Brought to you by
How to Provide High Quality, Low
Cost Healthcare
Best Practices And Technologies For Patients,
Businesse...
Thank You to Our Sponsor
About the Moderator
Brian McGowan, Ph.D., Moderator, @BrianSMcGowan
Brian S. McGowan, PhD is your host for this series. Dr...
About The Panel
Jason Hwang, M.D., M.B.A., @drjhwang
Jason Hwang, M.D., M.B.A. is an internal medicine physician who, toge...
Brought to you by
How to Provide High Quality, Low Cost
Healthcare
Best Practices And Technologies For Patients, Businesse...
How to Participate
• Submit your questions in the GoToWebinar presentation
window
• Follow along and share your thoughts o...
International Consortium for
Health Outcomes Measurement
Boston, October 8, 2012
ICHOM Powerpoint Template.pptx8 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All righ...
ICHOM Powerpoint Template.pptx9 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All righ...
ICHOM Powerpoint Template.pptx10 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rig...
ICHOM Powerpoint Template.pptx11 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rig...
ICHOM Powerpoint Template.pptx12 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rig...
The Innovator’s Prescription:
A Disruptive Solution for Health Care
Jason Hwang, M.D., M.B.A.
@drjhwang
jhwang@gmail.com
Performance
Time
Performance that customers
can utilize or absorb
Pace of
Technological
Progress
Sustaining innovations
Di...
“NON-CONSUMERS”
of health care
Specialist Physicians
General Hospitals
Generalist Physicians
Focused, Ambu Facilities
Allied Health Professionals
Conveni...
The Innovator’s Prescription:
A Disruptive Solution for Health Care
Jason Hwang, M.D., M.B.A.
@drjhwang
jhwang@gmail.com
“If you think about how healthcare is delivered, it’s on an ad hoc basis.
Someone comes into a hospital, someone comes int...
Patient Room 2020
• Serves ~ 55,000 Native American Indians
~10,000 in 55 remote villages
~1,400 Employees
• Patient care is integrated (inp...
• 40% Reduction in ER
• 50% Decrease in specialty care
• 20% Decrease in primary care visits
• 35% Decrease in hospital ad...
• 45% Funded by Indian Health Services
• 50% “Aggressive” billing of 3rd
party payers
• 5% From Foundation/Grant money
The...
About The Panel
Jason Hwang, M.D., M.B.A., @drjhwang
Jason Hwang, M.D., M.B.A. is an internal medicine physician who, toge...
How to Participate
• Submit your questions in the GoToWebinar presentation
window
• Follow along and share your thoughts o...
Thank You to Our Sponsor
Thanks for Joining Us
• This webinar will be available on-demand at
www.HealthWorksCollective.com.
• Stop by to learn more...
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
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Webinar Replay: How To Provide High Quality, Low Cost Healthcare

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  • What would I care about as a prostate cancer patient? I care about how the disease and its treatment affects how I live my life. I care about whether I will continent after my treatment? Will I have to wear pads for the rest of my life? Will I be impotent? Will I lose any chance of future intimacy? Will I be depressed or anxious for fear of recurrence? This German health plan had the right thinking to ask their patients these quesitons too. And what they found was shocking…
  • On the most obvious outcome, survival, there was virtually no difference across centers. Nearly all patients were still alive at 5 years. Now I’m not a medical doctor, but I’m told the reason for this is that prostate cancer itself is slowly progressing disease, and the survival rate even without treatment is quite long So you might say here, this is not impressive. There is very little difference across providers But survival is only one result that matters to patients
  • Building the weapon of mouse destruction
  • Webinar Replay: How To Provide High Quality, Low Cost Healthcare

    1. 1. Brought to you by How to Provide High Quality, Low Cost Healthcare Best Practices And Technologies For Patients, Businesses and Doctors
    2. 2. Thank You to Our Sponsor
    3. 3. About the Moderator Brian McGowan, Ph.D., Moderator, @BrianSMcGowan Brian S. McGowan, PhD is your host for this series. Dr McGowan is the Co-Founder and Chief Learning Officer at ArcheMedX a healthcare informatics and e-learning technology company. He is the author of '#socialQI: Simple Solutions for Improving Your Healthcare'. He has lectured both nationally and internationally on the need to drive innovation in healthcare. He is currently consulting with start-up companies, medical societies, patient advocacy groups, and academic medical centers committed to accelerate quality improvement through innovative technology and frictionless information flow.
    4. 4. About The Panel Jason Hwang, M.D., M.B.A., @drjhwang Jason Hwang, M.D., M.B.A. is an internal medicine physician who, together with Professor Clayton M. Christensen of Harvard Business School and the late Jerome H. Grossman of Harvard Kennedy School of Government, co-authored The Innovator's Prescription: A Disruptive Solution for Health Care (McGraw-Hill, January 2009), the American College of Healthcare Executives 2010 Book of the Year and recipient of the 2011 Health Service Journal Circle Prize for Inspiring Innovation. Dr. Hwang previously co-founded and was the Executive Director of Healthcare at Innosight Institute, a non-profit social innovation think tank. Jens Deerberg-Wittram, MD, President, International Consortium for Health Outcomes Measurement, @ICHOM_Org Trained as a physician and molecular oncologist, Jens served from 2004 to 2012 as Chief Executive for a German 15 hospital, 4.800 beds provider organization. He has developed and implemented valuebased corporate strategy and established a worldwide leading medical outcomes measurement and reporting system. Prior to working in hospital management, Jens was a project leader for BCG. He is a Senior Fellow and Faculty Member of the Harvard Business School and lecturer in executive courses about value-based healthcare delivery. Dan Munro, Contributor, Forbes, @danmunro Dan Munro is a Contributor at Forbes where he writes on the intersection of Healthcare IT, Innovation and Policy. His focus is broadly around those challenges, opportunities and solutions that are fundamentally geared to scale – and have the capacity to influence our $3.5 trillion healthcare system in significant ways. (http://onforb.es/danmunro and @danmunro). Dan graduated from the International School of Brussels before completing undergraduate degrees in Computer Science and Communications (with a minor in Journalism) at the University of Redlands.
    5. 5. Brought to you by How to Provide High Quality, Low Cost Healthcare Best Practices And Technologies For Patients, Businesses and Doctors
    6. 6. How to Participate • Submit your questions in the GoToWebinar presentation window • Follow along and share your thoughts on Twitter at #HWClive • This webinar will be recorded and available for download a few days after the webinar
    7. 7. International Consortium for Health Outcomes Measurement Boston, October 8, 2012
    8. 8. ICHOM Powerpoint Template.pptx8 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved Localized prostate cancer – what is the right therapy?
    9. 9. ICHOM Powerpoint Template.pptx9 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved Little variation in disease-specific survival rates for localized prostate cancer Death probably or definitely due to prostate cancer or prostate cancer treatment Radical Prostatectomy: 12,4% Watchful waiting: 16,9% Source: Wilt et al., N Engl J Med 367;3 2012
    10. 10. ICHOM Powerpoint Template.pptx10 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved Processes Patient experience/ engagement Indicators Patient initial conditions (Health) outcomes Structure e.g., Staff certification, facilities standards PSA Gleason Score Surgical margin (…) Protocols/ guidelines Survival Continence Erectile function Anxiety Outcomes are the 'real world' experience of patients Example prostate cancer Source: Porter, M. What is value in health care? Dec, 2010. NEJM.
    11. 11. ICHOM Powerpoint Template.pptx11 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved Huge differences in functional outcomes after radical prostatectomy between average and best hospital Urinary incontinence Erectile dysfunction 20 15 10 5 0 6.3% Best hospita l 4.5% Average hospital 17.1% Prevalence, % -74% Active surveillanc e 100 80 60 40 20 0 Prevalence, % -24% Active surveillanc e 44.1% Best hospital 61.5% Averag e hospital 81.1% Source: Wilt et al., N Engl J Med 367;3 2012, Quality report Martini Klinik
    12. 12. ICHOM Powerpoint Template.pptx12 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved ICHOMWorking Group Goal: Define a minimum standard set of outcomes we recommend all providers track Physician leaders Patient representatives Tier 1 Tier 2 Tier 3 Prostate Cancer: ICHOM Minimum Standard Set Outcomes Measures
    13. 13. The Innovator’s Prescription: A Disruptive Solution for Health Care Jason Hwang, M.D., M.B.A. @drjhwang jhwang@gmail.com
    14. 14. Performance Time Performance that customers can utilize or absorb Pace of Technological Progress Sustaining innovations Disruptive innovations Disruptive innovations democratize industries through simplicity, affordability and convenient accessibility
    15. 15. “NON-CONSUMERS” of health care
    16. 16. Specialist Physicians General Hospitals Generalist Physicians Focused, Ambu Facilities Allied Health Professionals Convenient kiosks High Low Complexityof diagnosisandtreatment Time High Low Patients Home, mHealth Disruptive innovation in health care encourages new avenues of care delivery with new caregivers
    17. 17. The Innovator’s Prescription: A Disruptive Solution for Health Care Jason Hwang, M.D., M.B.A. @drjhwang jhwang@gmail.com
    18. 18. “If you think about how healthcare is delivered, it’s on an ad hoc basis. Someone comes into a hospital, someone comes into a pharmacy, someone comes into a doctor. But beyond those touchpoints, the patients are on their own. There’s no real continuity of care.” Christopher A. Viehbacher CEO Sanofi Forum On Healthcare Innovation More than 50 percent (of our MinuteClinic patients) are effectively medically homeless. Patients at MinuteClinic did as well or better than those treated in traditional primary care settings, yet cost was 40 to 80 percent lower than in other settings.  Andrew J. Sussman, MD President, MinuteClinic & SVP/CMO, CVS Caremark
    19. 19. Patient Room 2020
    20. 20. • Serves ~ 55,000 Native American Indians ~10,000 in 55 remote villages ~1,400 Employees • Patient care is integrated (inpatient, outpatient & remote) • Team based care – no hierarchy • Teams comprised of Docs, Nurses, Behaviorists • Patients chose team – and can make changes • Same day access to primary care Nuka Model of Health Care
    21. 21. • 40% Reduction in ER • 50% Decrease in specialty care • 20% Decrease in primary care visits • 35% Decrease in hospital admissions Nuka Model of Health Care
    22. 22. • 45% Funded by Indian Health Services • 50% “Aggressive” billing of 3rd party payers • 5% From Foundation/Grant money The system we have is performing as designed. Designing a new system is the science of process improvement – not the science of economics. Don Berwick Nuka Model of Health Care
    23. 23. About The Panel Jason Hwang, M.D., M.B.A., @drjhwang Jason Hwang, M.D., M.B.A. is an internal medicine physician who, together with Professor Clayton M. Christensen of Harvard Business School and the late Jerome H. Grossman of Harvard Kennedy School of Government, co-authored The Innovator's Prescription: A Disruptive Solution for Health Care (McGraw-Hill, January 2009), the American College of Healthcare Executives 2010 Book of the Year and recipient of the 2011 Health Service Journal Circle Prize for Inspiring Innovation. Dr. Hwang previously co-founded and was the Executive Director of Healthcare at Innosight Institute, a non-profit social innovation think tank. Jens Deerberg-Wittram, MD, President, International Consortium for Health Outcomes Measurement, @ICHOM_Org Trained as a physician and molecular oncologist, Jens served from 2004 to 2012 as Chief Executive for a German 15 hospital, 4.800 beds provider organization. He has developed and implemented valuebased corporate strategy and established a worldwide leading medical outcomes measurement and reporting system. Prior to working in hospital management, Jens was a project leader for BCG. He is a Senior Fellow and Faculty Member of the Harvard Business School and lecturer in executive courses about value-based healthcare delivery. Dan Munro, Contributor, Forbes, @danmunro Dan Munro is a Contributor at Forbes where he writes on the intersection of Healthcare IT, Innovation and Policy. His focus is broadly around those challenges, opportunities and solutions that are fundamentally geared to scale – and have the capacity to influence our $3.5 trillion healthcare system in significant ways. (http://onforb.es/danmunro and @danmunro). Dan graduated from the International School of Brussels before completing undergraduate degrees in Computer Science and Communications (with a minor in Journalism) at the University of Redlands.
    24. 24. How to Participate • Submit your questions in the GoToWebinar presentation window • Follow along and share your thoughts on Twitter at #HWClive • This webinar will be recorded and available for download a few days after the webinar
    25. 25. Thank You to Our Sponsor
    26. 26. Thanks for Joining Us • This webinar will be available on-demand at www.HealthWorksCollective.com. • Stop by to learn more and share your comments.

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