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1: The Unsust...
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Cost growth c...
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2: Waste
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4: The Chroni...
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5: The Five P...
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6: Coordinat...
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FWA Solution...
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Analytics En...
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2013-07-17: Health Innovation, A General Dynamics IT Perspective

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2013-07-17: Health Innovation, A General Dynamics IT Perspective

  1. 1. 0 Property of General Dynamics Information Technology do not distribute or re-use content without permission Property of General Dynamics Information Technology do not distribute or re-use content without permission Health Innovation – A GDIT Perspective Craig Miller Vice President, Health Strategy and Innovation
  2. 2. 1 Property of General Dynamics Information Technology do not distribute or re-use content without permissionGeneral Dynamics Proprietary Information PROBLEMS
  3. 3. 2 Property of General Dynamics Information Technology do not distribute or re-use content without permission 1: The Unsustainable Cost Curve • Healthcare accounts for nearly 18% of US GDP (Health Affairs 31(1): 208-219) • $2.6 trillion in total spending in 2010, over 10x spending 25 years ago (Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, National Healthcare Expenditures Data, January 2012.) • Insurance premiums have risen 113% in last decade (Kaiser Family Foundation and Health Research and Educational Trust. Employer Health Benefits 2011 Annual Survey. September 2011.)
  4. 4. 3 Property of General Dynamics Information Technology do not distribute or re-use content without permission Cost growth comparison with other countries Source: Organisation for Economic Co-operation and Development (2010), "OECD Health Data", OECD Health Statistics (database)
  5. 5. 4 Property of General Dynamics Information Technology do not distribute or re-use content without permission Overall cost comparison with other countries (2009) Source: Organisation for Economic Co-operation and Development (2010), "OECD Health Data", OECD Health Statistics (database)
  6. 6. 5 Property of General Dynamics Information Technology do not distribute or re-use content without permission 2: Waste Almost one third of the US spending on healthcare ($750 billion) is unnecessary, according to the 2012 Institute of Medicine study Best Care at Lower Cost
  7. 7. 6 Property of General Dynamics Information Technology do not distribute or re-use content without permission 3. Unacceptable Outcomes • According to the recently release IOM report “U.S. Health in International Perspective: Shorter Lives, Poorer Health”, compared to 16 other peer industrialized countries: • America ranks last in probable life expectancy for males <50, second to last for females <50 • Americans as a group fare worse in at least nine health areas: - infant mortality and low birth weight - injuries and homicides - adolescent pregnancy and sexually transmitted infections - HIV and AIDS - drug-related deaths - obesity and diabetes - heart disease - chronic lung disease - disability
  8. 8. 7 Property of General Dynamics Information Technology do not distribute or re-use content without permissionGeneral Dynamics Proprietary Information INSIGHTS
  9. 9. 8 Property of General Dynamics Information Technology do not distribute or re-use content without permission 4: The Chronic Disease Epidemic • According to the CDC: - 7 out of 10 deaths among Americans each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year. - In 2005, 133 million Americans – almost 1 out of every 2 adults – had at least one chronic illness. - Obesity has become a major health concern. 1 in every 3 adults is obese and almost 1 in 5 youth between the ages of 6 and 19 is obese - If current trends continue 1 in 3 Americans will have diabetes by 2050 US Adult Type II Diabetes Incidence, 2008
  10. 10. 9 Property of General Dynamics Information Technology do not distribute or re-use content without permission 5: The Five Percent • According to AHRQ study The High Concentration of U.S. Health Care Expenditures: - Five percent of the population accounts for almost half (49 percent) of total health care expenses. - The 15 most expensive health conditions account for 44 percent of total health care expenses
  11. 11. 10 Property of General Dynamics Information Technology do not distribute or re-use content without permissionGeneral Dynamics Proprietary Information OPPORTUNITIES
  12. 12. 11 Property of General Dynamics Information Technology do not distribute or re-use content without permission 6: Coordinated Care • The “5 Percent” typically exhibit complex comorbidities and extensive chronic disease • Often characterized by frequent hospital readmissions and extensive end-of-life care • At-risk populations need to move from isolated, reactive models of care to coordinated, proactive models of care
  13. 13. 12 Property of General Dynamics Information Technology do not distribute or re-use content without permission Coordinated Care Enablers • Health Information Exchange • Open Source HIE solutions, such as HIEOS • Patient Centered Medical Homes • Care coordination teams • Accountable care organizations
  14. 14. 13 Property of General Dynamics Information Technology do not distribute or re-use content without permission 7. Disruptive Care Models • Move to value-based purchasing for healthcare presents unique opportunities for disruptive innovation • “Winners” in ACO-like environments will do the best job of aggressively managing chronic disease, incenting better patient self-care, and moving care to less expensive providers and settings Hospital Outpatient Home High cost of care Low cost of care Care provider Care setting Physician Nurse / NP PA Self-Care
  15. 15. 14 Property of General Dynamics Information Technology do not distribute or re-use content without permission Disruption Enablers • Remote monitoring • Remote consultation • Mobile platforms • Social networks • Increased autonomy/privileges for NP/PA and other non-physician clinicians
  16. 16. 15 Property of General Dynamics Information Technology do not distribute or re-use content without permission 8: Solutions for Three Types of Fraud • Identity: one or more participants in the transaction is a false identity (provider, patient, processor, etc.) • Transactional: real patient and provider, but fictitious or inappropriate/unnecessary service or product (also includes waste and abuse) • Collusive: Larger pattern of transactions indicates organized conspiracy to defraud, such as pill mills and rent-a-patient schemes • Each type of fraud needs a different solution
  17. 17. 16 Property of General Dynamics Information Technology do not distribute or re-use content without permission FWA Solution Enablers • Move to prepayment detection of potential fraud and claim denial • Integrate data from clinical sources and public/financial records in addition to traditional claims data • Create a longitudinal view of true patient health status to evaluate claims for waste and abuse
  18. 18. 17 Property of General Dynamics Information Technology do not distribute or re-use content without permission 9: The Analytics Revolution • Widespread EHR and HIE adoption will provide a rich stream of computable clinical data that can significantly enhance the utility of analytic applications • “Big data” tools will enable analytics on unstructured data (e.g. clinical notes, social media, etc.) to augment the traditional structured data analysis • Significant challenges remain in reconciling inconsistent data from multiple sources and in de-identifying personal health data for public use
  19. 19. 18 Property of General Dynamics Information Technology do not distribute or re-use content without permission Analytics Enabler: Data Fusion Clinical Encounters Claims Quality Reporting Research Data Public Records Analytics Comparative Effectiveness FWA Population Health Chronic Disease Management Clinical Decision Support
  20. 20. 19 Property of General Dynamics Information Technology do not distribute or re-use content without permission 10: Create a Learning Health System • Past studies have shown it may take a decade or more for new clinical knowledge to make its way into routine practice • A learning health system is one that collects digital evidence from clinical experience, analyzes it to gain new insights and then rapidly applies them to front-line care to lower cost and improve quality
  21. 21. 20 Property of General Dynamics Information Technology do not distribute or re-use content without permission LHS Enabler: The Circle of Health Data • Meaningful Use provisions and health economics are driving the industry towards the creation of “learning health systems” • EHR adoption and HIE alone are insufficient to achieve this • Real value comes from identifying populations at risk and moving from reactive to proactive, coordinated models of care that integrate analytic insights into practice • Follow example of integrated delivery network systems Collect and manage health data Exchange health data Analyze health data Integrate insights into practice
  22. 22. 21 Property of General Dynamics Information Technology do not distribute or re-use content without permission For More Information HIMSS Innovation Community http://66.77.252.5/asp/innovation_commu nity_home.asp HIEOS http://sourceforge.net/projects/hieos/ GDIT Health Solutions http://www.gdit.com/Capabilities/Health/ Learning Health Community http://healthinformatics.umich.edu/initiative s/lhs/national-summit
  23. 23. 22 Property of General Dynamics Information Technology do not distribute or re-use content without permission Contact Information Email craig.miller@gdit.com Website www.gdit.com Twitter @HealthITCraig Phone 703.405.1408
  24. 24. 23 Property of General Dynamics Information Technology do not distribute or re-use content without permission General Dynamics Proprietary Information

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