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Health Angels

Health Angels Concept and Method

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Health Angels is dealing with the simple fact of Health Promotion "gap" and proposes a quite simple technology solution to tackle this gap

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Page 1: Health Angels Concept and Method

   

     

Health Angels

Page 2: Health Angels Concept and Method

Agenda  

1.  Business  (Mission)  2.  The  Opportunity  3.  Change  Drivers  4. Ask For An Angel  5.  The  Method  6.  Services  and  Clients  7.  Market  Size  8.  Target  Markets  9.  Go  to  Market  10.  Financials    Appendix  1:  Adoptability  Appendix  2:  Value  for  All  

my Health Angels

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Business  Mission  

•  To  alert  and  empower  people  to  care  deeper  and  engage  for  their  health  with  instant  and  meaningful  access  to  high  value  health  services  

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The  Opportunity  

1.   Health  Promo9on  not  mainstream  yet  

Most  People  don’t  get  really  involved  with  their  health  un9l  they  get  sick  

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The  Opportunity  

1.   Health  Promo9on  not  mainstream  yet  

People  like  to  be  strong  and  healthy!      They  like  it  so  much  that  they  forget  their  weaknesses  and  hide  their  health  problems  

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The  Opportunity  

1.   Health  Promo9on  not  mainstream  yet  

Health  Promo9on  needs  to  be  branded:    People  have  to  “remember”  their  Health  in  all  of  their  everyday  ac9vi9es  

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The  Opportunity  

2.   e-­‐Health  Services  not  mainstream  yet  

People  started  using  ICT  in  Hospitals,  clinics  etc.    When  they  thought  of    e-­‐Health  they  thought  of  Hospitals    BUT  these  are  very  difficult  environments  for  successful  e-­‐Health  Services    

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The  Opportunity  

2.   e-­‐Health  Services  not  mainstream  yet  

Some  smartphone  apps  do  focus  on  wellness  (exercise  /  nutri9on)    But  not  on  personalized  Health  profiling  and  overall  Health  Promo9on  

 

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The  Opportunity  

3.   When  in  economic  crisis,  we  need:  

More  economical  and  efficacious  health  provision    Cut  down  on  insurance  (payers)  cost  urgently    Health  “safe  harbors”  for  consumers  hit  by  crisis  

 

Health Angels

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Change  Drivers  1.   People  “consume”  value:  the  value  that  they  

see  in  powerful  marke9ng  messages  

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Change  Drivers  2.   One  third  of  the  general  popula9on  have  health  

problems  because  they  do  not  “consume”  health  value:  a  huge  market!  

32%  of  the  popula9on  in  EU  do  not  think  they  have  good  Health!      

•  More  than  24%  are  regular  smokers  

•  Nearly  16%  are  obese  •  38%  do  not  eat  fruit  or  

vegetables  on  a  daily  basis  •  …….  

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Change  Drivers  3.   People  will  “consume”  health  when  they  see  a  

powerful  message  AND  real  health  value  in  health  campaigns  

Get  in  the  Health  Habit  !!!  

Value  

Message              

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Change  Drivers  

•  My Health Angels:  A  real  change  driver  that  drives  people  to  get  in  the  Heath  Habit  !!  

❷Get  Powerful  messages  

❸They  Connect  to  real  Health  Value  via  simple  and  meaningful  e-­‐Health  

services  

❹Everyone  is  connected  and  follow  powerful  

messages  

 ❶Everyone  

ü  People  that  are  in  pain  ü  Their  Families  ü  Their  Doctors  

  Get  in  the  Health  Habit  !!!  

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Ask For An Angel  Your Health Angel:  

Will  set  a  posi+ve  tone  for  you  and  your  health  every  day!!    

ü  Your  nutri+on,  exercise  &  general  health  +ps  

ü  Your  personalized  health  path  reminders  

ü  Your  doctor  encounters    

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Ask For An Angel  Your Health Angel:  Will  take  care  of  all  your  ques+ons  about  your  health:    •  From  +ny  problems  you  

would  never  had  the  +me  to  go  to  the  doctor  

•  To  serious  issues  that  you  want  to  ask  the  community  in  a  anonymous,  “incognito  mode”  

Community  Shout  box  

Doctor  Q&As  

Community  Comments  Incognito  

Doctor  Q&As  

Incognito  

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Ask For An Angel  Your Health Angel:  

Will  come  to  you  with  the  “right  stuff”  even  before  you  ask:    

•  With  a  certain  health  theme  i.e.  “kids  looove  chocolate”  

•  All  actors  organized  and  ready  to  offer  services  for  the  theme  

•  All  services  set  to  connect  the  actors  seamlessly  

•  All  communi+es  set  to  support  the  theme  sustainably  

Actors    Get  

Organized  

Your  Health  Angel  

Tells  you  

You  Connect  and  

Socialize  

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Ask For An Angel  ❸    

Connect!  

❹    Enjoy  

Health  !  

❶    Be  

Posi9ve!  

❷    Organize

!  

Get  in  the  Health  Habit  !!!  

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The  Method  

STEP  1  •  The  plaQorm  produces  Health  Campaigns  that  include:  

–  Medical  Actors:  Doctors  /  HCPs  –  Other  Health  Related  Actors:  PaVent  Orgs,  NGOs,  Community  Networks  etc.  

–  A  Health  Campaign  Protocol:  steps  and  acVons  that  the  parVcipants  should  do  in  order  to  achieve  campaign  results  

–  Health  Content:  medical  /  scienVfic  content  for  common  people  

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CHRs  /  PHRs  

The  Method  

Campaign  1,    

Health  Protocol  1  +  PHS  

C4,  step  1  ,  HP4   C4,  step  2  ,  HP4   C4,  step  3  ,  HP4  

Campaign  2,  HP2  

Campaign  3,  HP2  &  HP3  

……  

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The  Method  

   

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The  Method  

STEP  2  •  Each  health  campaign  sends  thousands  of  B2C  personalized  messages  

–  Via  e-­‐mail  –  Via  sms  –  Via  a  mobile  applica9on  – We  can  ever  send  FB  no+fica+ons  with  no  privacy  concerns  

–  Using  no  electronics:  we  can  issue  paper  media  coupons  

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The  Method  

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The  Method  

   

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The  Method  

•  Each  personalized  message  connects  the  person  who  receives  it  with  e-­‐Health  services  customized  for  the  specific  campaign  (via  a  web  site  and  a  mobile  app):  

1.   Medical  Scheduler  2.   e-­‐consulta9on  3.   Electronic  Health  Record  

STEP  3  

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The  Method    

1.  A  Medical  Scheduler  (with  automa9c  reminders)  that  follows  a  specific  health  campaign  protocol  which  can  include:  

•  Reminders  for  Health  Promo9on  habits  /  Vps  /  rouVnes  etc.  

•  Reminders  for  Medica9on  -­‐  with  Health  Profiling  Ques9onnaire  funcVon  for  doctor  follow-­‐up  or  research  purposes  

•  Reminders  for  Doctor  office  visits  -­‐  with  Doctor  Availability  Calendar  funcVon  

•  Reminders  to  access  specific  Health  content  -­‐  with  Health  Profiling  Ques9onnaire  funcVon  for  parVcipatory  health  and  experienVal  learning  purposes  

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The  Method  

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The  Method  

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The  Method  2.  An  e-­‐consulta9on  service  where  ciVzens  address  their  

quesVons  to  doctors  /  HCPs  in  three  ways:  

•  Individually  (direct  message)  from  a  list  of  available  doctors  that  are  assigned  to  the  specific  campaign  

•  Via  a  Health  Q&A  forum  organized  in  Health  CondiVon  Categories  (access  to  these  categories  is  provided  in  the  campaign  message)  

•  Via  Health  Condi9on  Groups  (on-­‐line  communiVes)  that  belong  to  paVent  orgs  or  doctors  /  HCPs  (access  to  these  groups  is  provided  in  the  campaign  message)  

 

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The  Method  

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The  Method  

   

e-­‐consulta+on  

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The  Method  

   

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The  Method  

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The  Method  

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The  Method  

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The  Method  3.  An  Electronic  Health  Record    repository  where  

everyone  keep  their  medical  data  in  state-­‐of-­‐art  private  and  safe  environment:  

•  CiVzens  keep  their  Personal  Health  Records  (PHRs)  granVng  secure  access  to  their  doctors  and  next  of  keens  

•  Doctors  keep  their  Electronic  Medical  Records  (EMRs)  and  have  Health  AnalyVcs  views  and  reports  for  their  paVents  

•  Campaign  managers  have  Health  Campaign  Analy9cs  Anonymous  Services  for  ROI  tracking  and  B2B  Medical  Research  contracts  

 

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The  Method  

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The  Method  

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The  Method  

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The  Method  STEP  4  

•  Clear  ROI  metrics  for  each  user:  •  Campaign  Par9cipa9on  

–  Health  Campaign  Messages  ac9vated  

•  Social  Health  Scores:  –  Health  Content  accessed  –  Reminder  Confirma9ons  received  –  e-­‐Consulta9on  9ckets  carried  out  –  Doctor  visit  coupons  spent  –  Electronic  Health  Records  entries  logged  

•  Health  Profiling  Ques9onnaire  inputs  processed  

 

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The  Method  STEP  5  

•  As  Health  Campaigns  go  on,  user  Health  Profiles  become  enriched:  

–  The  Health  Campaigns  Messages    become  more  personalized  –  The  e-­‐Health  services  become  smarter  –  People  get  more  and  more  engaged  with  doctors,  HCPs  and  online  health  communi9es  

 

People  get  more  and  more  ac9ve  about  their  Health  !    

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The  Method  

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State  of  Art  Technology  and  Campaigns  Management  •  Electronic  Campaigns  

Management  •  Health  Portals  •  Mobile  Apps  •  MyHealthAngels                  PlaQorm  •  Medical  Data  Repository  

Services        +          Clients  

 

Health  Profiling  and  Medical  Communi9es  Management  •  Health  Profiling  •  Medical  ConsultaVon  •  e-­‐Health  medical  content  •  e-­‐Health  medical  communiVes  

moderaVon    

B2B  ü  Medical  

OrganizaVons  ü  PaVent  

OrganizaVons  ü  Insurance  

Companies  ü  Pharma  Companies  ü  Media  Companies  

(for  Health  Clients)  ü  Large  CorporaVons  

(for  Social  Responsibility  Campaigns)  

B2C  (for  parBcipaBon  to  any  of  the  above)  ü  Doctors  and  HCPs  ü  CiVzens  and  PaVents  

Services  1.   Electronic  Campaigns  2.   “Tradi9onal”  Campaigns  3.   Holis9c  Campaigns  4.   EHRs  repository  5.   Personal  Health  Records  

(PHR)  6.   Electronic  Medical  Records  

(EMR)  7.   MyHA  PHR/EMR  

repository  API  8.   MyHA  Health  Profile  9.   MyHA  Medical  Scheduler  10.   MyHA  Medical  Scheduler  

API  11.   MyHA  e-­‐Consulta9on  12.   MyHA  e-­‐Consulta9on  API  13.   Health  CMS  14.   Q&A  Health  Forum  15.   Health  Condi9on    e-­‐

Communi9es  

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Market  Size  

1.  An  Aging  populaVon  

–  Giuseppe  Carone  and  Declan  Costello  of  the  InternaVonal  Monetary  Fund  projected  in  September  2006  that  the  raVo  of  reVrees  to  workers  in  Europe  will  double  to  by  2020  (0.54)  

– William  H.  Frey,  an  analyst  for  the  Brookings  InsVtuVon  think  tank,  predicts  the  median  age  in  Europe  will  increase  from  37.7  years  old  in  2003  to  52.3  years  old  by  2020  

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Market  Size  

1.  An  Aging  populaVon  

–  By  2010  the  55  to  64  year  olds  in  the  European  Union  would  be  more  than  the  15  to  24  year  olds  

–  The  Economic  Policy  Commigee  and  the  European  Commission  issued  a  report  in  2006  esVmaVng  that  between  2010  and  2050:  

•  the  working  age  populaVon  in  the  EU  will  decrease  by  a  16%  reducVon  (48  million)    

•  the  elderly  populaVon  will  increase  by  a  gain  of  77%  (58  million)  

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Market  Size  

2.  There  is  much  more  than  “paVents”  –  In  Greece  50%  of  the  populaVon  suffer  form  a  chronic  disease    

–  40%  of  those  people  suffer  from  more  than  one  disease    

–  Approx.  25%  of  the  populaVon  present  hyper  tension  •  a  surprising  10%  does  not  even  know  it  !!!!!  •  9%  of  people  that  are  aware  of  it  are  without  treatment  •  66%  with  insufficient  treatment  •  only15%  follow  a  sound  treatment  

–  There  are  900.000  diabeVcs  with:  •  400.000  following  no  treatment  •  while  only  250.000  do  

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Market  Size  

2.  There  is  much  more  than  “paVents”  

–  Heart  Diseases  that  are  responsible  for  50%  of  the  Deaths  

–  Cancer  can  be  treated  at  a  great  success  rate  just  by  changing  every  day  habits  is  responsible  for  23%  of  the  Deaths!  

–  75%  of  the  funds  spent  for  Health  are  allocated  for  no  more  than  10-­‐15  of  the  most  “popular”  chronic  diseases,  with  many  of  them  being  curable  if  diagnosed  early  enough  

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Target  Markets  

•  Greece  is  the  land  of  opportunity  for  e-­‐Health,  especially  when  in  economic  crisis:  

 ü The  Health  Services  market  opens  for  private  investments    

ü The  state  is  already  signing  contracts  with  Private  Health  Providers  at  very  compeVVve  prices      (ΕΟΠΥΥ:  Εθνικός  Οργανισμός  Πρωτοβάθμιας  Υγείας)  

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Target  Markets  

•  Greece  is  expected  to  hit  the  criVcal  mass  level  of  digiVzed  services  supporVng  Health  Care:  

–  There  is  a  new  naVonal  wide  digital  system  for  drug  prescripVons  –  all  doctors  will  have  to  use  it  !!    

–  Greeks  are  well  literate  with  Internet  Technologies  and  they  love  and  their  new  smartphones  

–  The  first  evidence  of  Managed  Care  OrganizaVon  s  appear  mostly  in  Primary  Care    

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Target  Markets  •  In  Greece  most  major  Health  Market  Stakeholders  are  the  local  branches  of  mulV-­‐naVonal  companies:  

–  This  means:  InternaVonal  Expansion  for  successful                          e-­‐Health  business  cases  that  prove  their  ROI  

PLUS:    

–  PharmaceuVcals  would  love  new  ways  of  communicaVng  directly  with  the  ciVzens  base  

–  Insurance  Companies  would  love  flexible  products  due  to  the  new  Solvency  criteria  

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Go  to  market  

Ver9cal  Health  Markets:    1.   Wellness  2.   Preven9on  3.   Primary  Care  4.   Chronic  Diseases  5.   Par9cipatory  Health  Care  

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Go  to  market  

❶  Aoract  ver9cal  Health  market  leaders  in  the  HAN  campaigns  porpolio  –  Ac+ve  now  –  

1.   Doctors  Orgs:    

       100+  enlisted  doctors  with  400+  pending  

2.   Insurance  Companies  :  One  acBve  installaBon  in  big  Insurance          company  

3.   Pharmaceu+cals:      In  ongoing  negoBaBons  with  major          pharmaceuBcal  companies  (Greek            branches  of  mulBnaBonal  groups)  

4.   Pa+ent  Networks:                                    One  acBve  installaBon  in  one  of  the          biggest  metropolitan  municipaliBes      

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Go  to  market  ❷a  Deploy  5  na9onal  wide  Health  Campaigns  engaging  the  most  influen9al  actors  –  Greece  –  

1.   Doctors  Org:    

         Customer  loyalty  cards  with  campaign  presence          for  the  doctor:  The    Greek  average  is            

                     1000+  pa+ent  visits  per  year      

2.   Insurance  Company:    health  insurance  “flexible  package  deals”            coupled  with  electronic  loyalty  health  cards    

3.   Pharmaceu+cals  :      acBve  test-­‐bed  and  clinical  groupware            automaBc  data  retrieval  network+  doctor          oriented  customer  loyalty  cards    

4.   Pa+ent  Networks:      coupon  loyalty  e-­‐Health  cards  for  any  of  the:          Insurance  Company,  PharmaceuBcal            Company,  Wellness  Club  and  Doctors  Org.  

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Go  to  market  ❷b  Enlist  over  20.000  users  in  the  plaporm  in  one  day  !  –  Greece  –  

Health Angels

1st International Summit Athens June 2012

ü  All  major  Health  Oriented  Networks  Key  Persons  invited  

ü  Keynote  Speakers  from  Europe  and  USA  (project  EUPHORIA)  

ü  Major  Pharma  providing  content  for  “live”  campaigns  for  the  summit  

ü  5  Round  tables  organized  featuring  live  “shows”  of  health  communi9es  rapid  crea9on  and  meaningful  use  

ü  Connectathlon  ogranized  for  mobile  home  care  

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Go  to  market  

❸a  Expand  the  HAN  campaigns  network  abroad  –  EU,  US–  

1.   Doctors  Org:    Propose  the  Greek  campaign  business          case  to  their  internaBonal  affiliates  

2.   Insurance  Company:    Propose  the  Greek  campaign  business          case  to  their  internaBonal  group  

3.   Pharmaceu+cals:      Propose  the  Greek  campaign  business          case  to  their  internaBonal  group  

4.   Pa+ent  Networks:      Propose  the  Greek  campaign  business          case  to  sister  PaBent  org  to  EU  and  US  

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Go  to  market  ❸b  Enlist  over  XX.000  users  in  the  plaporm  in  one  day  !  

Health Angels

xth National Summit XXXXX XXX 20XX

ü  Hannover  ü Milan  ü  Amsterdam  ü  Prague  ü  Tokyo  ü Montreal  ü  Phoenix  ü  Hong  Kong  ü ….  

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Go  to  market  

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Go  to  market  

•  Some  numbers  from  the  VerVcal  Markets:    

–  Doctors:                            300+  doctors  !  100.000  pa9ents  in  12          months    

–  Insurance  Companies:    1  Insurance  Company  à  30.000            paVents  in  12  months    

–  NGOs  (Sponsor):      2  Sponsors  à  50  MunicipaliVes  à          100.000  paVents  in  12  months    

–  Diagnos9c  Centers:    4  DiagnosVc  Centersà  20.000  paVents          in  12  months    

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Investment  Financials  ProposiVon  (2)  Revenue  Streams  1.   Business  to  Business  

―  Contract  fee  for  Technology  PlaQorm  Use  per  Campaign.    Proposed  price:  Contract  aTer  negoBaBons    

2.   Business  to  Client  1.   Free  for  ciVzens  for  the  base  services:  

a)  Full  PHR  b)  Medical  Diaries  and  Schedules  c)  Membership  to  selected  myHealthAngles  CommuniVes  and  InformaVon  

Portals  

2.   Paid  SaaS  service  for  Doctors:  Proposed  price  80-­‐  110  euros  annual  fee  3.   Paid  extra  services:  for  users  (doctors  /  ciVzens)  that  want  an  extra  service  /  

module  such  as  advanced  calendar  or  extra  space  for  x-­‐rays  storage):  Proposed  price:  2-­‐5  euros  one  Bme  fee  per  module  

       

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Appendix  1  

Adoptability  

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Adoptability  

•  To  succeed  in  helping  people  care  deeper  and  engage  for  their  health,  HealthAngels  embody  the  following  features:  1.  Prompt  people  to  frequently  review  their  health  outlook:  Alert  

Everyone  to  engage  for  their  health!  2.  Provide  instant  access  to  high  value  health  services:  Enhance  the  

Health  provider  /  consumer  rela9onship  building  loyalty  and  trust!  3.  “Couple”  the  campaigns  with  a  Health  2.0  social  plaQorm:  Give  

everybody  a  reason  to  come  back!    

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Adoptability  

•  Prompt  people  to  frequently  review  their  health  outlook:  Alert  Everyone  to  engage  to  their  health!  

–  Provide  Professional  Health  Profiling  Services  –  Communicate  with  them  at  a  frequent  basis  using  state  of  art  ICT  technologies  

–  Do  both  of  the  above  in  a  coordinated  manner:  Health  Promo9on  Campaigns  

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Adoptability  

2.  Provide  instant  access  to  high  value  health  services.  Enhance  the  Health  provider  /  consumer  relaVonship  building  loyalty  and  trust!  –  Based  on  the  Health  Profile  status  and  the  acVve  Health  Promo9on  Campaigns  people  are  given  access  to  a  selecVon  of  Health  Services:  •  e-­‐Health  Services  (extensive  use  of  mobile  phones)  •  On  site  Health  Services  

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Adoptability  1.  All  Health  Services  are  based  on  the  Personal  Health  Record  

(PHR)  2.  All  acVvaVons  of  PHRs  are  done  through  a  detailed  Health  

Profiling  Process  designed  by  OthrobioVki  professionals  3.  Campaigns  are  run  in  the  system.  Each  campaign  ac9vates:  

•  New  Health  Profiles  for  people  joining  the  campaign  •  ExisVng  Health  Profiles  for  people  that  have  parVcipated  in  the  past  •  Electronic  HealthAngels  Codes-­‐Services  

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Adoptability  4.  The  myHealthAngels  codes  are  matched  with  the  Health  

Profiles.  ü  In  this  way:  with  every  campaign  “good”  that  people  

consume,  their  PHR  changes  and  their  Health  Profile  adjusts  automaVcally  

5.  With  the  new  “adjusted”  profiles  people  can  enjoy:  ü  Instant  Access  to  e-­‐Health  Services  ü  Offers  and  discounts  from  Health  Care  Providers  

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The  SoluVon  ü  Offer  people  simple  Health  PromoBon  soluBons  coming  from  ONE  

technology  system  that  handles  BOTH  markeBng  campaigns  AND  e-­‐Health  personalized  Services  

ü  The  simplicity  of  the  customer  experience  is  breath-­‐taking  !!!  ü  The  campaign  message  that  you  receive  about  a  Health  

service  “carries”  the  service  itself  !!  ü  You  get  the  message  AND  the  service  at  the  same  +me  !!  

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Adoptability  

Free  Vitamins!!!  

Thanks!!  Here  is  my  

“free  vitamins  9cket”  

Here  is  your  free  vitamins  

Set:  Alarm;  “Vitamin  

Pill”;  8:30pm;  15  mins  

Thanks!!  Here  is  my  

“free  Checkup  9cket”  

Free  Checkup  /  Blood  tests!!      

Here  is  your  blood  test  results  

Record:  “Blood  Test  Results;  

Campaign  ID;  date;  source;  

Send:  “Blood  Test  Results;  Campaign  ID;  date;  source;  

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Adoptability  

3.  “Couple”  the  campaigns  with  a  Health  2.0  social  plaQorm:  Give  everybody  a  reason  to  come  back!    

–  Keep  ongoing  flow  of  Health  PromoVon  Campaigns  –  Organize  Health  2.0  communi9es  to  make  the  most  of  the  result  of  each  campaign  

–  Campaign  “goods”  coupled  with  a  well  organized  Health  2.0.  community  give  the  sense  of  a  “safe  harbor”  and  build  people’s  trust  

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Appendix  2  

Value  for  All  

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Value  for  ALL  

•  People  –  Access  high  value  health  services  with  considerable  less  cost  while  in  campaign  environment  

–  Acquire  a  Health  Profile  within  a  technology  system  that  “reminds”  them  automaVcally  and  on  a  frequent  basis  to  keep  a  healthy  standard  of  living  

–   Have  instant  access  to  a  Health  Community  within  a  technology  system  that  “guides”  them  to  the  best  possible  soluVon  to  any  Health  quesVon  /  problem  they  may  have  

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Value  for  ALL  

•  Doctors  /  Health  Providers  –  Provide  high  value  health  services  in  compeVVve  prices  and  to  a  much  wider  audience  while  in  campaign  environment  

–  Acquire  a  Health  Profile  within  a  technology  system  that  “reminds”  them  automaVcally  and  on  a  frequent  basis  to  keep  an  acVve  relaVonship  with  their  clients  

–  Have  instant  access  to  a  Health  Community  within  a  technology  system  that  “guides”  them  to  groups  and  online  communiVes  giving  them  a  chance  to  build  trust  with  viable  clients  

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Value  for  ALL  

•  Insurance  Companies  (payers)  –  Have  instant  access  to  state  of  art  screening  processes  (health  profiling)  for  their  clientele  

–  Acquire  considerable  Brand  Value  within  a  technology  system  that  can  run  mulVple  campaigns  on  their  exisVng  clientele  or  on  completely  new  market  segments  (i.e.  within  companies  with  thousands  of  workers  or  within  communiVes)    

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Value  for  ALL  

•  Pharmaceu9cal  Companies  –  Have  instant  access  to  state  of  art  screening  processes  (health  profiling)  for  their  clientele  

–  Get  valuable  feedback  on  customizable  campaigns  that  support  acVve  drug  research  

–  Acquire  considerable  Brand  Value  within  a  technology  system  that  can  run  mulVple  campaigns  on  their  exisVng  clientele  (doctors)