnerships or acquisitions; and Enter new spaces by providingtransformative offerings that eitherfacilitate data transfer, insight generation,and decision optimization across thehealth ecosystem or enable consumers tobetter and more proactively manage theirhealth (figure 3).A medtech company may operate in one ormultiple roles, depending on what productsand services it offers and what markets andcustomers it serves. For each role, we lookat key success factors and capabilities andprovide examples of companies that illustratecharacteristics of these future-focused roles.Figure 3. Six future medtech rolesExisting customersCustomersAdjacent or new customersRoles will evolve to help companies strengthen core capabilities, expand offerings, and/or enter new spacesENTER NEW SPACESConsumer healthenablerEcosystem data andinformatics providerOwning the diseaseNext-gen st-in-class innovatorSTRENGTHEN COREExisting offeringsEXPAND CAPABILITIESIncremental offeringsOfferings04New offerings

Six winning roles for medtech to thrive in the future of healthStrengthen corecapabilities todifferentiateFuture role 1: Next-gen commoditiessupplierSimilar to the product supplier role mostcurrent medtechs hold, the next-gencommodities supplier provides clinicallysound products at a much lower price viasuperior efficiencies that lead to meaningfuland sustainable cost advantages. Therole takes advantage of digitally enabledsupply chain capabilities, access to lowcost supplies and labor, partnershipsthat leverage new data, and a globalnetwork to achieve an industry-leadingcost-of-goods-sold profile. The next-gencommodities supplier role is critical tothe health ecosystem because it provides“good enough” products at the lowestprices, similar to generics manufacturersin the pharmaceutical industry. Potentialvariations of this role include fullspectrum manufacturer with lean R&Dand commercial functions; commoditymanufacturing company providingmedical devices; and vertically y, founded in Shenzhen, China,in 1991, has become the largest Chinesemedical technology company. It develops,manufactures, and supplies high-qualitymedical products at lower costs, makinghealth care more accessible and affordablearound the world in three core businesses:patient monitoring and life support, medicalimaging, and in vitro diagnostics.Mindray’s success has been largely driven by itscost advantage. In the Chinese market, Mindraycompetes with multinationalsby offering its devices at a 20% to 30% discountnext to those of its international competitors. Alow-cost production structure has enabled thecompany to sustain such price advantagewithout decimating margins. After its success inthe Chinese market, Mindray has beenexpanding its footprint globally. Its high-quality,low-cost value proposition resonates well inemerging and developed markets under globalhealth care cost containment trends. Today,Mindray is selling its products in more than 190countries and regions, reaching 2.3 billionannual revenue in 2019. Only two years afteran IPO on the Chinese A-share market inOctober 2018 at a price of CNY 89, Mindray’sstock grew more than 356% to close at CNY406 as of November 4, 2020.1Cardinal Health’s Medical Products &Equipment segment manufactures, sources,and distributes Cardinal Health-brandedmedical, surgical, and laboratory productsglobally. The company’s products bridge thegap between the constant need for qualityand the increasing demand for savings. Itsbrand portfolio includes a comprehensiveoffering of clinician-preference, cost-efficientproducts and physician-preferred items withlow clinical differentiation, helping providersimprove the bottom line while deliveringhigh-quality care.2In addition to selling Cardinal Health–brandedproducts, Cardinal also distributes a broadrange of medical, surgical, and laboratoryproducts from other manufacturers andprovides supply chain services and solutionsto hospitals, ambulatory surgery centers,clinical laboratories, and other health careproviders. It is one of the few verticallyintegrated manufacturer-distributor playersin the medtech industry that providecost-effective solutions to help customersimprove operational efficiency andfinancial performance.1 ng Matters A smart approach to intelligence.html.2 s/medical.html.05

Six winning roles for medtech to thrive in the future of healthFuture role 2: Best-in-class innovatorA best-in-class innovator provides productswith substantial clinical and economicdifferentiation, such as devices that cancure specific diseases, significantly slowdisease progression, or enable personalizedtreatment with higher clinical utilization.Best-in-class innovators excel in the idea-tomarket process and deliver superior productinnovations via customer-centric, datadriven, open innovation capabilities withsignificant access to world-class medicalresearchers and clinicians. Success in thisrole requires an agile ability to evaluateinnovative ideas both internally and withexternal partners. Market development willbe another required capability, as many ofthe products this role introduces will be firstof-their-kind. Investments in comparativeeffectiveness studies may be needed tosupport market-shaping and/or penetrationefforts. Although this role is still a productsupplier, it adds value to the healthecosystem by regularly and consistentlydesigning, developing, and introducing trulyvalue-enhancing, differentiated products.Potential variations of this role includefull-spectrum manufacturer with minimumcommercial capabilities (process or producttechnology innovators); R&D and small- ormedium-scale manufacturing capabilitiesonly (product technology innovators only);and academic or research institutions.Examples:Intuitive Surgical leverages AI and dataanalytics in its product developmentprocess to fuel innovations that canhelp enable better outcomes.3 Intuitive’swell-known robotic surgery platforms,VinciSP System and Ion, continue to makeheadway in the marketplace with novelcapabilities like pre- and intraoperativeaugmented reality (AR) guidance, delivering3D images of a patient’s anatomy. Inaddition to platform-based innovations,Intuitive Surgical continues to set newbenchmarks in core technologies, likeits X and Xi Endoscope Plus imagingtechnology, which provides fifthgeneration resolution. Intuitive’s businessmodel innovations, including increasinguse of operating leases of its equipment,at 34% of total placements in 2019, 4 isseen as being equally important in thisage of tight hospital budgets.Stryker uses in-house R&D andmanufacturing capabilities and partnerswith leading academic medical centersto develop and test new digitally enabledcare products that deliver better patientoutcomes.5 Stryker has consistentlyleveraged customers in leading academicmedical centers to improve its productsand help those customers improve themetrics they are measured on, includingrehospitalizations and cost savings fromprocedures where Stryker products areused. By going beyond core productbenefits and creating better metricsaround performance metrics of utmostimportance to health systems, Strykerhas been able to innovate both on keyproduct and solution dimensions.3 https://www.intuitive.com/en-us.4 Intuitive Surgical JPMorgan presentation, January 2020.5 ions-case-study 06

Six winning roles for medtech to thrive in the future of healthExpand offeringsFuture role 3: “Medical-solutions-as-aservice” providerA “medical-solutions-as-a-service” companyelevates the transaction-based productsupplier role to that of a customer businesspartner via data-driven delivery of holisticsolutions, including hardware, software, andprofessional services (e.g., clinical workflowconsulting, analytics, and management,enabling customers to optimize clinical,operational, and economic outcomes on aper-patient basis. Companies that adopt thisrole will need to embrace outcome-basedand/or subscription-based revenue models,as traditional volume-based models areunlikely to be as effective. These medtechswill be truly integrated into their customers’operations and eventually assumefull responsibility for specific enablingfunctions and processes (e.g., device datamanagement and analytics. Potentialvariations of this role include comprehensivesolutions provider, including all hardware,software, and service needs; provideroperations integrator creating meaningfulvalue clinically and operationally; andmedical solutions aggregator from differentsources, providing a single solution platform.The high tech industry went through a similarevolution from selling productsto delivering solutions a decade ago. Keylearnings from that process may be helpfulto medtech companies planning to becomea service provider.Examples:Siemens Healthineer is a leading globalmedical solution company that offers avariety of products in its portfolio thatsupport clinical experts in diagnostic andtherapeutic decision-making. Siemensalso provides a range of services andsolutions to enhance health care providers’ability to provide high-quality, efficientcare to patients. To transform its productfocused business model to a solutioncentered business model, Siemens hassuccessfully established many multiyearvalue partnership contracts with healthsystems globally to advance and supportcustomers’ strategic priorities relatedto continually improving care for theirpatients and communities. Under the valuepartnerships, Siemens provides customersaccess to its latest health innovations andmedical equipment, as well as educationalresources, professional services, andon-site staff to support clinical decisionmaking, optimize workflows, transform caredelivery, and improve patient experience.Many of these value partnerships alsoinclude innovative contract models suchas unitary, pay-per-use, subscriptions, andperformance-sharing.66 e-partnerships.7 ml.8 ml.Medtronic has operations in 150 countries worldwide7 and offers a diverseproduct portfolio treating more than 70health conditions. With the market evolvingand moving toward value-based healthcare, Medtronic formed its IntegratedHealth Solutions business to delivervalue and work with providers in newways. Integrated Health Solutions buildson Medtronic‘s unique combination ofcapital resources, process optimizationexpertise, and therapy knowledge andoffers hospitals and health care systemslong-term, all-inclusive managed services toimprove clinical, operational, and financialoutcomes. In 2014, to expand its servicedelivery capabilities, Medtronic acquiredNGC Medical in 2014, an Italian companywith more than 30 years of experience inbuilding and managing operating rooms(ORs, catheterization laboratories (cathlabs, and intensive care units (ICUs. Today,Medtronic has established more than 60managed services contracts, with 250 ORs, 600 ICU beds, and 50 cath labs.807

Six winning roles for medtech to thrive in the future of healthFuture role 4: Disease ownerA medtech company that “owns” a diseaseprovides superior care coordination and aone-stop shop portfolio of devices, digitaltools, services, and, potentially, drugs totreat or manage a specific disease acrossthe patient journey, from diagnosis andtreatment to ongoing monitoring. We expectto see this role be effective in managingchronic diseases (e.g., diabetes, renal,cardiovascular, and respiratory care) byoffering solutions that go across the carecontinuum and therapy lines, from patientdiagnosis through monitoring. The diseaseowner role aligns with population healthgoals rather than specific procedures orepisodes, and it will be critical in the caremodel transition from fee-for-service to feefor-value. A capitated payment model couldbe structured so that payers, providers,and manufacturers have aligned incentivesto optimize patient care with minimizedcosts. Potential variations of this role includefull-spectrum manufacturer for specificdisease states and vertically integratedmanufacturer-provider.Examples:Fresenius Medical Care provides acomplete solution for people with chronickidney failure—from research anddevelopment, to manufacturing dialysisproducts, to providing care options withinits own clinics. With the acquisition ofNxStage, Fresenius enhanced its homehemodialysis systems and services toinclude 24/7 on-call nurses, monthlycheck-ins, regular meetings with careteams, and medication.9 With homedialysis care currently underpenetratedin the United States (when comparedwith other OECD markets), Fresenius hasenhanced its ability to shift some currentclinic-based patients to the home tolessen costs and enhance the customerexperience. Alongside this shift has comethe need to think about the managementof comorbidities associated with renalfailure, including diabetes and heartdisease. Fresenius’s recent announcementof an innovative partnership withLivongo 10 to provide remote monitoringand personalized coaching for late-stageCKD patients who also suffer fromdiabetes points to the type of holisticpatient care management that leadingmedtech companies are undertaking.9 amilies/services-from-fresenius-medical-care.10 p-livongo-empowers-people-ckd.11 wound-management.08Smith&Nephew’s Advanced WoundManagement (AWM) division is a leadingglobal wound care product supplier. Asthe market continues to face significantpricing pressure and products becomemore commoditized, S&N expanded itsoffering portfolio from treatment productssolely to cover the entire wound carecontinuum. Through innovations andacquisitions, S&N’s current AWM portfolioincludes wound prevention, wounddetection and diagnosis, a wide rangeof wound treatment products, and carecoordination and monitoring solutions.As it expands the AWM portfolio, S&N isalso applying a disease lens to create endto-end solutions for specific acute andchronic wound conditions, including leg,diabetic, and pressure ulcers; burns; andpostoperative wounds.11

Six winning roles for medtech to thrive in the future of healthEnter new spacesFuture role 5: Ecosystem data andinformatics providerMany hospitals and health systems makeminimal use of analytics due to dataavailability and interoperability challenges.Data is the new gold in the increasinglydigitized health care space, given its vitalrole in improving clinical decision-makingand care quality. We expect an ecosystemdata and informatics provider role willemerge to collect, aggregate, curate,analyze, and interpret data from varioussources—and enable data interoperability—to generate superior insights andrecommend actionable next steps sothat providers can deliver superior care.Potential variations of this role include dataconveners and artificial intelligence (AI)algorithm developers for improved productsand treatments; application developersand insight generators; and advisoryservices for hospital systems. Becausebig health IT companies may already mayhave a competitive edge to win in thisrole and consumer tech giants are alsoinvesting heavily in health care, medtechcompanies interested in this role will need todramatically transform their capabilities orleverage these same consumer tech leadersvia partnerships.Examples:Verily (Google’s health care company)uses big data and the Internet of Things(IoT) to improve health care outcomes.12Verily develops computational toolsthat help create a stronger feedbackloop; support learning health systems inwhich better data continuously improvesinterventions and care; and increaseaccessibility to research and care.13 WithAlphabet’s recent acquisition of Fitbit,Verily now can leverage a number ofwearable devices as it looks to collectmeasurements and data about a patient’shealth so that it can be combined withother information that Google has aboutthat patient.Cerner offers analytics, populationhealth management, clinical solutions,revenue cycle management, and otherservices and technology that enablehealth care providers to make informeddecisions to better manage operationsand provide smarter patient care.14 As anelectronic medical record (EMR) leader,Cerner can leverage a number of datasources as it looks to offer enhanced dataanalytics and longitudinal records to thoseanalyses. Cerner’s HealthAnalyticsSMand HealthEDWSM analytic contentpackages15 are just two ways the companyis operationalizing this vast trove of datato glean more precise clinical insights.Cerner’s partnerships with AWS andothers point to additional ways in which itis teaming with other companies to offerresearchers access to de-identified data.1612 and-big-data-play-for-healthcare.13 https://verily.com/our-story/about-us.14 https://www.cerner.com/about.15 -management/analytics.16 artner-make-covid-19-data-available-researchers.09

Six winning roles for medtech to thrive in the future of healthFuture role 6: Consumer health enablerHealth care is transitioning to a preventionand wellness-oriented model, with morecare delivery happening in consumers’homes instead of the traditional physicianoffice or hospital. The consumer healthenabler role empowers consumers toproactively and continuously manage theirown health by collecting and analyzingdata from various diagnostic devices (e.g.,implantable, wearable, and environmentalsensors) to generate superior, consumerfriendly insights and care recommendationsdelivered via telehealth and virtual physiciantools. This role supports early diseasedetection and behavioral nudging byintegrating consumer health data with coredeterminants of health, such as an annualphysical (including blood pressure, pulserate, RBC and WBC count, and psychologicaltesting) and social determinants ofhealth data. Variations of this role includeconsumer-friendly, non-medical-gradedevice manufacturers and applicationsand platforms for virtual preventive andwellness services and care management.To succeed as a consumer health enabler,medtech companies will need to shift froma provider-centric to a consumer-centricbusiness model with efficient and effectivecapabilities to reach and engage a broadconsumer customer base.Examples:Zimmer Biomet partnered with Appleto create a consumer-friendly way forpatients to track their recovery fromknee or hip replacement surgery. TheZimmer Biomet mymobility app usesApple Watch to facilitate a new level ofconnection between patients and theirsurgical care teams.17 With this enhancedpatient engagement, Zimmer Biomet isdemonstrating how medtech companiescan embark on a digital transformation ofthe patient care journey, including pre-opeducation and activity monitoring linkingstep count and heart rate variability. Byusing the Apple iPhone to score peopleon the way they walk, detected evenbefore a procedure is needed, ZimmerBiomet is hoping to be “the first to developpredictive analytics that connects pre-,intra-, and post-operative data,” therebyenhancing prevention and wellnessfunctionality.17 news/2018/10-15-2018.18 https://www.jnj.com/jjhws.10Johnson & Johnson Health andWellness Solutions collaborates withhealth plans, health systems, and retailersto deliver behavior change solutions atscale to deliver better health outcomes,business performance, and patientexperience.18 J&J’s solutions offer a wayfor devices to integrate key behavioralscience concepts and approaches asthese become critical to helping cliniciansand patients change their behavior on theuse of those devices. By focusing around“last mile,” medtech leaders like J&J hopeto improve clinical outcomes beyond justproduct-based capabilities.

Six winning roles for medtech to thrive in the future of healthMedtech roles of the future will evolve alongwith the products and services they offerand what customers they serve (figure 4). Ofthe six future roles, the first two (next-gencommodities supplier and best-in-classinnovator) are embedded in many leadingmedtechs’ current operations. We expectthese roles to continue in the future.Examples of the other four roles (“medicalsolutions-as-a-service” provider, diseaseowner, ecosystem data and informaticsprovider, and consumer health enabler) areemerging; we expect these roles to grow inimportance and influence as time goes on.Figure 4. Roles of the future will evolve along with what they offer and where they serveThe future roles will evolve to either strengthen core capabilities, expand offerings, or enter new spacesPatientjourneyPreventionand wellnessScreeningand diagnosisTreatmentdecision isory andoperationalservicesConsumer healthenablers“Medical-solutions-as-a-service” providerOperationalworkflow,data, andanalyticsEcosystem data and informatics provider(1/2)Health ITsoftwareNext-gen commodity supplierDevicesBest-in-class innovatorDigital healthand algorithmsEcosystem data and informatics provider(2/2)Patient dataand analyticsDisease ownerCare planning,coordination,and delivery11

Six winning roles for medtech to thrive in the future of healthAct today to transformtomorrowHow do conventional medtech companiesbegin or advance their journey to the futureof health? What immediate steps shouldthey take? We suggest that companiesfirst assess each business and productportfolio’s capabilities and value propositionand map that to each role’s capabilities andvalue proposition (a business and productportfolio may operate in one or more roles).They should then identify capability gapsthat may prevent them from realizing thebenefits in the appropriate role(s) and,finally, create a build, buy, and partnerstrategy to close those gaps.Ultimately, what may help enable medtechcompanies to transform care deliveryand set them apart from competitors(both market incumbents and disruptiveentrants) will be their ability to harnessdata gathered by their devices and use it toimprove well-being, anticipate health issues,and help patients change the day-to-daybehaviors that affect their health.19 Ourview is that medtechs likely will be betterable to do this by partnering with consumertechnology leaders and specialized digitalhealth companies rather than going italone. Consumer tech companies typicallyhave access to large caches of consumergenerated data (nonhealth data thatleads to health insights), a massive R&Dbudget, efficient distribution channels,an embedded culture of innovation, andsophisticated data analytics capabilities thatcan buttress a medtech’s remote diagnosticand monitoring platforms.The time to act is now. The medtechcompany of the future will likely operatein a dramatically altered health carelandscape. We expect the revenue pool forthe traditional medtech role to continueshrinking as the value it delivers decreasesover time and new roles evolve. As companyleaders plan their migration strategy, somemay decide to focus on excelling in a singlerole, while others may choose to leverageinvestments in new technologies to take onseveral. In either case, they should quicklyassess their current offerings, customers,and unique capabilities (and identifygaps and ways to fill them) or risk beingoutmaneuvered by competitors.What to do on Monday morning will dependon how far behind a company is in its rolemigration strategy. To that end, a robust“zoom out, zoom in” strategic planning effortcan incorporate these roles and frame themmore in terms of a decision tree than a linearplan. By combining a long-term, scenariodriven strategic planning exercise with ashort-term action plan, medtech leaderscan operationalize this future role evolutionassessment and ground it in concrete stepsthat flow into specific businesses, productportfolios, and solutions.By zooming out, medtech companies candetermine what their relevant market orindustry will look like 10 to 20 years fromnow and what kind of roles they will need tohave in that time frame to be successful inthat market or industry. By zooming in, firmscan determine the two or three initiativesthey could pursue in the next six to 12months that would have the greatest impactin accelerating their movement toward thatlonger-term destination. It would also helpthem assess whether those initiatives havea critical

A medtech company may operate in one or multiple roles, depending on what products and services it offers and what markets and customers it serves. For each role, we look at key success factors and capabilities and provide examples of companies that illustrate characteristics of these future-focused roles. Figure 3. Six future medtech roles

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