New data-driven technologies are spurring digitization and automation across the board. Ecosystems can bring material benefits to all payers, but a certain level of market concentration is required for an orchestrator role. Given the risk that nonpayers—from technology giants to pharmaceutical companies—could make powerful moves to establish themselves in central positions of digital health ecosystems, the pressure to act now is increasing. During the Disruptive Innovations in Healthcare conference, topics included digital therapeutics, latest remote patient monitoring, expanding telehealth services, new insurance reimbursement models for virtual care and the power of AI, as predictive analytics increase evidence-based discoveries and provide new treatment options. By Mathis Friesdorf, Ulrike Deetjen, Ajit Sawant, Digital health ecosystems: A payer perspective. Given the clear underlying value for stakeholders, we believe the time is right for digital health ecosystems to emerge at scale. For a payer striving to build such an ecosystem, a crucial first step is to build the right components to establish the necessary digital backbone. Thus, while size is still a winning factor, ecosystem dynamics are more complex in healthcare than they are in most other industries. The increasing cancer prevalence in the country is expected to drive the demand for advanced diagnostic imaging systems, thereby driving the industry growth. It is the top fifth country in the world considering the age-standardized rate for all cancers. Ideally, the analytic models should draw on a wide range of data, including information about consumers’ physical activity and general health behavior (Exhibit 6). Here, one payer directs the ecosystem and has control over two strategic aspects. Depending on the role a payer decides to play, the partners could be health systems, solution providers, or even other payers. Often, these services are created and provided by entities specializing in such offers. Surgeons can livestream and virtually “train” students watching from anywhere, or consult with other surgeons around the world, in real-time, during complicated surgical procedures. A number of concerns around AI technologies and smart medical devices need to be addressed rapidly. In healthcare, localizing forces are usually at play, including laws, regulations, language barriers, and the dependence on local care facilities. Today, for many, technology is an inextricable part of life and healthcare. Front-end integration can provide a quick solution and allow ecosystem offers to be scaled up rapidly. In essence, the question is to what extent the payer is capable of coordinating ecosystem efforts, effectively utilizing its membership base, and competing in a highly dynamic market. The result is that few ecosystems are successful in the long run, making the role of orchestrator difficult to obtain. In all the countries covered in the report, X-ray is expected to be the fastest growing category in addition to being the largest. Close to 20 000 experts from industry, commerce, government, test and research labs, academia and consumer groups participate in IEC Standardization work.

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