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Anatomy of a Health System:

St. Joseph Health and The Innovation Institute

Darrin Montalvo
Bill Russell
Larry Stofko
November 7, 2013

1
St. Joseph Health
Indicator

SJH

Net Revenue

$5.3 Billion

FTEs

25,000

Acute
Discharges

165,000

Acute
Hospitals

14

Integrated
Medical
Groups

Nine – 550+
Physicians

Distinct
Communities

10

2
MISSION
To extend the healing ministry of Jesus in the tradition of the Sisters of St. Joseph of Orange by
continually improving the health and quality of life of people in the communities we serve.

VISION
We bring people together to provide compassionate care, promote health improvement
and create healthy communities

VALUES
Dignity

We respect each person as an inherently valuable member of the
human community and as a unique expression of life.

Service

We bring people together who recognize that every interaction is a
unique opportunity to serve one another, the community, and
society.

Excellence

We foster personal and professional development, accountability,
innovation, teamwork and commitment to quality.

Justice

We advocate for systems and structures that are attuned to the
• We will transition our business model to a balance of great
needs of the vulnerable and disadvantaged and that promote a
hospitals and great community care.
sense of community among all persons.
• We will embrace both an illness and a wellness model.
3

3
SJH Vision of U.S. Health Care
• Because health care provides a foundation for human
dignity to flourish, everyone has a right to basic health care

• As part of the common good, health care must take its
limited place among other basic goods that protect dignity
– education, stable economy, environment, jobs, etc.
• Individuals have a duty to promote and protect their
health; society has a duty to provide a sustainable health
care system
• We aspire to a health care system that:
– Is health-promoting and preventive
– Is transparent and accountable in its inevitable
rationing decisions
– Is a genuine system, integrated and coordinated
across our national community
– Allocates its resources across a balanced
continuum of care – prevention, acute, emergency,
end-of-life, mental, long-term care, etc.
– Dedicates health resources to acute care, minimizing
spending on administration
– Is evidence-based

Population Health
Management

– Is financed according to ability to pay
– Keeps inflation at a level that is sustainable
• We commit ourselves, with our communities, to make this
vision of human dignity a reality
4
Planning for the Future
TRANSFORMATIONAL STATEMENTS
While the Mission, Vision and Values are the foundation for SJH’s strategic planning as
well as a guide for all decisions, in 2006, SJH recognized the need to transform our
organization.
• We will transition our business model to a balance of great hospitals and great
community care
• We will embrace both an illness and a wellness model

MISSION OUTCOMES
To align efforts across the organization and measure our success in carrying out our Mission and
achieving our transformation, SJH also introduced three long-term goals in 2006 called
Mission Outcomes.
Sacred Encounters
Perfect Care
Healthiest Communities

Every experience will be experienced as a sacred encounter

All patients will receive perfect care
The communities we serve will be among the healthiest in our nation
5

5
We are in a Transition

Fee-for-service:
Current

Population health:
Future

Care delivery
Care coordination
Care tracking
Patient engagement

Patient engagement
Care tracking
Care coordination
Care delivery

Confidential

6

6
Transformation 2018
MISSION
To extend the healing ministry of
Jesus in the tradition of the
Sisters of St. Joseph of Orange
by continually improving the health
and quality of life of people
in the communities we serve.

VISION
We bring people together to provide
compassionate care, promote health
improvement and create healthy
communities.

VALUES
Dignity
Service
Excellence
Justice

MISSION OUTCOMES
Sacred Encounters
Perfect Care
Healthiest Communities

FY2014-2018 Dimensions of Performance
What are we Designing to Meet Our Mission &
Accomplish our Vision of U.S. Health Care?
From:
• Fragmented,
Siloed Care
• Sickness
• Patients
• Cost vs. Quality

To:
• Integrated delivery system
• Sickness and wellness
• Improving the health of the communities we serve
• Reducing Cost of Care
• Improving the Care Experience

8
FY2014-2018 Strategic Goals
Dimension of
Performance
Population Health
Management
Physician
Partnership

FY2014-2018 Strategic Goal
We embrace population health management and take accountability for our
communities’ health and healing, while promoting wellness and caring for each individual’s
needs.
Our physician relationships are mutually-beneficial partnerships, founded on shared
Mission and Values, as well as aligned goals and incentives, in the management and
promotion of quality health services.

Network of Care

By partnering with others, we provide an integrated, accessible and comprehensive
network of care that benefits the health and well being of those we serve in our regions.

Value

We excel in quality/safety, efficiency and the patient experience, demonstrating what
can be achieved when we focus on stewarding our communities’ health resources.

Engaged People

The community of St. Joseph Health co-ministers are highly engaged and thriving,
integrated with Mission, Values and expectations in the delivery of quality health services.

Information
Sophistication

We apply technology to empower the communities we serve to manage their health and
wellness and SJH to deliver the highest efficiency, reliability and value.

Essentiality

St. Joseph Health will be an indispensable partner to those who use, provide and
purchase health services. We will use our influence to be a voice for the voiceless in
responding to the needs of our communities.

9
FY2014-2018 Measures of Success
• Increase share of communities’ care
• Reduce the prevalence of access difficulties

Increase the primary
care providers
participating in the
management of care
through the health
information exchange

• Improve quality, safety
and patient experience
• Year over year reduction
in the cost of providing
services

• Increase formation
participation
• Maintain top decile
employee engagement

Each region has seamless
partnerships in place for an
integrated, accessible and
comprehensive network

• Provider adoption of physician
portal
• Member/patient adoption of
electronic health record / health
portal

• Improve the health status
of a defined population
• Grow the number of
members in the SJH
10c 10
network
What happens when…
…we can know, quite precisely what people are
eating?

Tellspec is a laser scanner that reads chemical composition of food.
…we can remotely administer therapies?

MIT Thermoelectric Band that raises perceived body temperature remotely.
My Fitness
Pal

…apps and devices band together to create
solutions?

Runtastic products integrate with MyFitnesPal, as do dozens of other apps and
devices.
…tracking just melts into the background?

PerformTek® from Valencell
…mHealth meets the Smart Home?
So what happens?
We don’t know.
We can’t know.
What I eat

What I eliminate

How I feel, emotionally

Where I go

How my heart beats

How I move

My body
temperature
My skin
temperature

How I feel,
physically
How stressed I am

How I sleep

How busy I am

Here’s what we do know.
How fast I move How I exercise

How much I weigh

My altitude

My blood oxygen

Where I live

My friends

My insulin levels

Where I travel

My insurer

How my blood flows

Anything I’ll share
Moore’s Law

Metcalfe’s Law

+
Here’s what we do know.
Integration hassle

Effort required

=

Cost/functionality
Data quality
Wearability
Cultural acceptance
time
It’s not in our control.
So we have to be great at listening for, looking
at, learning from and linking to the innovation of
others.
And we need a system to organize what we
learn.
A Platform for Innovation

25
SJH Portal Principles for Innovation
iHT2 Health IT Summit
Anatomy of a Health System –
St. Joseph Health & The Innovation Institute
Larry Stofko
EVP, Innovation Lab
November 7, 2013
© 2013 The Innovation Institute
Innovation Institute’s Goals
The Institute was conceived with two overarching goals: Growth and
Innovation Potential

• Growth
– New Revenue Streams
– Growth through Building Networks of Partnership with Non-Profit Healthcare
and Other Innovators
– “Do More, with Less, for More People”

• Innovation Potential
–
–
–
–

Advance Innovation Design
Transform the Traditional Healthcare Model
Harness Synergies with Industry Participants
Unleash the Creativity of Investor’s Employees, Physicians and Partners

28
Business Model

29
Innovation Lab

30
Innovation Lab
•
•
•
•

Collector of Ideas
Idea Developer
Technology Accelerator
Showcase Destination

31
Participation Opportunities

Challenges

Specific
Inventor
Ideas

Disclosure

Individual

Team

Evaluation

Participate
with
Partners

Partner
Originates
Idea

Provider
Originates
Idea

Monetization

32
Enterprise Development Group

33
EDG Value Proposition
1

Guaranteed cost savings

2

Conversion of cost center to revenue center

3

Profit sharing interests and capital appreciation

4

Faster decision-making process and execution

5

Capital funding source for new projects

6

Capitalize as investment vs. expense line item

7

Access to debt capital as for-profit company

8

Ability to share “Best Practices”
34
Innovation Fund

35
Investment Lifecycle
Lab
SEED

Fund
EARLY

MID/
EXPANSION

LATE/
MEZZANINE

EXIT

REVENUES

Mezzanine
Breakeven Point

Debt Investments

Venture
Angel
TIME

36
The Spread of Innovation
Collaborate with
like minded
organizations.

Community

Create a “culture
of innovation”
for members.

Collaboration
Culture
Have broad
reaching impact
on communities.

Individual

Recognize and
reward the
individual.

37
Questions

38

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iHT² Health IT Summit Beverly Hills – Anatomy of a Health System – St. Joseph Health and The Innovation Institute

  • 1. Anatomy of a Health System: St. Joseph Health and The Innovation Institute Darrin Montalvo Bill Russell Larry Stofko November 7, 2013 1
  • 2. St. Joseph Health Indicator SJH Net Revenue $5.3 Billion FTEs 25,000 Acute Discharges 165,000 Acute Hospitals 14 Integrated Medical Groups Nine – 550+ Physicians Distinct Communities 10 2
  • 3. MISSION To extend the healing ministry of Jesus in the tradition of the Sisters of St. Joseph of Orange by continually improving the health and quality of life of people in the communities we serve. VISION We bring people together to provide compassionate care, promote health improvement and create healthy communities VALUES Dignity We respect each person as an inherently valuable member of the human community and as a unique expression of life. Service We bring people together who recognize that every interaction is a unique opportunity to serve one another, the community, and society. Excellence We foster personal and professional development, accountability, innovation, teamwork and commitment to quality. Justice We advocate for systems and structures that are attuned to the • We will transition our business model to a balance of great needs of the vulnerable and disadvantaged and that promote a hospitals and great community care. sense of community among all persons. • We will embrace both an illness and a wellness model. 3 3
  • 4. SJH Vision of U.S. Health Care • Because health care provides a foundation for human dignity to flourish, everyone has a right to basic health care • As part of the common good, health care must take its limited place among other basic goods that protect dignity – education, stable economy, environment, jobs, etc. • Individuals have a duty to promote and protect their health; society has a duty to provide a sustainable health care system • We aspire to a health care system that: – Is health-promoting and preventive – Is transparent and accountable in its inevitable rationing decisions – Is a genuine system, integrated and coordinated across our national community – Allocates its resources across a balanced continuum of care – prevention, acute, emergency, end-of-life, mental, long-term care, etc. – Dedicates health resources to acute care, minimizing spending on administration – Is evidence-based Population Health Management – Is financed according to ability to pay – Keeps inflation at a level that is sustainable • We commit ourselves, with our communities, to make this vision of human dignity a reality 4
  • 5. Planning for the Future TRANSFORMATIONAL STATEMENTS While the Mission, Vision and Values are the foundation for SJH’s strategic planning as well as a guide for all decisions, in 2006, SJH recognized the need to transform our organization. • We will transition our business model to a balance of great hospitals and great community care • We will embrace both an illness and a wellness model MISSION OUTCOMES To align efforts across the organization and measure our success in carrying out our Mission and achieving our transformation, SJH also introduced three long-term goals in 2006 called Mission Outcomes. Sacred Encounters Perfect Care Healthiest Communities Every experience will be experienced as a sacred encounter All patients will receive perfect care The communities we serve will be among the healthiest in our nation 5 5
  • 6. We are in a Transition Fee-for-service: Current Population health: Future Care delivery Care coordination Care tracking Patient engagement Patient engagement Care tracking Care coordination Care delivery Confidential 6 6
  • 7. Transformation 2018 MISSION To extend the healing ministry of Jesus in the tradition of the Sisters of St. Joseph of Orange by continually improving the health and quality of life of people in the communities we serve. VISION We bring people together to provide compassionate care, promote health improvement and create healthy communities. VALUES Dignity Service Excellence Justice MISSION OUTCOMES Sacred Encounters Perfect Care Healthiest Communities FY2014-2018 Dimensions of Performance
  • 8. What are we Designing to Meet Our Mission & Accomplish our Vision of U.S. Health Care? From: • Fragmented, Siloed Care • Sickness • Patients • Cost vs. Quality To: • Integrated delivery system • Sickness and wellness • Improving the health of the communities we serve • Reducing Cost of Care • Improving the Care Experience 8
  • 9. FY2014-2018 Strategic Goals Dimension of Performance Population Health Management Physician Partnership FY2014-2018 Strategic Goal We embrace population health management and take accountability for our communities’ health and healing, while promoting wellness and caring for each individual’s needs. Our physician relationships are mutually-beneficial partnerships, founded on shared Mission and Values, as well as aligned goals and incentives, in the management and promotion of quality health services. Network of Care By partnering with others, we provide an integrated, accessible and comprehensive network of care that benefits the health and well being of those we serve in our regions. Value We excel in quality/safety, efficiency and the patient experience, demonstrating what can be achieved when we focus on stewarding our communities’ health resources. Engaged People The community of St. Joseph Health co-ministers are highly engaged and thriving, integrated with Mission, Values and expectations in the delivery of quality health services. Information Sophistication We apply technology to empower the communities we serve to manage their health and wellness and SJH to deliver the highest efficiency, reliability and value. Essentiality St. Joseph Health will be an indispensable partner to those who use, provide and purchase health services. We will use our influence to be a voice for the voiceless in responding to the needs of our communities. 9
  • 10. FY2014-2018 Measures of Success • Increase share of communities’ care • Reduce the prevalence of access difficulties Increase the primary care providers participating in the management of care through the health information exchange • Improve quality, safety and patient experience • Year over year reduction in the cost of providing services • Increase formation participation • Maintain top decile employee engagement Each region has seamless partnerships in place for an integrated, accessible and comprehensive network • Provider adoption of physician portal • Member/patient adoption of electronic health record / health portal • Improve the health status of a defined population • Grow the number of members in the SJH 10c 10 network
  • 12. …we can know, quite precisely what people are eating? Tellspec is a laser scanner that reads chemical composition of food.
  • 13. …we can remotely administer therapies? MIT Thermoelectric Band that raises perceived body temperature remotely.
  • 14. My Fitness Pal …apps and devices band together to create solutions? Runtastic products integrate with MyFitnesPal, as do dozens of other apps and devices.
  • 15. …tracking just melts into the background? PerformTek® from Valencell
  • 16. …mHealth meets the Smart Home?
  • 20. What I eat What I eliminate How I feel, emotionally Where I go How my heart beats How I move My body temperature My skin temperature How I feel, physically How stressed I am How I sleep How busy I am Here’s what we do know. How fast I move How I exercise How much I weigh My altitude My blood oxygen Where I live My friends My insulin levels Where I travel My insurer How my blood flows Anything I’ll share
  • 21. Moore’s Law Metcalfe’s Law + Here’s what we do know. Integration hassle Effort required = Cost/functionality Data quality Wearability Cultural acceptance time
  • 22. It’s not in our control.
  • 23. So we have to be great at listening for, looking at, learning from and linking to the innovation of others.
  • 24. And we need a system to organize what we learn.
  • 25. A Platform for Innovation 25
  • 26. SJH Portal Principles for Innovation
  • 27. iHT2 Health IT Summit Anatomy of a Health System – St. Joseph Health & The Innovation Institute Larry Stofko EVP, Innovation Lab November 7, 2013 © 2013 The Innovation Institute
  • 28. Innovation Institute’s Goals The Institute was conceived with two overarching goals: Growth and Innovation Potential • Growth – New Revenue Streams – Growth through Building Networks of Partnership with Non-Profit Healthcare and Other Innovators – “Do More, with Less, for More People” • Innovation Potential – – – – Advance Innovation Design Transform the Traditional Healthcare Model Harness Synergies with Industry Participants Unleash the Creativity of Investor’s Employees, Physicians and Partners 28
  • 31. Innovation Lab • • • • Collector of Ideas Idea Developer Technology Accelerator Showcase Destination 31
  • 34. EDG Value Proposition 1 Guaranteed cost savings 2 Conversion of cost center to revenue center 3 Profit sharing interests and capital appreciation 4 Faster decision-making process and execution 5 Capital funding source for new projects 6 Capitalize as investment vs. expense line item 7 Access to debt capital as for-profit company 8 Ability to share “Best Practices” 34
  • 37. The Spread of Innovation Collaborate with like minded organizations. Community Create a “culture of innovation” for members. Collaboration Culture Have broad reaching impact on communities. Individual Recognize and reward the individual. 37