Skip to main content

Driving Outcomes-Digital Health Business Model Innovation

  • Chapter
  • First Online:
Digital Health Entrepreneurship

Part of the book series: Health Informatics ((HI))

  • 386 Accesses

Abstract

This is a unique time for healthcare and digital entrepreneurs. A multitude of factors are driving an enhanced quest for operational resiliency solutions to withstand future challenges by improved workflow.

Years into the most pervasive, painful health emergency of our lifetimes, huge persistant challenges must be resolved. Existing chronic conditions combined with digital inequities stymied the delivery of inclusive whole person care to lower income groups and people of color. Disproportionate COVID-19 hospitalizations and death rates laid bare system gaps adding to existing healthcare challenges.

Institutions and entrepreneurs are challenged to deliver new sustainable value propositions for equitable and behavioral health outcomes at reduced costs through business model innovations and value based care. Interoperability with healthcare work environments and workflows is an added consideration and adoption criterion.

Whether developing products or building business opportunities to resolve marketplace pain, a key determinant is whether a customer will pay for the solution being sold.

Business model innovation is built on this initial assessment. Customer discovery tools and customer development processes are available to determine potential customers’ pain. Concepts are tested with prospective customers, iterating toward product offerings and quantifiably testing the perceived value or worth placed for either a purchased or internally created enhancement. These processes continuously validate data driven learnings to improve the offered product or service solution.

The healthcare industry has urgent needs. Entrepreneurs are required to develop business concepts aligning key resources, processes and profit formulas to create, deliver and capture perceived value for paying customers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 69.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Artiga S, Hinton E. Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity, Kaiser Family Foundation website, May 10, 2018. www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/

  2. DeSilva J, Dell’Aquilio G, Zweig M. Consumer Adoption of telemedicine in 2021, December 15, 2021, Rock Health website. www.rockhealth.com/insights/consumer-adoption-of-telemedicine-in-2021/

  3. Pearl R, Wayling B The Telehealth Era Is Just Beginning, Harvard Business Review Magazine, May-June 2022, https://hbr.org/2022/05/the-telehealth-era-is-just-beginning

  4. Centers for Disease Control and Prevention website, Health Equity, https://www.cdc.gov/chronicdisease/healthequity/index.htm

  5. The National Committee for Quality Assurance (NCQA)The Future of Telehealth Roundtable, May 2022, page 5. https://www.ncqa.org/wp-content/uploads/2022/05/NCQA-TelehealthAndEquity-Whitepaper-Draft5.pdf

  6. Text: H.R. 4040-117th Congress (2021-2022), July 28, 2022, https://www.congress.gov/bill/117th-congress/house-bill/4040/text

  7. Interoperability and Patient Access Final Rule. CMS.gov website. https://www.cms.gov/files/document/cms-9115-f.pdf

  8. Interoperability and Patient Access Fact sheet. CMS.gov website. https://www.cms.gov/newsroom/fact-sheets/interoperability-and-patient-access-fact-sheet

  9. Evans B, Krasiniansky A, Zweig M. Year-end digital health funding: Seismic shifts beneath the surface. Rock Health website; 2021. https://rockhealth.com/insights/2021-year-end-digital-health-funding-seismic-shifts-beneath-the-surface/

    Google Scholar 

  10. What Bubble? Digital Health Funding Year in Review 2021, Seth Joseph, Forbes.com website January 11, 2022

  11. Plaster L. StartUp Health, Global Health Innovation Funding Hits $16B Despite Market Recalibration, July 2022 https://healthtransformer.co/global-health-innovation-funding-drops-yoy-yet-continues-10-year-growth-curve-2dcb8dc387b0

  12. Out-of-Pocket Healthcare Expenditures in the United States, 5th Edition. Kalorama Information. https://kaloramainformation.com/product/out-of-pocket-healthcare-expenditures-in-the-united-states-5th-edition/

  13. Muoio D. August 3, 2021, Nationwide out-of-pocket spending jumped 10% in 2021 Fierce Healthcare website. https://www.fiercehealthcare.com/payer/nationwide-out-pocket-spending-grew-10-to-1-650-per-person-2021-expect-to-continue-through

  14. PwC’s Health Research Institute (HRI). Medical cost trend: behind the numbers 2019. 2018. www.pwc/us/medicalcosttrends.

  15. Wiik J. Healthcare revolution: the patient is the new payer. 2017. https://www.wellsteps.com/blog/2018/01/03/benefits-of-wellness-lower-health-care-costs/.

    Google Scholar 

  16. Mercer. https://www.mercer.com/newsroom/mercer-survey-shows-employers-face-increase-in-health-benefit-cost-in-2018.html.

  17. Mercer. National survey of employer sponsored health plans. In: Health insurance coverage in the United States. 2021. https://www.mercer.us/what-we-do/health-and-benefits/strategy-and-transformation/mercer-national-survey-benefit-trends.html

  18. Williams R, Gunja M, Bumgartner J, Gumas E. Americans, no matter the state they live in, die younger than people in many other countries. The Commonwealth Fund. https://www.commonwealthfund.org/blog/2022/americans-no-matter-state-they-live-die-younger-people-many-other-countries

  19. Swanson E. National Hospital Flash Report: July 2022, Kaufman Hall website. https://www.kaufmanhall.com/sites/default/files/2022-07/KH-NHFR-July-2022.pdf

  20. Doyle P. Hospitals innovate amid dire nursing shortages, American Association of Medical Colleges website. https://www.aamc.org/news-insights/hospitals-innovate-amid-dire-nursing-shortages

  21. Newswise.com “Geisinger to roll out eICU program”, December, 3, 2009. https://www.newswise.com/articles/geisinger-to-roll-out-eicu-program

  22. National Health Expenditure Projections 2021-2030-CMS. https://www.cms.gov/files/document/nhe-projections-forecast-summary.pdf

  23. Research Trends in health care spending. American Medical Association. websit: https://www.ama-assn.org/about/research/trends-health-care-spending

  24. National Health Expenditure Projections 2021-2030 Forecast Summary Major Findings. https://www.cms.gov/files/document/nhe-projections-forecast-summary.pdf

  25. Kaiser Family Foundation website,State Health Facts, Health Insurance Coverage of the Total Population, 2019 https://www.kff.org/other/state-indicator/total population/?dataView=0&currentTimeframe=0&selectedDistributions=employer&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

  26. Institute of Medicine of the National Academies, Recommendations. Best of care at lower cost. Washington, DC: National Academies Press; 2012.

    Google Scholar 

  27. Institute for Healthcare Improvement website https://www.ihi.org/Engage/Initiatives/TripleAim/Pages/default.aspx

  28. Rittel H, Webber M. Dilemmas in a general theory of planning. Policy Sciences. 1973;4(2):155–69.

    Article  Google Scholar 

  29. Higley T. Process? I don’t need no stinkin’ process, a serial entrepreneur’s guide to opportunity and risk. 25 May 2017. 2017.

    Google Scholar 

  30. Higley T. Creating a model for successful generation of new ventures (Part Two); 2017.

    Google Scholar 

  31. @TomHigley, @101010.net, July 22, 2018, [Twitter Post] Advice for founders from our CEO @tomhigley Start with a problem you care about. Or start with a customer you care about who has a problem you care about. All customers have problems, All problems have solutions, Not all solutions have problems Not all problems have customers.

  32. Blank S. The four steps to the epiphany. Pescadero, CA: K&S Ranch Inc.; 2003.

    Google Scholar 

  33. Blank S, Dorf B. The startup owner’s manual, vol. 1. Pescadero, CA: K&S Ranch Inc.; 2012.

    Google Scholar 

  34. Blank S. Harvard business review. In: Why the Lean startup changes everything; 2013.

    Google Scholar 

  35. Ries E. The Lean Startup: how today’s entrepreneurs use continuous innovation to create radically successful businesses. New York: Crown Business, Random House; 2011.

    Google Scholar 

  36. Osterwalder A, Pigneur Y. Business model generation: a handbook for visionaries, game changers, and challengers. Hoboken: Wiley; 2010.

    Google Scholar 

  37. Porter ME, Teisberg EO. Redefining health care: creating value-based competition on results. Boston: Harvard Business School Publishing; 2006.

    Google Scholar 

  38. Knapp J, Zeratsky J, Kowitz B. Sprint: how to solve big problems and test new ideas in just five days. New York: Simon and Schuster; 2016.

    Google Scholar 

  39. Fitzpatrick R. The mom test: how to talk to customers & learn if your business is a good idea when everyone is lying to you. New York: Founder Centric Press; 2013.

    Google Scholar 

  40. Ulwick AW. Jobs to be done: theory to practice. Idea Brite Press; 2016.

    Google Scholar 

  41. Maurya A. Running lean, iterate from plan A to a plan that works. Sebastopol, CA: O’Reilly Media Inc; 2011/2012.

    Google Scholar 

  42. Garbugli E, Lean B. Leanpub.com. https://leanpub.com/lean-b2b-build-products-businesses-want-customer-development

  43. Yoo J. The new go-to market playbook for digital health startups. https://a16z.com/2021/10/19/the-new-go-to-market-playbooks-for-digital-health-startups/

  44. Willcox-Lee C. Value-based reimbursement: an overview, health recovery solutions, April 27, 2022 https://www.healthrecoverysolutions.com/blog/value-based-reimbursement-an-overview

  45. Kaganoff S. The starter pistol for the virtual care platforms race, https://rockhealth.com/the-starter-pistol-for-the-virtual-care-platforms-race/

  46. Pereira, D. The Business Model Analyst, March 19, 2022, https://businessmodelanalyst.com/multisided-platform-business-model/

  47. Clark E,Singhai S, Weber K. The future of healthcare: Value creation through next-generation business models, McKinsey & Company, January 4, 2021., https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-future-of-healthcare-value-creation-through-next-generation-business-models

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nathanson, J.M. (2023). Driving Outcomes-Digital Health Business Model Innovation. In: Meyers, A. (eds) Digital Health Entrepreneurship. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-031-33902-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-33902-8_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-33901-1

  • Online ISBN: 978-3-031-33902-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics