mHealth: Consumerism & Connectivity
Dave Levin, MD
CMIO, Cleveland Clinic
CEO, Tres Rios Group, LLC
Dave@TresRiosGroup.com...
The Perfect Storm
• Value-based Care
• The Rise of Consumerism
• Explosion of Mobile Devices
At The Breaking Point ?
• US spends approximately 2.4
Trillion annually.
• US health care expenditures
expected to account...
Health IT: The Story So Far…
• We have $pent a lot of
money.
• Adoption has increased
substantially for both MD
practices ...
Rx: From Volume to Value
• Volume: Today we get
paid to do stuff. Do more
stuff; get paid more
regardless of results.
• Va...
Volume Based Value Based
Provider Incentive Activity Clinical Results & Cost
Provider Payment Fee for Service Outcomes
Pat...
The Challenge: Living in Two Worlds
Fee for
Service
Pay for
Performance
Bundled
Payments
Full Risk
Models
Less than 11% of...
Delivery of Clinical Services: The Three “P’s”
Personalized (Zoom In)
•Highly customized for each individual
•“Omics”, Rea...
“Every day I work in healthcare and then I go home
and live in the 21st Century.”
- Dave Levin, MD
Keynote Address, Health...
mHealth is the use of mobile and wireless devices to
improve health outcomes, healthcare services and
health research.
- N...
Consumerism & Patient Engagement
Patient or Consumer?
• Transparency
• Transactions
• Trust
Should Patients Contribute
Data to their Record?
• Types of Data
- Demographic/Financial
- Status
- Clinical Outcomes
• Po...
Caregivers Are Consumers Too!
• ~40% of Adults are
Caregivers
• The “Panini
Generation”
• Caregivers affect
patient outcom...
Case Study
A. Don’t forget
your
appointment
on Tuesday
with Dr. Smith
B. Did you have
any side effect
with your
meds
Patie...
Barriers
Privacy & Security
Infrastructure
Shifting Reimbursement Models
Culture
Design
Delivering REAL VALUE
EMR Integrat...
Apps or CrApps ?
 Secure and private
 Interactive
 Intuitive to use
 Portable across platforms
 Integrated into EHR /...
©2014 Tres Rios Group, LLC. All Rights Reserved.
Implementation
• New
• Replacement
• Deeper Clinical Impact
Transformatio...
©2014 Tres Rios Group, LLC. All Rights Reserved.
Implementation
• New
• Replacement
• Deeper Clinical Impact
Transformatio...
Case Study
http://www.healthcare-informatics.com/blogs/david-levin/can-propeller-health-propel-us-future
Discussion
Dave Levin, MD
CMIO, Cleveland Clinic
CEO, Tres Rios Group, LLC
Dave@TresRiosGroup.com
@DaveLevinMD
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Health IT Summit Chicago – 2014 – Keynote presentation “Consumerism and Connectivity” with David Levin, MD, CMIO, Cleveland Clinic Health System

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Health IT Summit Chicago – 2014 – Keynote presentation “Consumerism and Connectivity” with David Levin, MD, CMIO, Cleveland Clinic Health System

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Health IT Summit Chicago – 2014 – Keynote presentation “Consumerism and Connectivity” with David Levin, MD, CMIO, Cleveland Clinic Health System

  1. 1. mHealth: Consumerism & Connectivity Dave Levin, MD CMIO, Cleveland Clinic CEO, Tres Rios Group, LLC Dave@TresRiosGroup.com @DaveLevinMD ©2014 Tres Rios Group. All Rights Reserved.
  2. 2. The Perfect Storm • Value-based Care • The Rise of Consumerism • Explosion of Mobile Devices
  3. 3. At The Breaking Point ? • US spends approximately 2.4 Trillion annually. • US health care expenditures expected to account for 17% of GDP • Expected to increase 2% above economic growth rate • Chronic Disease accounts for 70% of health care costs “Health Spending Projections Through 2019: The recessions impact continues,” Health Affairs. Feb 4, 2010
  4. 4. Health IT: The Story So Far… • We have $pent a lot of money. • Adoption has increased substantially for both MD practices and hospitals. • Mixed results for ROI/VOI • Rising Financial challenges • Increased scrutiny of HIT expenditures • Users and HIT Professionals are frustrated No one is giving us 10’s …
  5. 5. Rx: From Volume to Value • Volume: Today we get paid to do stuff. Do more stuff; get paid more regardless of results. • Value: Tomorrow we will be paid based on the actual results, not for just doing stuff. “If you can’t explain it to your mom and dad, you don’t really understand it.”
  6. 6. Volume Based Value Based Provider Incentive Activity Clinical Results & Cost Provider Payment Fee for Service Outcomes Patient Role Passive ; Dependent Active; Engaged Partnership Care Model Acute; Episodic; Individual Patients. Continuous; Chronic Disease; Prevention; Individuals and Populations Provider Role Silos of individual providers or groups Collaboration; Medical Home; Teams; ACO’s Analytics Retrospective; Fragmented; Administrative Real Time & Predictive; Integrated; Clinical, Operational & Administrative Technology Stand-alone EMR; Enables existing care models (cow paths) EMR-HIE; Enables new care models; Virtual care
  7. 7. The Challenge: Living in Two Worlds Fee for Service Pay for Performance Bundled Payments Full Risk Models Less than 11% of payments to hospitals and providers are Value based. The Catalyst for Payment Reform has set a goal of 20% of payments to be value based by 2020 Source: Catalyst for Payment Reform
  8. 8. Delivery of Clinical Services: The Three “P’s” Personalized (Zoom In) •Highly customized for each individual •“Omics”, Real Time Info, Individual Needs & Tastes Population-based (Zoom Out) •Systems designed to care for large groups of similar patients Pervasive (Zoom Everywhere) •Ubiquitous; Everything connected
  9. 9. “Every day I work in healthcare and then I go home and live in the 21st Century.” - Dave Levin, MD Keynote Address, Healthbeat 2013 D
  10. 10. mHealth is the use of mobile and wireless devices to improve health outcomes, healthcare services and health research. - National Institutes of Health Consensus Group mHealth: Bringing Healthcare To People www.mhealthbook.info C Global mHealth market estimated value at 6.6 billion in 2013. Expected to reach 20.7 billion by 2018 at a healthy CAGR of 25.5%.
  11. 11. Consumerism & Patient Engagement
  12. 12. Patient or Consumer? • Transparency • Transactions • Trust
  13. 13. Should Patients Contribute Data to their Record? • Types of Data - Demographic/Financial - Status - Clinical Outcomes • Potential Benefits - Engagement - Efficiency - Enhanced research • What’s the down side?
  14. 14. Caregivers Are Consumers Too! • ~40% of Adults are Caregivers • The “Panini Generation” • Caregivers affect patient outcomes. • Patient outcomes affect Caregivers too!
  15. 15. Case Study A. Don’t forget your appointment on Tuesday with Dr. Smith B. Did you have any side effect with your meds Patient’s Daughter Patient Healthcare Professional All sharing the same view! As ExperiencedAs Observed
  16. 16. Barriers Privacy & Security Infrastructure Shifting Reimbursement Models Culture Design Delivering REAL VALUE EMR Integration
  17. 17. Apps or CrApps ?  Secure and private  Interactive  Intuitive to use  Portable across platforms  Integrated into EHR /PHR  Transmit data wirelessly  User perspective  Tested with intended audience  Designed to meet personal need  Designed to become part of ecosystem (like Facebook)
  18. 18. ©2014 Tres Rios Group, LLC. All Rights Reserved. Implementation • New • Replacement • Deeper Clinical Impact Transformation • New Delivery Models • Physical • Virtual • IT Enabled • Analytics • Transactional • Mobile Optimization • Benefits Realization • Planned? • Measured? • User (Dis)satisfaction Skill / Demand Tech IQ Hi Med Low Operations IQ Low Med High Strategic IQ Low Med High Leadership Challenge Low Med High Emotional Intelligence (EQ) Low Med High Overall Benefit (ROI/VOI) Low Med High Frustration Level High Med Low Typical Path Towards HIT Benefits ©2014 Tres Rios Group, LLC. All Rights Reserved.
  19. 19. ©2014 Tres Rios Group, LLC. All Rights Reserved. Implementation • New • Replacement • Deeper Clinical Impact Transformation • New Delivery Models • Physical • Virtual • IT Enabled • Analytics • Transactional • Mobile Optimization • Benefits Realization • Planned? • Measured? • User (Dis)satisfaction Skill / Demand Tech IQ Hi Med Low Operations IQ Low Med High Strategic IQ Low Med High Leadership Challenge Low Med High Emotional Intelligence (EQ) Low Med High Overall Benefit (ROI/VOI) Low Med High Frustration Level High Med Low Typical Path Towards HIT Benefits ©2014 Tres Rios Group, LLC. All Rights Reserved. Great Technology is Not Enough… We Need Great Leadership!
  20. 20. Case Study http://www.healthcare-informatics.com/blogs/david-levin/can-propeller-health-propel-us-future
  21. 21. Discussion Dave Levin, MD CMIO, Cleveland Clinic CEO, Tres Rios Group, LLC Dave@TresRiosGroup.com @DaveLevinMD

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