Changing healthcare into a proactive, patient focussed system

Changing healthcare into a proactive, patient focussed system

NetherlandsZeist, Netherlands
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

INSIDER® is a unique, system independent IT solution that enables doctors to get insight in the outcome data of patients. This allows them to change their usually reactive behaviour into a patient focussed, proactive attitude. Patients experience better healthcare, enabling them to do more, feel better and live longer.

About Project

Problem: What problem is this project trying to address?

We solved the problem of measuring outcomes in a very fragmented IT infrastructure. The Dutch Healthcare system is moving from an input oriented reward system via ‘pay for performance’ towards an outcomes driven reward system, ‘pay for outcomes’. The most important barrier in this change is the very fragmented IT infrastructure which makes it impossible to get insight in the outcomes, the healthcare quality. The impact of this barrier is huge: payers cannot contract healthcare on the basis of outcome criteria, healthcare providers have difficulties with knowing exactly the results of their interventions and patients cannot choose their healthcare providers on the basis of quality criteria.

Solution: What is the proposed solution? Please be specific!

GSK (with IT partner) has developed a data selection and analysis tool, called INSIDER®, that makes it possible to extract all data out of the database of all 11 different GP systems. This was the first gap that was filled. The second gap we filled was the fact that each system has its own way of registering data. Via a clever way of integrating data we have made it possible to aggregate data in a similar way at group level. The result is a system independent tool that can help with identifying patient groups on the basis of outcome criteria and that can help healthcare groups to get insight in and compare the quality of the different practices within the care group or even outside the care group with peer groups.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

Example: identifying patients at risk and measuring outcomes in osteoporosis (drug compliance is a big issue here) 1) GSK has developed a specific dashboard with INSIDER software to get insight in the population of the osteoporoses patients in practice, providing information about their use of medicines and most importantly providing insight about the medication compliance. Names and addresses of these patients are provided and the doctor is asked to 2) Take action by implementing professional treatment guidelines. Less and non-compliant patients are invited for consultation and the treatment will be adapted, or the patients get additional support/ information 3) After a defined period INSIDER will be used to measure the results (outcomes) of the intervention. This is an example of the big promise of INSIDER: transforming an input driven, reactive healthcare system into an output driven, proactive system in which doctors perform population / disease management.

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

In the marketplace there are no competitors if you define competition in a very narrow way. There is no solution like INSIDER that works on every GP system. However, there are many ways to extract data from GP systems. Most of them are provided as standard functionality by the GP system supplier (in less advanced form). There are also data suppliers that have developed ways to extract data from different systems. These traditional methods are costly, time consuming and relatively inaccurate. The challenges traditional players can pose are potentially trying to prevent Insider working on the GP systems. The business model we have chosen is based upon cooperation (also with the traditional players) and open innovation in order to cope with this potential challenge.

Founding Story

The first time we saw what INSIDER could do with the data from one GP system, made us realize what a unique product we had developed, knowing we could do the same for all existing GP systems. INSIDER showed outcome data from therapies and diseases and was able to drill down to the lowest level, the individual patient. Now it was possible to proactively identify patients who needed a therapeutic intervention. We decided to start the commercialization process. We were confirmed in our belief when we visited KaiserPermanente in the US. They had invested billions of dollars in an IT system which had a similar approach as we developed. And very recently we shared our experiences with BMJ Informatica, a UK company with a similar approach for the UK. These two experiences had one thing in common: they both used IT solutions to change the behavior of their doctors in order to create a proactive, outcomes oriented healthcare system.
About You
About You
First Name


Tell us about yourself/your team.

My passion is to make a contribution to the health of patients and our society. Not only by helping to deliver medicines to patients for a better life, but also by developing solutions for a sustainable healthcare system. As a senior strategist, with a background as economist, developing simple solutions for complex challenges inspires me.

What makes you an intrapreneur? What are the skills, capabilities, and personality traits that make you an intrapreneur?

It is the strategic thinking and the organizational skills to develop and implement healthcare solutions. Combined with an enormous drive and passion to overcome the challenges…

About Your Organization
Company Country

, UT, Zeist

Primary country where this project is creating social impact
Additional countries or regions

Health Care

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Select the stage that best applies to your solution

Start-Up (a pilot that has just begun operating)

The Solution: Why is this solution innovative for your company and industry?

1)It does not exist because of the fact that traditional IT suppliers usually only work for their own system.
2)The IT market is more supply driven than demand driven. Strategies are based on ‘customer lock in’ principle, meaning that barriers for switch are high. Hence real innovation doesn’t come from the traditional suppliers.
3)The unique knowledge that is brought in by GSK has resulted in functionality that does not exist, like patient compliance information.

What has been the impact of your solution to date?

Having officially launched nine months ago (March 2012) it is too early to say anything about the impact on the healthcare delivery. However, with more than 300 INSIDER installations (out of 7000), paid licenses, and several care groups under contract we are satisfied with the uptake so far. Knowing that there is large and concrete interest from important stakeholders like patient organizations, Healthcare Insurers, the national GP association and more.
Furthermore there are case reports that patient management with INSIDER has improved.
In 2011 we also decided that other pharmaceutical companies could work with INSIDER for use in healthcare improving projects. In 2012 there are two other pharmaceutical companies working with INSIDER and two other companies are about to sign contracts.

What is your projected impact over the next 1 to 3 years?

2013 will be an important year, we have planned that the top 3 GP system suppliers will adopt Insider which will lead to >40% market share by the end of 2013 (conversations are ongoing). In 2014 InZo (supplier of INSIDER) will make break even revenues and by the end of 2015 the aim is a market share of 80% in the GP market.
Depending on the success of INSIDER in the Netherlands GSK will look for expansion of this idea through other GSK affiliates in other countries.

What barriers might hinder the success of your project? How do you plan to overcome them?

1.GP system suppliers work against INSIDER
Plan: In the business model we have chosen GP system suppliers can offer Insider ‘for free’ to their users.
2.The target audience (GP’s) doesn’t accept INSIDER
Plan: Having learned from the success of BMJ Informatica, we know that acceptance of the user group (GP’s) is the most important factor to gain such a large coverage. For this reason we have been discussing with the national GP associations for years and basically the proposition to them is that they can use Insider for every member at the lowest possible price.
3.INSIDER being marketed as a completely independent product
Plan: Since INSIDER is developed by GSK a trustworthy product image is not immediately earned. For this reason Insider is marketed by a third party: InZo.

What is the benefit or value you're creating for your business?

The patient and the healthcare system are the parties that benefit the most from INSIDER. For this reason GSK has decided not to earn any money out of INSIDER sales and ‘donate’ the investment of over 1 million Euros to society.
However, there is absolutely value for GSK’s business: when the ‘reactive’ attitude of healthcare suppliers is changed into a proactive, patient focused approach, more patients will be seen by doctors to get the appropriate medicines they need, including medicines supplied by GSK.

How are you leveraging internal resources (funds, time, knowledge, etc.) to support this initiative?

For years the GSK Netherlands Management Team has deliberately separated a small department especially devoted to healthcare innovation. This innovation has its own separated expense budget, unrelated to commercial product targets. The budget can be used to develop healthcare innovations to better deliver (pharmaceutical) patient care. These innovations may be related to GSK’s drug portfolio but can also be unrelated (in the case of INSIDER for example). In the innovation team there are people working with unique knowledge, for example in the field of healthcare IT and business model innovation.
All the major decisions, like the commercialization of INSIDER and the privatization with InZo are taken with and supported by the Dutch Management Team.

Expand on your answer, explaining the long-term funding and support plan.

As mentioned before, the decision was made in 2010 to bring INSIDER to the market with its own, independent business model. From 1 January the marketing of INSIDER will be done by an independent company called InZo, with the ambition to make INSIDER commercially viable in 2 years time. Until 2014 GSK will continue to support InZo with financial investments (1 fte personnel and development subsidies) and investments in kind (1,2 fte).
After 2014 GSK will support InZo less financially but with knowledge and in use.
The aim of this strategy is to ensure that INSIDER can deliver value in the long term, even without financial support from GSK.

Tell us about your partnerships across your company and externally that are key to your project's success.

The success of this project is totally dependent on (new) partnerships with:
1. the IT developer and reseller (InZo)
2. the GP system suppliers to acquire their technical support and reach many customers in the shortest time frame (‘fish where the fish is’)
3. the Healthcare Insurers and the national doctors association to get maximum user acceptance
4. patient organizations to get the voice of the patient and deliver value patients need

What internal support have you gotten for your project? What kind of push-back have you received?

Although we have had our internal debates (‘why should GSK invest in IT’, ‘should we really offer any customer the chance to work with INSIDER’, ‘should we really allow our competitors(!) working with INSIDER’) the actual project has never been under discussion. The reason is that we have a fundamental belief that we / GSK can do much more for patients and society than developing medicines alone. Selling outcomes, instead of selling medicines!