The document discusses current and emerging technologies that support patient-centered care, emphasizing the shift from a fee-for-service to value-based reimbursement model. It highlights how technology enables individuals to actively manage their health, fosters partnerships between patients and care teams, and integrates wellness data with healthcare services. The future vision includes improved self-management, fluid data sharing, and a healthcare system that prioritizes informed patient choices and outcomes.

1. Current & Emerging Technologies Supporting
Patient Centered Care
Wednesday, October 22, 2014
Disclaimer: Nothing that we are sharing is intended as legally binding or prescriptive advice. This
presentation is a synthesis of publically available information and best practices.

2. Person Instead of Patient
• Patient centered care can only go so far. We
are now being held responsible for what
patients do when they leave the clinic and
become people again.
• The power of each individual is unleashed to
be active in managing their health and
partnering in their health care, enabled by
information and technology.

3. The New Healthcare
Paradigm

4. ONC’s Core Values
• Individual self determination and the public good are both
optimized.
• People can decide whether and how much to participate in
managing their health and health care.
• People can access wellness and health care services
enabled by technology that reflects their individual needs,
values, and choices.
• Health care is a partnership between the patient, their
caregivers, the care team, and supporting services.
• Information is shared as appropriate, between the
individual and all their care partners to enable informed,
participatory decision making as desired by the individual.

5. Why Do We Care?
• “We will replace once and for all our fee for service
model with provider-led community wide care that
can compete on quality, value over volume.” Hillary
Clinton, HIMSS 2014
• “Transforming health care to slow the growth of
spending requires a radical restructuring of how
health services are paid for. The most powerful way
to reduce costs (and make room to expand coverage)
is to shift away from ‘volume based’ reimbursement
(the more you do, the more money you make) to
‘value-based’ reimbursement.” Newt Gingrich

6. Physicians Are Already Paid
Based On Health of Patients
• In the Value Based Payment Modifier, we are
judged on outcomes not just reporting data.
• These outcomes will be published on the
Physician Compare website and are already
published by some Commercial Payers.

7. LOOK INTO TECHNOLOGY

8. Healthcare Technology
• Dan Holleran: Case Study
– Medtronic Minimed 530G Enlite
– Medtronic CareLink USB
• FollowMyHealth Mobile
• Emerging Technology

9. Healthcare Technology
• Wellpoint already provides seniors with
chronic diseases in-home monitoring
equipment that alert to issues:
– Diabetes – Glucometers
– Hypertension – BP cuffs
– CHF - Scales

10. Patient Portals
• MU2 requirement for interaction with portal
and message to doctor.
• Responsibility is put on the provider for
adoption.

11. Data Aggregators
• HIEs consuming data and bringing them to
payers and ACOs to identify trends.
• MU2 requirement for creating and sending a
CDA for transitions of care.
• MU2 requirement to codify chart with
SNOMED.

12. Wellness Technology
• Fitbit, Nike Fuelband, etc
• Calorie Counters
• MyFitnessPal

13. Nutritional Literacy
• Calorie counts on menus.
• Healthy options at chain restaurants.
• Smoking bans.

14. REMAINING HURDLES

15. Separation Between
Healthcare and Wellness
• Healthcare
– Healthcare technology
– Patient portals
– Data aggregators to pull together micro and macro
patient trends
• Wellness
– Wellness technology
– Nutritional literacy

16. Data Aggregation
• Integrating HIE and wellness data into clinical
visit.

17. Pay for Value
• Reimbursement model to support care
coordination and reduced visits.

18. Closest Solution: Apple
Health
• Despite current challenges, Apple Health is a
strong push into bringing health and wellness
data into clinic and engaging with patients
when they become people.
• Uptake and efficacy remain to be seen.

19. A CASE STUDY: “SAVANNAH
INNOVATION CENTER”

22. Health Crisis in Savannah

23. Our Model Starts With a Patient
Centered Medical Home

24. …Includes the Four Components of
Wellness…

25. …And Expands to Accountable Care

26. Funding Models
• Shared cost savings
• Subscription
– Employer covered
– Shared between employer and employees
• Plan Covered (In Discussions)

27. The Underpinnings
• NextGen EHR for clinic EHR
• Netpulse for wellness integration
• Mirth to compile claim, clinical, and wellness
data into actionable care management

28. 2020: WHERE WE WILL BE

29. Where ONC Wants Us to Be
• Self management and prevention – Persons
are educated and make informed choices.
• Interactions – Healthcare data flows fluidly to
persons and vice versa.
• Shared management – Providers are
responsible for persons actions outside visit.
• Cross-cutting – Breaking down the barrier
between health and wellness.

30. The Rest of The Story
• Apple Health will make wellness fashionable.
• The reimbursement model to support the
personal technology and fewer visits will come
from payers and employers.
• Fee for service will be increasingly replaced by
pay for value.
• Physicians who don’t make change will be see
lower reimbursement or be removed from
networks.

31. QUESTIONS?

32. For More Information:
• Ben Quirk
• Quirk Healthcare Solutions
• info@quirkhealthcare.com