John Squeo
Lazer Focus Advisors
Find us on LinkedIn
Hospital Setting Perspective Ambulatory & Home Settings Perspective
TOPIC OUTLINE
Pressures driving Medical data convergence -
Quality, Safety and Productivity
Hospital Setting Perspective Ambulatory & H...
Opportunities to achieve better outcomes
leveraging Medical Device Integration (MDI)
Pressures driving Medical data conv...
Opportunities to achieve better outcomes
leveraging Medical Device Integration (MDI)
Pressures driving Medical data conv...
Putting Hospital Device Integration Together
Opportunities to achieve better outcomes
leveraging Medical Device Integrat...
Pressures toward extending patient
monitoring beyond the hospital
Putting Hospital Device Integration Together
Opportun...
Emerging needs for Medical Device
Integration (MDI) beyond hospital
Pressures toward extending patient
monitoring beyond...
Emerging needs for Medical Device
Integration (MDI) beyond hospital
Pressures toward extending patient
monitoring beyond...
Emerging needs for Medical Device
Integration (MDI) beyond hospital
Pressures toward extending patient
monitoring beyond...
NURSES HAVE MANY NEW THINGS
TO DO & LEARN IN ADDITION TO
DELIVERING EXCEPTIONAL PATIENT CARE
 Clinical Documentation – Paper to EHR
NURSES HAVE MANY NEW THINGS
TO DO & LEARN IN ADDITION TO
DELIVERING EXCEPTIONAL PA...
 Clinical Documentation – Paper to EHR
 Medication Administration – Scanned & Digitized
NURSES HAVE MANY NEW THINGS
TO D...
 Clinical Documentation – Paper to EHR
 Medication Administration – Scanned & Digitized
 Process improvement programs e...
 Clinical Documentation – Paper to EHR
 Medication Administration – Scanned & Digitized
 Achieving optimal Core Measure...
 Clinical Documentation – Paper to EHR
 Medication Administration – Scanned & Digitized
 Heightened emphasis on patient...
 Clinical Documentation – Paper to EHR
 Medication Administration – Scanned & Digitized
 Trend - fewer nurses for each ...
 Clinical Documentation – Paper to EHR
 Medication Administration – Scanned & Digitized
 Trend - fewer nurses for each ...
Source: Hospital nurse staffing ratio trends 1993-2004.1 No significant trend in median
hospital nurse to patient ratio 19...
Source: Hospital nurse staffing ratio trends 1993-2004.1 No significant trend in median
hospital nurse to patient ratio 19...
Human Error
Avoidance with
increased Efficiency
Ancillary Clinical
Repository to house
non-truncated “atomic”
data for analytical research
Human Error
Avoidance with
incr...
SpO2 Data
?ALGORITHM TO
SCRUB DATA POINTS FROM
GOING INTO RECORD
Patient
Monitor
Clinical
Network
Gateway
Phillips, GE, others
Clinical
Info
System(s)
McKesson,
EPIC, Cerner,
MEDITECH
oth...
 RESULTS - 2012 Capsite Survey 300 US hospitals
 44% had purchased MDI in recent years majority in 2011 & 2012
 Breakdo...
Source: Medical Device Integration Software Surges in Hospitals,
InformationWeek Healthcare, Ken Terry, August 15, 2012
R...
31%
19%
50%
0
MDI Industry
Market Share
Cerner
Capsule
Epic
GE
MEDITECH
Siemens
iSirona
Nuvon
Source: Medical Device Integ...
Source: Santa Rosa Consulting & BMoorman Consulting, LLC
THE DOWNSIDE TO MDI
Source: Santa Rosa Consulting & BMoorman Consulting, LLC
THE DOWNSIDE TO MDI
Source: Santa Rosa Consulting & BMoorman Consulting, LLC
IT &
TELECOM
THE DOWNSIDE TO MDI
Source: Santa Rosa Consulting & BMoorman Consulting, LLC
IT &
TELECOM
BIOMED
THE DOWNSIDE TO MDI
Source: Santa Rosa Consulting & BMoorman Consulting, LLC
IT &
TELECOM
BIOMED FACILITIES
THE DOWNSIDE TO MDI
Source: Santa Rosa Consulting & BMoorman Consulting, LLC
IT &
TELECOM
BIOMED FACILITIES VENDORS
THE DOWNSIDE TO MDI
Patient
Monitoring
system
Medical Device Alerts Sent
directly to the phones or
badges of the Nurses to
elevate “situation ...
Patient
Monitoring
system
Medical Device Alerts Sent
directly to the phones or
badges of the Nurses to
elevate “situation ...


OPPORTUNITIES – WELLNESS AND FINANCIAL
REQUIREMENTS – TECHNICAL
 Ability to monitor most “at risk” patients such as elderly
and chronically ill to preemptively intervene before an ED
vi...
 Ability to monitor most “at risk” patients such as elderly
and chronically ill to preemptively intervene before an ED
vi...
 Ability to monitor most “at risk” patients such as elderly
and chronically ill to preemptively intervene before an ED
vi...
 Ability to monitor most “at risk” patients such as elderly
and chronically ill to preemptively intervene before an ED
vi...
1% of U.S. population consumes
20% of ALL HEALTH CARE DOLLARS
Source: National Institute of Health Care Management 2012
1% of U.S. population consumes
20% of ALL HEALTH CARE DOLLARS
Source: National Institute of Health Care Management 2012
To...
$90,000
$41,000
$236
0
COST BREAK DOWN
Average Annual Healthcare Spend in USA
Per Person
Heart
Disease
Diabetes
Arthritis
...
#3 Biggest Issue – Patient Safety & Quality
2011 Results - Biggest Issue Facing Hospital CEOs
Source: American College of ...
#3 Biggest Issue – Healthcare Reform
Implementation
2012 Results - Biggest Issue Facing Hospital CEOs
Source: American Col...
•Hospital Readmissions– Hospital DRGs 1% in 2013 3% by 2015
•Medicaid DSH cuts - $18.1Billion 2014 – 2020 (Pres. Obama pro...
Source: Southcentral Foundation, “The Trust for
Health Excellence‟s Better Health Initiative”
Looking “in” on the patient Looking “out” to the Health Care Environment
Looking “in” on the patient Looking “out” to the Health Care Environment
Patient-centered medical homes (PCMH) – Not neces...
Aging in Place
SILVER TSUNAMI - Growth of Senior Citizen Population
 78 Million Baby Boomers turned 65 in 2011
 9 out of...
Care At Home
Care At Home
HEALING AND AGING IN THE HOME – REMOTE MONITORING PILOT PROGRAM
 Leverage Home Care nursing augmented by rem...
Care At Home
HEALING AND AGING IN THE HOME – REMOTE MONITORING PILOT PROGRAM
 Leverage Home Care nursing augmented by rem...
Source: Current and Future Trends in Medical
Electronics, Steven Dean, Texas
Instruments, September 23, 2009
HOME SETTING
...
Qualcomm
Life 2net
Sensors
Qualcomm
Life 2net
Sensors Implantable
In Vivo Glucose Monitor
Qualcomm
Life 2net
Sensors Implantable
In Vivo Glucose Monitor
Wearable
fitbi
t
Qualcomm
Life 2net
Sensors Implantable
In Vivo Glucose Monitor
Wearable
fitbi
t
Behavior
Tracking
Glowcaps
SET THE DATA COLLECTION SYSTEM “IN REVERSE” TO CONDUCT
PATIENT OUTREACH, INFLUENCE HABITS AND PREEMPTIVELY
MONITOR ADVERSE...
SET THE DATA COLLECTION SYSTEM “IN REVERSE” TO CONDUCT
PATIENT OUTREACH, INFLUENCE HABITS AND PREEMPTIVELY
MONITOR ADVERSE...
Source: Southcentral Foundation, “The Trust for
Health Excellence‟s Better Health Initiative”
Source: Southcentral Foundation, “The Trust for
Health Excellence‟s Better Health Initiative”
Influence the
RIGHT
PEOPLE
a...
Web Email Text/Mobil
e
Mail
Social
Communities IVRTelephonic Face-to-
Face
Home Care
Web Email Text/Mobil
e
Mail
Social
Communities IVRTelephonic Face-to-
Face
Home Care
Web Email Text/Mobil
e
Mail
Social
Communities IVRTelephonic Face-to-
Face
Home Care
Web Email Text/Mobil
e
Mail
Social
Communities IVRTelephonic Face-to-
Face
Home Care
Source: Oliver Wyman, The Volume-To-Value Revolution, Rebuilding the DNA of Health from the Patient
in, Tom Main & Adrian ...
OLAP/SQL
OLAP/SQL
RISK SCORES
Episode Risk Groups (ERGs)
Episode Treatment Groups (ETGs)
Hierarchical Condition Categories (HCC)
OLAP/SQL
MIDDLEWARE
Connexall, EXTENSION, ASCOM,
Phillips Emergin, Amcom
MIDDLEWARE
Connexall, EXTENSION, ASCOM,
Phillips Emergin, Amcom
MIDDLEWARE
Connexall, EXTENSION, ASCOM,
Phillips Emergin, Amcom
MIDDLEWARE
Connexall, EXTENSION, ASCOM,
Phillips Emergin, Amcom
MIDDLEWARE
Connexall, EXTENSION, ASCOM,
Phillips Emergin, Amcom
IDEALLY……. LAYER IN
SELF-SERVICE MESSAGE ROUTING
& AVAILABILITY STATUS
PLAN OF ACTION
HOW TO BEGIN THE JOURNEY IN A HOSPITAL
PLAN OF ACTION
HOW TO BEGIN THE JOURNEY IN A HOSPITAL
PLAN OF ACTION
 Which perspective is your organization?
 Hospital only?
 Hospita...
HOW TO BEGIN THE JOURNEY IN A HOSPITAL
Include all stakeholders early on
Administrative Leadership
Physicians
Nurse Le...
HOW TO BEGIN THE JOURNEY IN A HOSPITAL HOW TO BEGIN OUTSIDE OF A HOSPITAL
Include all stakeholders early on
Administrati...
 Which perspective is your organization?
 Not closely affiliated with hospital(s)?
 Closely Integrated with hospital(s)...
 Which perspective is your organization?
 Not closely affiliated with hospital(s)?
 Closely Integrated with hospital(s)...
REACH ME AT LinkedIn: John Squeo
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
Medical Device Integration for Patient Centered Health Care
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Medical Device Integration for Patient Centered Health Care

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This presentation describes considerations when evaluating BioMed and IT solutions for integrating patient monitors and medical devices to EHRs EMRs.

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  • Thank you for attending this sessionTHE TOPIC this session isMy name is John Squeo, TITLEVANGUARD HEALTH SYSTEMSInvestor Owned Health Delivery System29 HospitalsDOCTORS in 1000 Care settings across the United StatesCurrently undergoing a major transformation in the way we are being compensated by the Payers such asMEDICAREMEDICAIDANDCommercial InsurersShow of hands from audience from Health Care, Pharmaceutical or Life SciencesTHIS TOPIC should be of interest to you for professional reasonsDEFINE PERSONALIZED HEALTHCARETHIS TOPIC affects all because we will all be affected by it due to recent shifts in HealthCare Payment and Delivery driven by changes in way Government pays for healthcare
  • WHAT CAN TECHNOLOGY TELL US ABOUT POPULATION HEALTH?According to the National Institute of Health Care Management1% of Insured USED $90K per person in health care expenses in 20115% accounted for $41K per person50% of the insured average only $236 in health care expenses in 2011MAIN COST DRIVERS OBESITY RELATED HEART DISEASE Diabetes ArthritisOn Track in 2012 for !4,250 Transplants at average cost of $730K eachIF WE CAN IDENTIFY WHICH PEOPLE ARE HEADED TOWARDS THESE DISEASES, WE CAN INTERVENE EARLY ON AND AVOID THE HIGH EXPENSE
  • According to the 2011 Annual Survey American College of Healthcare Executives – THE BIGGEST ISSUES FACING HOSPITAL CEOs
  • According to the 2011 Annual Survey American College of Healthcare Executives – THE BIGGEST ISSUES FACING HOSPITAL CEOs
  • Last week, Rep. John Lewis (D-Ga.) proposed the DSH Reduction Relief Act, which would delay Medicare and Medicaid DSH payment cuts until the government's 2016 fiscal yearIL Bill Status of SB2840  98th General Assembly Senate SponsorsSen. Heather A. Steans - John G. Mulroe"pay and chase" model to a prospective pre-payment model - Contains provisions concerning eligibility and payment verifications; data sharing; and the benefits of a pre-payment, post-adjudication, and post-edit claims system
  • HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
  • HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
  • HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
  • HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
  • USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
  • USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
  • USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
  • USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
  • USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
  • QUESTIONS?>>>>>>>>>>>>>LISTEN TO AUDIENCE………..I WANT TO THANK YOU FOR ATTENDINGI CAN BE REACHED ON LINKEDIN by searching for JOHN SQUEO
  • Medical Device Integration for Patient Centered Health Care

    1. 1. John Squeo Lazer Focus Advisors Find us on LinkedIn
    2. 2. Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    3. 3. Pressures driving Medical data convergence - Quality, Safety and Productivity Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    4. 4. Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    5. 5. Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Medical Device Integration (MDI) Landscape - Industry Players and Technology Challenges Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    6. 6. Putting Hospital Device Integration Together Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Medical Device Integration (MDI) Landscape - Industry Players and Technology Challenges Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    7. 7. Pressures toward extending patient monitoring beyond the hospital Putting Hospital Device Integration Together Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Medical Device Integration (MDI) Landscape - Industry Players and Technology Challenges Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    8. 8. Emerging needs for Medical Device Integration (MDI) beyond hospital Pressures toward extending patient monitoring beyond the hospital Putting Hospital Device Integration Together Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Medical Device Integration (MDI) Landscape - Industry Players and Technology Challenges Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    9. 9. Emerging needs for Medical Device Integration (MDI) beyond hospital Pressures toward extending patient monitoring beyond the hospital Putting Hospital Device Integration Together Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Overview of Patient & Care Provider Alerting & Outreach Systems - “Events Bus” Medical Device Integration (MDI) Landscape - Industry Players and Technology Challenges Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    10. 10. Emerging needs for Medical Device Integration (MDI) beyond hospital Pressures toward extending patient monitoring beyond the hospital Putting Hospital Device Integration Together Opportunities to achieve better outcomes leveraging Medical Device Integration (MDI) Pressures driving Medical data convergence - Quality, Safety and Productivity Proposed Plan of Action to begin journey Overview of Patient & Care Provider Alerting & Outreach Systems - “Events Bus” Medical Device Integration (MDI) Landscape - Industry Players and Technology Challenges Hospital Setting Perspective Ambulatory & Home Settings Perspective TOPIC OUTLINE
    11. 11. NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    12. 12.  Clinical Documentation – Paper to EHR NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    13. 13.  Clinical Documentation – Paper to EHR  Medication Administration – Scanned & Digitized NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    14. 14.  Clinical Documentation – Paper to EHR  Medication Administration – Scanned & Digitized  Process improvement programs e.g. LEAN NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    15. 15.  Clinical Documentation – Paper to EHR  Medication Administration – Scanned & Digitized  Achieving optimal Core Measures & HCAHPS scores  Process improvement programs e.g. LEAN NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    16. 16.  Clinical Documentation – Paper to EHR  Medication Administration – Scanned & Digitized  Heightened emphasis on patient discharge process  Achieving optimal Core Measures & HCAHPS scores  Process improvement programs e.g. LEAN NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    17. 17.  Clinical Documentation – Paper to EHR  Medication Administration – Scanned & Digitized  Trend - fewer nurses for each patient  Heightened emphasis on patient discharge process  Achieving optimal Core Measures & HCAHPS scores  Process improvement programs e.g. LEAN NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    18. 18.  Clinical Documentation – Paper to EHR  Medication Administration – Scanned & Digitized  Trend - fewer nurses for each patient  Heightened emphasis on patient discharge process  Achieving optimal Core Measures & HCAHPS scores  Process improvement programs e.g. LEAN Can Information Technology DECREASE the burden of additional workload on nurses? NURSES HAVE MANY NEW THINGS TO DO & LEARN IN ADDITION TO DELIVERING EXCEPTIONAL PATIENT CARE
    19. 19. Source: Hospital nurse staffing ratio trends 1993-2004.1 No significant trend in median hospital nurse to patient ratio 1993-99; chi square test for trend for median hospital nurse staffing ratio 1999-2004 (p _.001). Journal of Hospital MedicineVolume 3, Issue 3, Article first published online: 20 JUN 2008 Nurse Staffing Ratios: Trends and Policy Implications for Hospitalists and the Safety Net, Patrick H. Conway, MD, MSc, et. al.
    20. 20. Source: Hospital nurse staffing ratio trends 1993-2004.1 No significant trend in median hospital nurse to patient ratio 1993-99; chi square test for trend for median hospital nurse staffing ratio 1999-2004 (p _.001). Journal of Hospital MedicineVolume 3, Issue 3, Article first published online: 20 JUN 2008 Nurse Staffing Ratios: Trends and Policy Implications for Hospitalists and the Safety Net, Patrick H. Conway, MD, MSc, et. al. Source: Implications of the California nurse staffing mandate for other states. Health Serv Res. 2010 Aug;45(4):904-21. doi: 10.1111/j.1475-6773.2010.01114.x. Epub 2010 Apr 9., Aiken LH, et al.
    21. 21. Human Error Avoidance with increased Efficiency
    22. 22. Ancillary Clinical Repository to house non-truncated “atomic” data for analytical research Human Error Avoidance with increased Efficiency
    23. 23. SpO2 Data
    24. 24. ?ALGORITHM TO SCRUB DATA POINTS FROM GOING INTO RECORD
    25. 25. Patient Monitor Clinical Network Gateway Phillips, GE, others Clinical Info System(s) McKesson, EPIC, Cerner, MEDITECH others HIS/ADT Info System McKesson, E PIC, Cerner, MEDITECH others HL7 Interface Engine Cloverleaf, Jcaps, others Central Station Phillips, GE, others Medical Device Integrator (MDI) Cerner, Capsule, Nuvon, iS irona, [DAS] Data Acquisition Systems, others Ancillary Medical Devices Serial to Ethernet or Wi-Fi Convertor
    26. 26.  RESULTS - 2012 Capsite Survey 300 US hospitals  44% had purchased MDI in recent years majority in 2011 & 2012  Breakdown of Current MDI adopters  400 + Beds = 63% in category implemented MDI  399 - 200 Beds = 75% in category implemented MDI  200 Beds or less = 33% in category implemented MDI
    27. 27. Source: Medical Device Integration Software Surges in Hospitals, InformationWeek Healthcare, Ken Terry, August 15, 2012 Reasons Stated for MDI purchase Improve Clinical Outcomes = 40% Improve Efficiency = 37% Meaningful Use for government EHR financial incentives = 17% Other reasons = 6%  RESULTS - 2012 Capsite Survey 300 US hospitals  44% had purchased MDI in recent years majority in 2011 & 2012  Breakdown of Current MDI adopters  400 + Beds = 63% in category implemented MDI  399 - 200 Beds = 75% in category implemented MDI  200 Beds or less = 33% in category implemented MDI
    28. 28. 31% 19% 50% 0 MDI Industry Market Share Cerner Capsule Epic GE MEDITECH Siemens iSirona Nuvon Source: Medical Device Integration Software Surges in Hospitals, InformationWeek Healthcare, Ken Terry, August 15, 2012
    29. 29. Source: Santa Rosa Consulting & BMoorman Consulting, LLC THE DOWNSIDE TO MDI
    30. 30. Source: Santa Rosa Consulting & BMoorman Consulting, LLC THE DOWNSIDE TO MDI
    31. 31. Source: Santa Rosa Consulting & BMoorman Consulting, LLC IT & TELECOM THE DOWNSIDE TO MDI
    32. 32. Source: Santa Rosa Consulting & BMoorman Consulting, LLC IT & TELECOM BIOMED THE DOWNSIDE TO MDI
    33. 33. Source: Santa Rosa Consulting & BMoorman Consulting, LLC IT & TELECOM BIOMED FACILITIES THE DOWNSIDE TO MDI
    34. 34. Source: Santa Rosa Consulting & BMoorman Consulting, LLC IT & TELECOM BIOMED FACILITIES VENDORS THE DOWNSIDE TO MDI
    35. 35. Patient Monitoring system Medical Device Alerts Sent directly to the phones or badges of the Nurses to elevate “situation awareness”
    36. 36. Patient Monitoring system Medical Device Alerts Sent directly to the phones or badges of the Nurses to elevate “situation awareness” BUT Alerts are “throttled” by Middleware to avoid “Alert Fatigue”
    37. 37.   OPPORTUNITIES – WELLNESS AND FINANCIAL REQUIREMENTS – TECHNICAL
    38. 38.  Ability to monitor most “at risk” patients such as elderly and chronically ill to preemptively intervene before an ED visit is necessary   OPPORTUNITIES – WELLNESS AND FINANCIAL REQUIREMENTS – TECHNICAL
    39. 39.  Ability to monitor most “at risk” patients such as elderly and chronically ill to preemptively intervene before an ED visit is necessary  Emerging opportunity to get a broader glimpse of a patient‟s health profile and living habits   OPPORTUNITIES – WELLNESS AND FINANCIAL REQUIREMENTS – TECHNICAL
    40. 40.  Ability to monitor most “at risk” patients such as elderly and chronically ill to preemptively intervene before an ED visit is necessary  Emerging opportunity to get a broader glimpse of a patient‟s health profile and living habits   OPPORTUNITIES – WELLNESS AND FINANCIAL REQUIREMENTS – TECHNICAL  Requires – Scalable data network  100s OR 1000s of connections into monitoring center
    41. 41.  Ability to monitor most “at risk” patients such as elderly and chronically ill to preemptively intervene before an ED visit is necessary  Emerging opportunity to get a broader glimpse of a patient‟s health profile and living habits  Requires – Nimble data warehouse or core clinical repository.  Able to parse structured and non-structured data with lower confidence of data match via master “person” index OPPORTUNITIES – WELLNESS AND FINANCIAL REQUIREMENTS – TECHNICAL  Requires – Scalable data network  100s OR 1000s of connections into monitoring center
    42. 42. 1% of U.S. population consumes 20% of ALL HEALTH CARE DOLLARS Source: National Institute of Health Care Management 2012
    43. 43. 1% of U.S. population consumes 20% of ALL HEALTH CARE DOLLARS Source: National Institute of Health Care Management 2012 Total expenditure on healthcare: per capita per year: $7,960 Source: Organization for Economic Co-operation and Development on global health issues: Michael B. Sauter, Charles B. Stockdale, 24/7 Wall St. , 2012 - Countries that spend the most on health care, NBCNEWS.com, http://www.nbcnews.com/business/countries-spend-most-health-care-618241 Expenditure as percent of GDP: 17.4 percent
    44. 44. $90,000 $41,000 $236 0 COST BREAK DOWN Average Annual Healthcare Spend in USA Per Person Heart Disease Diabetes Arthritis Asthma Source: National Institute of Health Care Management 2012 C O S T D R I V E R S
    45. 45. #3 Biggest Issue – Patient Safety & Quality 2011 Results - Biggest Issue Facing Hospital CEOs Source: American College of Healthcare Executives, Annual Poll – Top Issues Confronting Hospitals: 2012 Annual Survey American College of Healthcare Executives
    46. 46. #3 Biggest Issue – Healthcare Reform Implementation 2012 Results - Biggest Issue Facing Hospital CEOs Source: American College of Healthcare Executives, Annual Poll – Top Issues Confronting Hospitals: 2012 Annual Survey American College of Healthcare Executives
    47. 47. •Hospital Readmissions– Hospital DRGs 1% in 2013 3% by 2015 •Medicaid DSH cuts - $18.1Billion 2014 – 2020 (Pres. Obama proposed delay to 2015) •Value-Based Purchasing •70% - Core Measures: Heart Failure, Acute Myocardial Infarction (AMI), Pneumonia & Surgical Care •30% - HCAHPS score: Patient Satisfaction •Physician (SGR) Sustainable Growth Rate – 27% Reduced Reimbursements CMS & Commercial Carriers •Accountable Care – Provider Risk Acceptance & Shared Savings •Bundled payment for episodic care Global Payments Innovations – CMS & Carriers •Payers setting up Accountable Care Organizations •Hospital Systems offering health insurance on public Health Insurance Exchanges (HIX) Payer/Provider Convergence
    48. 48. Source: Southcentral Foundation, “The Trust for Health Excellence‟s Better Health Initiative”
    49. 49. Looking “in” on the patient Looking “out” to the Health Care Environment
    50. 50. Looking “in” on the patient Looking “out” to the Health Care Environment Patient-centered medical homes (PCMH) – Not necessarily a “place” rather a central point from which assistance is provided to navigate the fragmented healthcare system Source: Oliver Wyman, Tom Main & Adrian Slywotzky
    51. 51. Aging in Place SILVER TSUNAMI - Growth of Senior Citizen Population  78 Million Baby Boomers turned 65 in 2011  9 out of 10 seniors want to stay in the home they retired in. Source: AARP Alzheimer‟ s Patients
    52. 52. Care At Home
    53. 53. Care At Home HEALING AND AGING IN THE HOME – REMOTE MONITORING PILOT PROGRAM  Leverage Home Care nursing augmented by remote sensor monitoring  Good Samaritan – LivingWell@Home [Pilot of 40 connected assisted living facilities] study 1/2011 through 6/2013  WellAware – motion sensors detect movement in bed, showering, toileting etc.  Phillips Lifeline – auto-alert function detects falls  Honeywell Hommed Telehealth monitoring: Heart rate, Blood pressure, Weight, Oxygen saturation, Temperature, ECG rhythm, Spirometry, Prothrombin time/INR Source: „The Matrix‟ Meets Medicine: Surveillance Swoops Into Health Care, Michael Millenson, January 9, 2013
    54. 54. Care At Home HEALING AND AGING IN THE HOME – REMOTE MONITORING PILOT PROGRAM  Leverage Home Care nursing augmented by remote sensor monitoring  Good Samaritan – LivingWell@Home [Pilot of 40 connected assisted living facilities] study 1/2011 through 6/2013  WellAware – motion sensors detect movement in bed, showering, toileting etc.  Phillips Lifeline – auto-alert function detects falls  Honeywell Hommed Telehealth monitoring: Heart rate, Blood pressure, Weight, Oxygen saturation, Temperature, ECG rhythm, Spirometry, Prothrombin time/INR Source: „The Matrix‟ Meets Medicine: Surveillance Swoops Into Health Care, Michael Millenson, January 9, 2013 Source: Iboun Taimiya Sylla, Texas Instruments NantLife by NantCare
    55. 55. Source: Current and Future Trends in Medical Electronics, Steven Dean, Texas Instruments, September 23, 2009 HOME SETTING Connectivity HOSPITAL SETTING Connectivity
    56. 56. Qualcomm Life 2net Sensors
    57. 57. Qualcomm Life 2net Sensors Implantable In Vivo Glucose Monitor
    58. 58. Qualcomm Life 2net Sensors Implantable In Vivo Glucose Monitor Wearable fitbi t
    59. 59. Qualcomm Life 2net Sensors Implantable In Vivo Glucose Monitor Wearable fitbi t Behavior Tracking Glowcaps
    60. 60. SET THE DATA COLLECTION SYSTEM “IN REVERSE” TO CONDUCT PATIENT OUTREACH, INFLUENCE HABITS AND PREEMPTIVELY MONITOR ADVERSE TRENDS
    61. 61. SET THE DATA COLLECTION SYSTEM “IN REVERSE” TO CONDUCT PATIENT OUTREACH, INFLUENCE HABITS AND PREEMPTIVELY MONITOR ADVERSE TRENDS
    62. 62. Source: Southcentral Foundation, “The Trust for Health Excellence‟s Better Health Initiative”
    63. 63. Source: Southcentral Foundation, “The Trust for Health Excellence‟s Better Health Initiative” Influence the RIGHT PEOPLE at the RIGHT TIME at the RIGHT PLACE by the RIGHT METHOD USE PATIENT OUTREACH TO
    64. 64. Web Email Text/Mobil e Mail Social Communities IVRTelephonic Face-to- Face Home Care
    65. 65. Web Email Text/Mobil e Mail Social Communities IVRTelephonic Face-to- Face Home Care
    66. 66. Web Email Text/Mobil e Mail Social Communities IVRTelephonic Face-to- Face Home Care
    67. 67. Web Email Text/Mobil e Mail Social Communities IVRTelephonic Face-to- Face Home Care
    68. 68. Source: Oliver Wyman, The Volume-To-Value Revolution, Rebuilding the DNA of Health from the Patient in, Tom Main & Adrian Slywotzky, 2012
    69. 69. OLAP/SQL
    70. 70. OLAP/SQL
    71. 71. RISK SCORES Episode Risk Groups (ERGs) Episode Treatment Groups (ETGs) Hierarchical Condition Categories (HCC) OLAP/SQL
    72. 72. MIDDLEWARE Connexall, EXTENSION, ASCOM, Phillips Emergin, Amcom
    73. 73. MIDDLEWARE Connexall, EXTENSION, ASCOM, Phillips Emergin, Amcom
    74. 74. MIDDLEWARE Connexall, EXTENSION, ASCOM, Phillips Emergin, Amcom
    75. 75. MIDDLEWARE Connexall, EXTENSION, ASCOM, Phillips Emergin, Amcom
    76. 76. MIDDLEWARE Connexall, EXTENSION, ASCOM, Phillips Emergin, Amcom
    77. 77. IDEALLY……. LAYER IN SELF-SERVICE MESSAGE ROUTING & AVAILABILITY STATUS
    78. 78. PLAN OF ACTION
    79. 79. HOW TO BEGIN THE JOURNEY IN A HOSPITAL PLAN OF ACTION
    80. 80. HOW TO BEGIN THE JOURNEY IN A HOSPITAL PLAN OF ACTION  Which perspective is your organization?  Hospital only?  Hospital, SNF, Ambulatory, Home Health, Other?  Converging service lines?
    81. 81. HOW TO BEGIN THE JOURNEY IN A HOSPITAL Include all stakeholders early on Administrative Leadership Physicians Nurse Leaders Informaticists Clinical Engineering/BioMed Information Systems Telecommunications Facilities/Maintenance Others PLAN OF ACTION  Which perspective is your organization?  Hospital only?  Hospital, SNF, Ambulatory, Home Health, Other?  Converging service lines?
    82. 82. HOW TO BEGIN THE JOURNEY IN A HOSPITAL HOW TO BEGIN OUTSIDE OF A HOSPITAL Include all stakeholders early on Administrative Leadership Physicians Nurse Leaders Informaticists Clinical Engineering/BioMed Information Systems Telecommunications Facilities/Maintenance Others PLAN OF ACTION  Which perspective is your organization?  Hospital only?  Hospital, SNF, Ambulatory, Home Health, Other?  Converging service lines?
    83. 83.  Which perspective is your organization?  Not closely affiliated with hospital(s)?  Closely Integrated with hospital(s)?  Integrated Delivery Network?  Accountable Care Organization? HOW TO BEGIN THE JOURNEY IN A HOSPITAL HOW TO BEGIN OUTSIDE OF A HOSPITAL Include all stakeholders early on Administrative Leadership Physicians Nurse Leaders Informaticists Clinical Engineering/BioMed Information Systems Telecommunications Facilities/Maintenance Others PLAN OF ACTION  Which perspective is your organization?  Hospital only?  Hospital, SNF, Ambulatory, Home Health, Other?  Converging service lines?
    84. 84.  Which perspective is your organization?  Not closely affiliated with hospital(s)?  Closely Integrated with hospital(s)?  Integrated Delivery Network?  Accountable Care Organization? HOW TO BEGIN THE JOURNEY IN A HOSPITAL HOW TO BEGIN OUTSIDE OF A HOSPITAL  Include all DATA source/destination stakeholders early on  IPA or PHO (Case Managers)  Home Health Agency(s)  Durable Medical Equipment (DME) providers  Local retail and outpatient pharmacies  Hospital based & stand alone outpatient clinics  ASCs - Labs - Radiology clinics/Imaging centers  WorkCenter health partners (ASOs/Self-insured Co‟s.)  Information systems staff or partner(s)  EHR & PMS vendor(s)  Registry vendor  Care Coordination Software vendor  Others Include all stakeholders early on Administrative Leadership Physicians Nurse Leaders Informaticists Clinical Engineering/BioMed Information Systems Telecommunications Facilities/Maintenance Others PLAN OF ACTION  Which perspective is your organization?  Hospital only?  Hospital, SNF, Ambulatory, Home Health, Other?  Converging service lines?
    85. 85. REACH ME AT LinkedIn: John Squeo
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