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High Tech and Personal Touch in Chronic Care

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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. 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 1 Lifeways Conference - Steve Brown 10/22/08
  2. 2. Agenda   Background – Health Hero Network   Chronic Care Models   Example from US   Example from Africa   False Dichotomies in Chronic Care   A Better Mental Model 2 Lifeways Conference - Steve Brown 10/22/08
  3. 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 3 Lifeways Conference - Steve Brown 10/22/08
  4. 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 4 Lifeways Conference - Steve Brown 10/22/08
  5. 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 5 Lifeways Conference - Steve Brown 10/22/08
  6. 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. 6 Lifeways Conference - Steve Brown 10/22/08
  7. 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” 7 Lifeways Conference - Steve Brown 10/22/08
  8. 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 8 Lifeways Conference - Steve Brown 10/22/08
  9. 9. False Dichotomies in Chronic Care   High Tech versus Personal Touch   Improving Care versus Saving Money   Information Technology versus Simplicity 9 Lifeways Conference - Steve Brown 10/22/08
  10. 10. False Dichotomy: Tech versus Touch. Explain the growth in social media! Life can be richer when we share more of it. 10 Lifeways Conference - Steve Brown 10/22/08
  11. 11. False Dichotomy: Improving Care versus Saving Money 11 Lifeways Conference - Steve Brown 10/22/08
  12. 12. False Dichotomy: Hi Tech versus Simplicity How About a Better Mental Model! Value Potential Value Cost Opportunity Realized Value Complexity 12 Lifeways Conference - Steve Brown 10/22/08
  13. 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. 13 Lifeways Conference - Steve Brown 10/22/08
  14. 14. Design can change the shape of the Realized Value Curve   Simplicity must be a strength 14 Lifeways Conference - Steve Brown 10/22/08
  15. 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 15 Lifeways Conference - Steve Brown 10/22/08
  16. 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. 16 Lifeways Conference - Steve Brown 10/22/08

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