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  • 1. SYSTEMIC TRansformations in health care by design Stories from the Center for Innovation (CFI) AHO josinavink manuelaaguirreu
  • 2. WHY DO SO MANY PEOPLE (FROM ALL OVER THE WORLD) COME TO THIS TORNADO-BORN TOWN? * image by Patti Kuche AHO josinavink manuelaaguirreu
  • 3. 1860 1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 ED: OPEN SURGERIES THE MAYO´S CLINIC SALARIED STAFF ECONOMY TECHNOLOGY PROACTIVE APPROACH TOWARDS PHILANTROPY FIRST BLOOD BANK IN UNITED STATES & USE OF EEG TEST FIRST OPERATING TABLE FIRST USE OF X-RAYS 2000 FIRST ICU ICU PRECURSOR FIRST CT SCANNER EARLY USE OF VIDEO VISITS FIRST USE OF COMPUTER EARLIEST PATIENT RECORD WORKFLOW 2020 cfi EARLY USE OF TELEPHONE COMMUNICATION 2010 spark THE NEEDS OF THE PATIENTS COME FIRST & INTEGRATED GROUP PRACTICE VISION 1990 UNIFIED MEDICAL RECORD MEDICAL SURGICAL INDEX COMPUTERS GO MAINSTREAM EMR REPLACED PAPER MEDICAL RECORDS ORANGE/BLUE CALENDAR DAYS EXPERIMENTAL RADIAL NURSING UNIT MAYO CLINIC HEALTH SYSTEM PARTNERSHIPS MAYO CLINIC OPENS IN FLORIDA AND ARIZONA AHO josinavink MAYO CLINIC CARE NETWORK manuelaaguirreu
  • 4. center for innovation Transforming the experience and delivery of health care 64 58 32 28 24 6 8 2 2004 AHO 2005 2007 2008 josinavink 2009 2010 2012 2013 manuelaaguirreu
  • 5. Research Admin Facilities & Support Services Planning Services Mayo Health System Admin Human Resources Public Affairs Finance Systems and Procedures Neurology Legal Dental Specialities Environmental Services Dermatology Education Admin Emergency Med Development Molecular Farm Family Med 1900 Nursing Medical Genetics ENT Internal Medicine Molecular Med Oncology 1925 Orthopedics Physical Med Anesthesiology Immunology Radiation Oncology Anatomy Surgery Urology TODAY Lab Med & Pathology Comparative Med Health Sciences Research Biochemistry & Molecular Biology AHO Radiology Psychiatry & Psychology Neurosurgery Obstetrics & Gynecology Ophthalmology - Head & Neck Surgery Physical & Biomedical Engineering josinavink manuelaaguirreu
  • 6. AHO josinavink manuelaaguirreu
  • 7. evidence based rational linear reductive analytical comparative consensus reactive possibility based creative divergent generative reflexive disruptive provocative proactive * Comparison by Lorna Ross AHO josinavink manuelaaguirreu
  • 8. AHO josinavink manuelaaguirreu
  • 9. THE GOAL Reduce outpatient practice costs by at least 30% while improving the patient experience and maintaining/enhancing quality. TIMELINE Implement new models to >40% of the outpatient practice by the end of 2014. EXPERIMENT FAMILIES: Pre-Visit Smart Space AHO Micro-Consults Group Visits Remote Recheck Flexible Day josinavink manuelaaguirreu
  • 10. AHO josinavink manuelaaguirreu
  • 11. CREATING AN ADAPTIVE AND INTELLIGENT SYSTEM KNOW THE PATIENT group visits awareness micro-consult smart space pre visit remote recheck flexible day costumized ed adaptability enhanced integrated care OPTIMIZED CARE OFFERINGS AHO josinavink manuelaaguirreu
  • 12. group visits awareness micro-consult smart space pre visit remote recheck flexible day costumized ed adaptability AHO enhanced integrated care josinavink manuelaaguirreu
  • 13. pulmonary specialist AHO josinavink manuelaaguirreu
  • 14. AHO josinavink manuelaaguirreu
  • 15. AHO josinavink manuelaaguirreu
  • 16. Healthcare Industry Mayo System Outpatient Practice Service Offerings AHO josinavink manuelaaguirreu
  • 17. AHO josinavink manuelaaguirreu
  • 18. AHO josinavink manuelaaguirreu
  • 19. Curry, A. and Hodgson, A. (2008). “Seeing in multiple horizons: connecting futures to strategy” . Journal of Futures Studies 13(1). Pp. 1 - 20. AHO josinavink manuelaaguirreu
  • 20. AHO josinavink manuelaaguirreu
  • 21. change fatigue AHO josinavink manuelaaguirreu
  • 22. prove it AHO josinavink manuelaaguirreu
  • 23. systemic short term long term narrow vision discrete * Model from Peter Coughlan and Colleen Ponto AHO josinavink manuelaaguirreu
  • 24. mitigation vs optimization AHO josinavink manuelaaguirreu
  • 25. structure drives behavior AHO josinavink manuelaaguirreu
  • 26. adding or disrupting AHO josinavink manuelaaguirreu
  • 27. do you see any of these challenges in the context you are working in AHO josinavink manuelaaguirreu
  • 28. successes in facilitating systems change AHO josinavink manuelaaguirreu
  • 29. making space for change AHO josinavink manuelaaguirreu
  • 30. embrace the unintended AHO josinavink manuelaaguirreu
  • 31. ENABLING practice champions AHO josinavink manuelaaguirreu
  • 32. building on what is working AHO josinavink manuelaaguirreu
  • 33. identifying strategic levers AHO josinavink manuelaaguirreu
  • 34. connecting the dots AHO josinavink manuelaaguirreu
  • 35. possibilities for the future AHO josinavink manuelaaguirreu