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Using information to deliver world-class care at lower cost. Cerner
 

Using information to deliver world-class care at lower cost. Cerner

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III Edició "The British Experience in Technologies for Health". Hospital de Sant Pau, Barcelona. 9 de novembre de 2011. Esdeveniment organitzat per la Fundació TICSalut i el Departament de Comerç i ...

III Edició "The British Experience in Technologies for Health". Hospital de Sant Pau, Barcelona. 9 de novembre de 2011. Esdeveniment organitzat per la Fundació TICSalut i el Departament de Comerç i Inversions del Consolat General Britànic a Barcelona, UK Trade & Investment, per posar en contacte oportunitats i coneixements entre el Regne Unit i Catalunya.

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  • 12-month cumulative cost by Pathway status.
  • JMB comments to RJF: we could remove since we have the picture, but you are right about it not easily changeable given the image and movement, as well as our print timeline…
  • Walking is now added to the patient’s Personal Plan for Health
  • RJF: I added some text and graphics. Please help with slide “clean up”
  • Round edges of pictures

Using information to deliver world-class care at lower cost. Cerner Using information to deliver world-class care at lower cost. Cerner Presentation Transcript

  • “ Using information to deliver world-class care at lower cost”
    • Simon Hill
    • Head of Corporate Affairs, Cerner
  • Biography
    • Currently
    • Head of Corporate Affairs, Cerner
      • Health Policy
      • Government/KOL Engagement
      • Strategy
      • Investor Relations
      • Communications
    • Previously
    • Graduate of the University of Durham & the Royal Military College Sandhurst
    • Army officer
    • Chief of Staff & policy advisor to the then ‘shadow,’ now current UK Health Minister
    • Senior Counsel with a leading UK healthcare consultancy
  • The cost implications of ageing
    • Dutch study
    • A 90 year old consumes 10x as much healthcare as a 50 year old
    • Cost increases over just 4 years is much greater, the older the age group
    • UK Implications
    • Ageing population
    • Very elderly group growing the fastest
    • 75+ costs 5x as much per annum as a 40 year old
  • The cost implications of ageing Fuente: Informe INE ( http://www.ine.es/daco/daco42/sociales/infosoc_envej.pdf )
    • Spain implications
    • Ageing population
    • Severe and moderate physical disabilities appear more frequently in people from 65-79 years-old
    • People from 80 years-old above, are subjected to higher chances of full disability (50 % present with total disability).
    Fuente: EUROSTAT, Base de Datos Newcronos
  • Budget pressures everywhere ... CANADA: From 2012–13 to 2017–18, the Ontario government will attempt to hold health-care spending increases to just 3 per cent per year. Over the last five years, health-care spending has risen by an annual average of 6.5 per cent. (March 2010) German Health Care Spending Cut, Fees Raised (July 2010) DANISH healthcare spending cuts (June 2010) ITALY: EUR24bn Austerity Package Contains Healthcare Spending Cuts (June 2010) SPAIN’s budget for healthcare has been decreased by 2.8 billion euros through a 19 billion dollar austerity plan. (WHO, June 2010)
  • We know there is a great deal of variation 6 fold variance of your chances of surviving an aneurism across London 4 fold variance of your chances of surviving a stroke across London 10 fold variance of your chances of surviving a heart attack across London Despite 15 years of evidence based standardisation there is still wide variation in outcomes across the NHS Data 2005/06
  • Outcome against cost of intensive care No evidence that shows spending more creates better outcomes or spending less creates worse outcomes Data 2005/06
  • Relationship between quality of care and Medicare spending, by US State, 2004 Composite measurement of quality of care 100 = maximum Source: Congressional Budget Office based on data from the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality The evidence does not indicate that higher Medicare spending is associated with better care for Medicare beneficiaries. In fact, it suggests the opposite: After adjusting for other factors, areas with higher Medicare spending tend to score substantially worse on a composite indicator of the quality of care provided to Medicare beneficiaries
  • Cost Effectiveness of Evidence-Based Treatment Guidelines for the Treatment of Non–Small-Cell Lung Cancer in the Community Setting 12-month cumulative cost by Pathway status. Neubauer M A et al. JOP 2010;6:12-18 ©2010 by American Society of Clinical Oncology
  • Reducing cost through the use of evidence “ Finish medical school and residency knowing everything…read and retain 2 articles every single night…at the end of 1 year you’re only 1,225 years behind.” W Stead. JAMIA 2005;12:113-20 Alper BS, Hand JA, Elliott SG, et al. J Med Lib Assoc 2004;92:429-37
  • Slow Innovation Adoption
    • From time new knowledge discovered until ½ of physicians act on that knowledge = 15 - 17 years
    Everett Rogers, Diffusion of Innovations, 1995 % of population time Adoption Half-life = 17y Knowledge Half-life = 10y Balas, Boren. Managing Clinical Knowledge for Health Care Improvement. Yearbook of Medical Informatics 2000
  • How to drive cost reduction Make the institutions more productive Make the system more productive
  • Driving cost reduction by being better
  • Integrating The UK Health System
  • Reducing costs system-wide (Spain)
  • Rural Hospital Clinic Local Hospital Satellite Campus Pharmacy Rehab Surgery Imaging Center Nursing Home Government Physician Office Laboratory Healthcare System/Hospital (main campus) HUB AND SPOKE CONNECTIVITY MODEL
  • eHealth Path
  • Reducing cost through process efficiency Managing discharge to reduce readmissions Managing nurse time effectively Automated infusion management Integrated information availability
  • Readmission Risk Algorithm: Daily assessment
  • Managing LTCs – Individual support with technology
    • Personal Health Record
      • Clinical, financial, self-entry
    • Personal Plan for Health
      • Managing health goals
      • Can tie incentives
    • Managing a family’s whole health
    • Convenient patient services
      • Scheduling
      • Messaging
      • Bill Pay
      • eVisits
    • Community Integration
    • Device integration
  • Engaging the patient in managing their own health
    • Registries
    • Safety reporting
    • Late phase
    Translational Research Cycle Molecular Diagnostics Pharmacogenomic Alerts Integrated Data Capture in EMR Trials
  • Finally – Redesign to improve the service Computerisation of poor process solves nothing