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??? ??? ????? ?? - ??? (2011-7-8)

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Sung Yoon Bae
Sung Yoon Bae

2011? 7? 8?, ???????? ??????? ??? ?? "??? ??? ????? ??" ???????. ??? ???? ???? ????????? ??? ?? ??? ???? ????. (???: ???, ????? ??)

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??? ??? ?? ??? ?? ???????? ??????? 2011. 7. 8 ??? PhD, MPH, MBA ????? ???? ? ????? ??
?? ?? ? ??? ???? ????? ? ??? ??? ??? ????? ? ??, ??? ???? ???? ? ????? ???? ? ????? ??? ?? ? ???? ??? ??? ? ????? ????? ?? ? ??????? ?? ???? ??
??? ??? ?? 10? ?? Source: Ten Innovations That Will Transform Medicine, HBR’s Health Care Innovations Insight Center, March 8, 2010.
??? ??? ?? 10? ?? Source: Ten Innovations That Will Transform Medicine, HBR’s Health Care Innovations Insight Center, March 8, 2010.
??? ??? ?? 10? ?? Source: Ten Innovations That Will Transform Medicine, HBR’s Health Care Innovations Insight Center, March 8, 2010.
???? ????(Decentralization) ??? ??
??(Disruption)? ????? ?? ???? ?? ?? ??? ??? ??? ??? ???? $500,000 (60% ??) $250,000 (45% ??) ? ?? ???? ?? ????? ??? ??? ??? ?? $2,000 (40% 20% ??) Copyright Clayton M. Christensen
???-???? ??? ?? ??? ???? ??! ?????/?? ?? ?? ??? ?? ??/??? ??? ??/??
??? ??? ???? ??? ??? ???? ???? ?? ?? ?? ?? ???? ???? ?? ?? ????? ???? ????? ???? ? ?? ???? ??? ???? ??? ?? ??? ??
??? ??? 3?? ?? 2. Business model Innovation
?????? ????? ???? ?? ??? ??? ?? ?? ? ?????, ? ???? ???? ??? ? ??? ???? ??? ??? ?????? ????? ???? ? ??? ??, ??, ??(???), ??, ??, ???, ?? ? ???? ???? ??? ??????, ??? ?? ???? ? ??? ????? ??? ???? ?? ??? ???? ???? ??: ????, ????, ??, ????, ?? ?
???? ?? ???? ??? ???????? ?? ????! ???? ???? ?? ? ??? ??? ?? ??? ????!
??? ????? ???? ? ??? ??? ?? ??(????) & ???? ??? ?? ?? ??? ?? ???? ???? ???? ?????? (EBM) ??????? ??? ??? ???? ? ??? ?????… ??????, ????(Imaging), ?????
????? ????? ?????? ???? ??? ????… ???? ???????. ?? ???? ????
?? ?? ??? ??? A ????? ?? ?? ?? B ??? ?? ??? B ??? ??? MMC Pontiac Factory ??B ???? ??? A ???? ?? ?? ?? ?? ???
??? ??? vs. ??? ?? ??? ??? 10.0 10 ??? ??: 8.0 ????? 2?? ???? ??? ???? 27% ?? Pontiac (20) 6.0 (4) 5.0 Essex (4) Lima (10) Saginaw 4.0 (5) (2) Lebanon Fremont Tiffin Sandusky 3.0 (10) (6) ???? 8? (2) Maysville 2.0 ???? 4? ???? 2? ??? ???: ??? 2?? ??? ??? ???? 15% ?? 1.0 ???? 16? ???? 1? 1 10 10 20 40 100 80 100 160 ?? ??? (????) 320 1000
????? ????? ?? ?? - ??? ???? Shouldice Hospital General Hospital (hernia repair) (U.S. Typical) ?? ?? ? ?? ?? $200 $200 ?? ?? ?? $650 $770 ????(overhead) $1,450 $6,030 ??? (?? ???? ??) $2,300 $7,000 ???? ??? ?? ? 1? 100? ??? ??? 2.2 7.8 ???? ??: Herzlinger, Regina E., Market Driven Health Care. Cambridge, Massachusetts: Perseus, 1997
??? ????? “? ?? ? ??”? ??? ? ???? ?? ???? ?? ???? ? ??? ?? ? ?? ?? ?? ? ???? ?? ? ??? ?? ? ???? ?? ? ??? ? ?? ? ??? ? ?? ??? ????? ???? ? ??? ? ?? ? ???(eBay) ? ???? ??? ?? ???? ??? ?? (Fee for Service) ??? ?? (Fee for Outcome) ????? (Fee for Membership)
????? ?? ???? ?? ? ??? ??? ???? ???? ???? ??? ???? ????? ???? ? ?? ? ?? ? ????? ? ???? ? ??????? ? ??????? ? ??? ? ????? ? ??? ? ???/??? ? ? ???? ? ?? ? ??? ? ????? ? ??? ? ???? ? ??/?? ??? ??? ? ?? ? ??? ??? ? ???? ? ?2? ??? ? HIV ? ??? ???(GERD) ? ?? ?? ? ???/ ??? ??? ? ?? ??? ? ??? ??? ? ???? ??? ? ?? ??? ? ??? ? ?1? ??? ? ??? ????? ? ??? ? ???? ? ???? ? ?? ? ???(?????) ? ?? ??? ??? ? ?? ? ????(??? ??)
????? ?? ?? ?? ????? ??? ??? ?? ?? ??? ????? ?? ???? ??? ??? ??? ??? ??? ??? ??? ??? ?? HIV ???? ?? ???? ???? ?1? ??? ???? ?? ??? ??? ?? B? ?? ????? ????? ???? ??? ??? ???? ?????? ?????? ??? ???? ?? ???? ?? ?2? ??? ???? ???? ?? ?? ???? ???? ??
????? ?? ??? ?? ???? ?? ?? ?? ??? ????? ?? ???? ???? ?? ???? ?? ??? ?? ??? ??? ??? ??? ??? ??? ??? ??? ?? HIV ???? ?1? ??? ???? ?? ??? ??? ??? ???? ?? ???? ?? ?2? COST ??? ?????? CENTER?? ????? ????? ???? ??? ???? ?????? ?? B? ?? ?? ??? ?? ?? ?? ??? ?? ???? ??? ??? ?? ???? ?? ???? ???? ?? ???? ???? ??
????? ?? ??? ?? ???? ?? ?? ?? ??? ????? ?? ???? ???? ?? ???? ?? ??? ?? ??? ??? ???? ??? ???? ??? ??? ??? ??? ??? ?? ?? ???? (??) ?? HIV ??? ??? ??? ???? ???? ?? ?? ??? ???? ?2? ??? ?? ??? ?????? ?? ???? ????? ????? ???? ?? ?1? ??? ?????? ?? B? ?? ???? ?? ??? ?? ?? ?? ??? ???? ??? ??? ?? ???? ?? ???? ???? ?? ???? ???? ??
??? ???? ??? ??? ??? ???, ??? ????? ??????. ?? ?? ????, ????(????) ??? ???? ??? ????? ?? ?? ??? ???? ???? ?????? ???? ???? ????? ??? ?? ? ??? ???, ????? ??, ??? ?????? ??
??? ????? ??? ??? ????? ?? Wellness programs Telehealth / e-visits Wireless health devices Telecommunications and Home monitoring Precision diagnostics Retail clinics Information management and decision-making tools Medical homes and care teams Hospital at home
???? ? ????(MDDE)? ?? ?? ??? ??? ??? ???? ????? ???(??)
???? ? ???? 1 2 3 ???? ….
???? ? ???? ????? ??? Cardiac Surgeons Cardiologist Family Doctor with operation team Interventionalist Nurse Practitioner Highly Invasive Least Invasive More Expensive Cheaper
??? ??? ?? ?????(angioplasty) Estimated Inpatient Cardiovascular Procedures, 1979-2002 000s of procedures 1,400 CAGR 1995-2002 Balloon Angioplasty/Stenting 1,200 15.69% 1,000 800 Bypass 600 -1.51% 400 200 0 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 . Source: United States Centers for Disease Control and Prevention National Hospital Discharge Survey; Innosight analysis
High “When angioplasty was introduced, it captured the imagination of cardiologists and surgeons differently. ??? ??? ??? ??? ??? ??? ?? “動機 非對稱” Surgeons were skeptical about this new procedure. They were used to seeing small arteries in the operating room and questioned how one would be able to introduce a small catheter into the femoral artery, navigate it via the left main coronary artery into a distal vessel, and dilate it. Cardiologists saw this as an incredible opportunity to treat patients with ischemic heart disease.” Low Time —Chief, Division of Cardiothoracic Surgery, Miami, Florida
??? ?? ??? ?? ?? ?? ?? ??????? ????? ??? ? ? ? ? ? ? ? ? ? ???? ??? ???? ???? ???? ??? ?? ??? ?? ??? ??
???? ?????
??????? ?? ??? ?? ???? ???? ? ??????? ?? ? ???? ????? ?? ????? ?? ?????? ????? (??/??? ??? ?? ???) ? ????? ?? ??? ? ??? ????? ?? ??? ???? ??? ???? ????? ?? ? ????? ??? ? ?????? ?? ??
??????? ?? ?? ?? (1) ???????? ?? ? ?????? ? ??? ??????? ?? ? ?????? ??-????? ??? ????? ?? ?? ? ????(?????, ??? ???? ?? ? ???? ??? ??, ??? ? ??) ? ?????? ??? ?? ? ???? ??, ???? ?? ? ???? ? ??, ???? ?????? ? ????: FICO Medication Adherence Score, Ingenix’s Health Score (BCBS) ? ? ???????? ??? ??/?? ? ????? ???? ???? ???, ???, ??/??????, ??? ?? ???? ??? ????? ?? ? ???? ??? ??
??????? ?? ?? ?? (1) ??????(PHR) ??? ?? ? Web-based Personal Electronic Health Record(PEHR) ? Google Health vs. Microsoft Vault ? Portable Electronic Health Record: Smart IC Card ?? LifeNexus’ Personal Health Card ??? Carte Vitale ?? ?????? ??
??????? ?? ?? ?? (2) ?? ????? ?? ? ????? ?? ??? ? ??????, ??????, ????, ?????? ? ??? ??? ??? ???? ?? ?? ???? ??? ??, ????? ?? ??? ???? ?? ?? ?????? ??? (??)???? ?? ?? ? ??? ??? ????? ??? ?? ?? (????? ???? ??? ??? ???) ? ??? ?? ??? ?? ???? ??? ? ???? ?? ? ??? ???+????(P4P) ? ???? ?? ? ?????+?????(P4P) ? ?????? ? ???(????, ??????) ? ??? ????? ?? ? ??????(???)
??????? ?? ?? ?? (3) ???? ????? ?? ? ????? ??? ? ?????? ?? ?? ?? ?? ???? ??? ???? ?????? ?????? ? ??? ???? ? ?? ?, ???? (????)? ???? ???? ????/?????? ?? ?? ?? ?? ?? ???? ??? ???? (???? ??? ??) ????? ????? ?? ????/???? ?? ???? ??? ????, ????? ?? ??????? ?? ????? ??? ??? ???? ????/???? ?? ??????? ??
“I skate to where the puck is going to be, not where it has been.” - Wayne Gretzky
????? ehealth@inje.ac.kr @BaeSungYoon

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??? ??? ????? ?? - ??? (2011-7-8)

  • 1. ??? ??? ?? ??? ?? ???????? ??????? 2011. 7. 8 ??? PhD, MPH, MBA ????? ???? ? ????? ??
  • 2. ?? ?? ? ??? ???? ????? ? ??? ??? ??? ????? ? ??, ??? ???? ???? ? ????? ???? ? ????? ??? ?? ? ???? ??? ??? ? ????? ????? ?? ? ??????? ?? ???? ??
  • 3. ??? ??? ?? 10? ?? Source: Ten Innovations That Will Transform Medicine, HBR’s Health Care Innovations Insight Center, March 8, 2010.
  • 4. ??? ??? ?? 10? ?? Source: Ten Innovations That Will Transform Medicine, HBR’s Health Care Innovations Insight Center, March 8, 2010.
  • 5. ??? ??? ?? 10? ?? Source: Ten Innovations That Will Transform Medicine, HBR’s Health Care Innovations Insight Center, March 8, 2010.
  • 7. ??(Disruption)? ????? ?? ???? ?? ?? ??? ??? ??? ??? ???? $500,000 (60% ??) $250,000 (45% ??) ? ?? ???? ?? ????? ??? ??? ??? ?? $2,000 (40% 20% ??) Copyright Clayton M. Christensen
  • 8. ???-???? ??? ?? ??? ???? ??! ?????/?? ?? ?? ??? ?? ??/??? ??? ??/??
  • 9. ??? ??? ???? ??? ??? ???? ???? ?? ?? ?? ?? ???? ???? ?? ?? ????? ???? ????? ???? ? ?? ???? ??? ???? ??? ?? ??? ??
  • 10. ??? ??? 3?? ?? 2. Business model Innovation
  • 11. ?????? ????? ???? ?? ??? ??? ?? ?? ? ?????, ? ???? ???? ??? ? ??? ???? ??? ??? ?????? ????? ???? ? ??? ??, ??, ??(???), ??, ??, ???, ?? ? ???? ???? ??? ??????, ??? ?? ???? ? ??? ????? ??? ???? ?? ??? ???? ???? ??: ????, ????, ??, ????, ?? ?
  • 12. ???? ?? ???? ??? ???????? ?? ????! ???? ???? ?? ? ??? ??? ?? ??? ????!
  • 13. ??? ????? ???? ? ??? ??? ?? ??(????) & ???? ??? ?? ?? ??? ?? ???? ???? ???? ?????? (EBM) ??????? ??? ??? ???? ? ??? ?????… ??????, ????(Imaging), ?????
  • 14. ????? ????? ?????? ???? ??? ????… ???? ???????. ?? ???? ????
  • 15. ?? ?? ??? ??? A ????? ?? ?? ?? B ??? ?? ??? B ??? ??? MMC Pontiac Factory ??B ???? ??? A ???? ?? ?? ?? ?? ???
  • 16. ??? ??? vs. ??? ?? ??? ??? 10.0 10 ??? ??: 8.0 ????? 2?? ???? ??? ???? 27% ?? Pontiac (20) 6.0 (4) 5.0 Essex (4) Lima (10) Saginaw 4.0 (5) (2) Lebanon Fremont Tiffin Sandusky 3.0 (10) (6) ???? 8? (2) Maysville 2.0 ???? 4? ???? 2? ??? ???: ??? 2?? ??? ??? ???? 15% ?? 1.0 ???? 16? ???? 1? 1 10 10 20 40 100 80 100 160 ?? ??? (????) 320 1000
  • 17. ????? ????? ?? ?? - ??? ???? Shouldice Hospital General Hospital (hernia repair) (U.S. Typical) ?? ?? ? ?? ?? $200 $200 ?? ?? ?? $650 $770 ????(overhead) $1,450 $6,030 ??? (?? ???? ??) $2,300 $7,000 ???? ??? ?? ? 1? 100? ??? ??? 2.2 7.8 ???? ??: Herzlinger, Regina E., Market Driven Health Care. Cambridge, Massachusetts: Perseus, 1997
  • 18. ??? ????? “? ?? ? ??”? ??? ? ???? ?? ???? ?? ???? ? ??? ?? ? ?? ?? ?? ? ???? ?? ? ??? ?? ? ???? ?? ? ??? ? ?? ? ??? ? ?? ??? ????? ???? ? ??? ? ?? ? ???(eBay) ? ???? ??? ?? ???? ??? ?? (Fee for Service) ??? ?? (Fee for Outcome) ????? (Fee for Membership)
  • 19. ????? ?? ???? ?? ? ??? ??? ???? ???? ???? ??? ???? ????? ???? ? ?? ? ?? ? ????? ? ???? ? ??????? ? ??????? ? ??? ? ????? ? ??? ? ???/??? ? ? ???? ? ?? ? ??? ? ????? ? ??? ? ???? ? ??/?? ??? ??? ? ?? ? ??? ??? ? ???? ? ?2? ??? ? HIV ? ??? ???(GERD) ? ?? ?? ? ???/ ??? ??? ? ?? ??? ? ??? ??? ? ???? ??? ? ?? ??? ? ??? ? ?1? ??? ? ??? ????? ? ??? ? ???? ? ???? ? ?? ? ???(?????) ? ?? ??? ??? ? ?? ? ????(??? ??)
  • 20. ????? ?? ?? ?? ????? ??? ??? ?? ?? ??? ????? ?? ???? ??? ??? ??? ??? ??? ??? ??? ??? ?? HIV ???? ?? ???? ???? ?1? ??? ???? ?? ??? ??? ?? B? ?? ????? ????? ???? ??? ??? ???? ?????? ?????? ??? ???? ?? ???? ?? ?2? ??? ???? ???? ?? ?? ???? ???? ??
  • 21. ????? ?? ??? ?? ???? ?? ?? ?? ??? ????? ?? ???? ???? ?? ???? ?? ??? ?? ??? ??? ??? ??? ??? ??? ??? ??? ?? HIV ???? ?1? ??? ???? ?? ??? ??? ??? ???? ?? ???? ?? ?2? COST ??? ?????? CENTER?? ????? ????? ???? ??? ???? ?????? ?? B? ?? ?? ??? ?? ?? ?? ??? ?? ???? ??? ??? ?? ???? ?? ???? ???? ?? ???? ???? ??
  • 22. ????? ?? ??? ?? ???? ?? ?? ?? ??? ????? ?? ???? ???? ?? ???? ?? ??? ?? ??? ??? ???? ??? ???? ??? ??? ??? ??? ??? ?? ?? ???? (??) ?? HIV ??? ??? ??? ???? ???? ?? ?? ??? ???? ?2? ??? ?? ??? ?????? ?? ???? ????? ????? ???? ?? ?1? ??? ?????? ?? B? ?? ???? ?? ??? ?? ?? ?? ??? ???? ??? ??? ?? ???? ?? ???? ???? ?? ???? ???? ??
  • 23. ??? ???? ??? ??? ??? ???, ??? ????? ??????. ?? ?? ????, ????(????) ??? ???? ??? ????? ?? ?? ??? ???? ???? ?????? ???? ???? ????? ??? ?? ? ??? ???, ????? ??, ??? ?????? ??
  • 24. ??? ????? ??? ??? ????? ?? Wellness programs Telehealth / e-visits Wireless health devices Telecommunications and Home monitoring Precision diagnostics Retail clinics Information management and decision-making tools Medical homes and care teams Hospital at home
  • 25. ???? ? ????(MDDE)? ?? ?? ??? ??? ??? ???? ????? ???(??)
  • 27. ???? ? ???? ????? ??? Cardiac Surgeons Cardiologist Family Doctor with operation team Interventionalist Nurse Practitioner Highly Invasive Least Invasive More Expensive Cheaper
  • 28. ??? ??? ?? ?????(angioplasty) Estimated Inpatient Cardiovascular Procedures, 1979-2002 000s of procedures 1,400 CAGR 1995-2002 Balloon Angioplasty/Stenting 1,200 15.69% 1,000 800 Bypass 600 -1.51% 400 200 0 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 . Source: United States Centers for Disease Control and Prevention National Hospital Discharge Survey; Innosight analysis
  • 29. High “When angioplasty was introduced, it captured the imagination of cardiologists and surgeons differently. ??? ??? ??? ??? ??? ??? ?? “動機 非對稱” Surgeons were skeptical about this new procedure. They were used to seeing small arteries in the operating room and questioned how one would be able to introduce a small catheter into the femoral artery, navigate it via the left main coronary artery into a distal vessel, and dilate it. Cardiologists saw this as an incredible opportunity to treat patients with ischemic heart disease.” Low Time —Chief, Division of Cardiothoracic Surgery, Miami, Florida
  • 30. ??? ?? ??? ?? ?? ?? ?? ??????? ????? ??? ? ? ? ? ? ? ? ? ? ???? ??? ???? ???? ???? ??? ?? ??? ?? ??? ??
  • 32. ??????? ?? ??? ?? ???? ???? ? ??????? ?? ? ???? ????? ?? ????? ?? ?????? ????? (??/??? ??? ?? ???) ? ????? ?? ??? ? ??? ????? ?? ??? ???? ??? ???? ????? ?? ? ????? ??? ? ?????? ?? ??
  • 33. ??????? ?? ?? ?? (1) ???????? ?? ? ?????? ? ??? ??????? ?? ? ?????? ??-????? ??? ????? ?? ?? ? ????(?????, ??? ???? ?? ? ???? ??? ??, ??? ? ??) ? ?????? ??? ?? ? ???? ??, ???? ?? ? ???? ? ??, ???? ?????? ? ????: FICO Medication Adherence Score, Ingenix’s Health Score (BCBS) ? ? ???????? ??? ??/?? ? ????? ???? ???? ???, ???, ??/??????, ??? ?? ???? ??? ????? ?? ? ???? ??? ??
  • 34. ??????? ?? ?? ?? (1) ??????(PHR) ??? ?? ? Web-based Personal Electronic Health Record(PEHR) ? Google Health vs. Microsoft Vault ? Portable Electronic Health Record: Smart IC Card ?? LifeNexus’ Personal Health Card ??? Carte Vitale ?? ?????? ??
  • 35. ??????? ?? ?? ?? (2) ?? ????? ?? ? ????? ?? ??? ? ??????, ??????, ????, ?????? ? ??? ??? ??? ???? ?? ?? ???? ??? ??, ????? ?? ??? ???? ?? ?? ?????? ??? (??)???? ?? ?? ? ??? ??? ????? ??? ?? ?? (????? ???? ??? ??? ???) ? ??? ?? ??? ?? ???? ??? ? ???? ?? ? ??? ???+????(P4P) ? ???? ?? ? ?????+?????(P4P) ? ?????? ? ???(????, ??????) ? ??? ????? ?? ? ??????(???)
  • 36. ??????? ?? ?? ?? (3) ???? ????? ?? ? ????? ??? ? ?????? ?? ?? ?? ?? ???? ??? ???? ?????? ?????? ? ??? ???? ? ?? ?, ???? (????)? ???? ???? ????/?????? ?? ?? ?? ?? ?? ???? ??? ???? (???? ??? ??) ????? ????? ?? ????/???? ?? ???? ??? ????, ????? ?? ??????? ?? ????? ??? ??? ???? ????/???? ?? ??????? ??
  • 37. “I skate to where the puck is going to be, not where it has been.” - Wayne Gretzky