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Disruptive Innovation: Patient Centred Healthcare and the Extinction of Dinoisaurs


Published on

William Pascal
Canadian Medical Association
(Friday, 8.15am, Forum Room)

Published in: Health & Medicine
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Disruptive Innovation: Patient Centred Healthcare and the Extinction of Dinoisaurs

  1. 1. Disruptive Innovation: PatientCentered Healthcare and the Extinction of Dinosaurs William Pascal CTO Canadian Medical Association November 9th, 2012
  2. 2. Tough Road Aheadfor Premiers
  3. 3. Fiscal MeltdownDemographics -Growing costs
  4. 4. Health Care Costs Per Working Age CitizenSource: Statistics Canada and Provincial Budgets & Deloitte report entitled Provinces in Transition
  5. 5. $65.8 billion
  6. 6. Targeted Investment Areas EMR Program296 active and completed projects with an estimated value of $ 3.0 $1.527 billion as at March 31, 2010
  7. 7. Investment Programs 20
  8. 8. Availability of information for authorized users Client Dispensed Demographics Drugs 99.8% 54% Provider Lab Test Demographics 2012 Results 99.9% 71% Clinical Reports Diagnostic or Immunizations Images 83% 99% Telehealth Videoconferencing in 90% of HospitalsNote: Availability does not measure the extent of use by providers, but rather the information and systems that are in place.
  9. 9. The Current Agenda EHR Infostructure $$$ Drug Lab DI Reports Telehealth Info Info & Images The Return on Health Care HIAL Point Of Point Of Service Service EHR Viewer Applications ApplicationsLess than 10% of IT spending is at the point of care
  10. 10. SYZYGY Fiscal Health ICT Awareness Risk Aversion Shared Risks
  11. 11. Health Care TransactionsSource: White, William, Greenberg, New England Journal of Medicine 1961
  12. 12. Who are we innovating our health systems for? Figure 1. Health Care Cost Concentration: Distribution of health expenditure for the Ontario population, by magnitude of expenditure, 2007 Ontario Population Health Expenditure 0% 1% Expenditure 5% Threshold (2007 10% 10% Dollars) 20% 34% 30% $33,335 40% 50% 50% 66% 60% $6,216 79% 70% $3,041 80% 99% 90% $181 100% On average, health care spending is highly concentrated with the top 5% of the population (ranked by cost) accounting for 66% of expenditure
  13. 13. Determinants of Health and TheirContribution to Premature Death Social circumstances 15% Genetic Environmental predisposition exposure 30% 5% Health care 10% Behavioral patterns 40% Adapted from: McGinnis JM, Williams-Russo P, Knickman JR. The case for more active policy attention to health promotion. Health Aff (Millwood) 2002;21(2):78-93.
  14. 14. Source: Morgan Stanley 37
  15. 15. Categories of Use Better healthcare and improved health for Canadians Health System Use Clinical Health Care to the Program System Public Health Research Patient Management ManagementUse of data toUse of data to Use of data to Use of data to Use of data to Use of data to Use of data to Use of data to Use of data for Use of data forprovide direct provide direct improve front- improve front- improve the improve the understand the health research understand the health research care to the care to the line health care line health care effectiveness effectiveness health of the health of the patient patient programs and programs and and efficiency and efficiency public and for public and for services services of the health of the health public health public health care system care system activities activitiesNote: Health information is also used to support other uses of information as permitted by law, such as ensuring food safety and complyingwith regulatory and medical certification requirements. Better Information for Improved Health: A Vision for CanadaNovember 15, 2012 44
  16. 16. Dr. Clayton ChristensenDr. Eric Topol
  17. 17. Discussion