High Tech and Personal Touch: Case Studies in Chronic Care from United States and Africa. Presentation at the On Lok Lifeways Conference, October 22, 2008: Sustainable Long Term Care: Ethics, Technology and International Perspectives, by Steve Brown, Founder and Former CEO, Health Hero Network, http://brown2020.com
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High Tech and Personal Touch in Chronic Care
1. High Tech and Personal Touch: Case Studies in
Chronic Care from United States and Africa
Steve Brown, Founder and Former CEO, Health Hero Network
On Lok Lifeways Conference, October 22, 2008
Sustainable Long Term Care: Ethics, Technology and International Perspectives
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2. Agenda
Background – Health Hero Network
Chronic Care Models
Example from US
Example from Africa
False Dichotomies in Chronic Care
A Better Mental Model
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3. Background: Health Hero Network
We recognized a problem
Too much effort spent treating the complications of chronic disease, and not enough
on preventing them
We had an idea
A technology platform to enable a better model of care based on identifying problems
early and changing behavior
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4. Health Buddy in 2008: Patients receive
better support and monitoring at home
Daily check-in starts
with “how are you
feeling today”
Reporting symptoms
and device readings
like glucose and
weight
Receiving supportive
feedback and
education
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5. Health Buddy 2008: Nurses can identify
problems early and prevent complications
Dashboard to see
how all patients are
doing today.
Patients needs are
triaged using red,
yellow, green coding
Full picture includes
symptoms, behavior
and knowledge
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6. Why is innovation addressing the chronic
care problem so painfully slow?
It is well known that
monitoring high risk patients at
home can improve care and
reduce hospitalizations.
ABC World News Tonight
featured Health Buddy way
back in 1999 and predicted a
new model of care for the 21st
century.
The business of healthcare –
especially in Medicare – still
rewards treating complications
far more than preventing them.
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7. Meanwhile in Rwanda Africa, necessity is
the mother of invention
Community health
workers support and
monitor at-risk
patients at home
Focus on the simple
things that have the
biggest impact
Everything starts with
“how are you feeling
today”
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8. Partners in Health is a community-based
model focused on prevention and education
The regional hospital
sees its mission as
preventing hospital
admissions
Training community
health workers to
extend care into the
community
Keeping organized and
tracking patients with
an open source
electronic medical
record system
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9. False Dichotomies in Chronic Care
High Tech versus Personal Touch
Improving Care versus Saving Money
Information Technology versus Simplicity
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10. False Dichotomy: Tech versus Touch.
Explain the growth in social media!
Life can be richer when we share more of it.
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12. False Dichotomy: Hi Tech versus Simplicity
How About a Better Mental Model!
Value
Potential Value
Cost
Opportunity
Realized
Value
Complexity
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13. Content can change the shape of the
Potential Value Curve
Example:
congestive heart
failure, the leading
hospital admission
in Medicare
Focus on areas
where you can
make a difference.
Start with the
simple things first.
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14. Design can change the shape of the Realized
Value Curve
Simplicity must be a strength
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15. Disruptive technology has radically changed
the shape of the Price Curve
Cloud computing
and resources
Open source tools
for everything
Consumer
electronics with
open APIs
Result: 100x or
greater capital
efficiency
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16. Conclusions
High Tech can increase Personal Touch
Technology is just a tool, not a transformation
Apply the mental model to choose wisely
We can gain insights and inspiration in how to improve
care and leverage technology from innovative models of
care in highly resource constrained environments.
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