IoT, Big Data Healthcare Summit Western Canada - Increased Connectivity: Improving Community Healthcare Provision - Dr. Thom Tyson

www.appletreemedicalgroup.com | www.appletreetoronto.com
Dr. Thom V Tyson
BA (Econ), MD
CEO, Canadian Health
Systems Inc.,
CEO, Appletree Medical
Group
Canadian Health Systems Inc.
provides Electronic Medical
Records to doctors caring for
5.3 Million Canadians
Find us at: www.chsinc.ca
Relevant Experience
-24 Years of Group Practice Management
Experience
-President, Canada’s Largest Medical Group
-18 Years of Designing, Developing, Integrating &
Implementing Health Informatics Systems
-CHS provides the EMR Advantage ® platform to
over 2,500 different MD practices, clinics and
chains.
-Winner of the 2016 National
Microsoft Impact Award for
Innovative Application of Technology

Increased
Connectivity:
Improving Community
Healthcare Provision
Dr. Thom Tyson,
CEO, Canadian Health Systems Inc.
CEO, Appletree Medical Group

Research
Data
Consumer
Health
Data
Treatment
Option &
Evidence
Data
Electronic
Medical &
Health
Records
Pharmacy
Data
Mortality,
Birth &
Other
Registries
Hospital
Visits &
Services
Test
Results,
Lab Vitals,
DI
Genomic
Data
Claims
Databases
Social
Media,
Apps, RDC

Three Lenses
1. Population Health
2. Patient Health
3. Healthcare Community

Population Health
Does Flu Vaccine
Work?
Vaccinated patients
took significantly
fewer sick days
than their
unvaccinated
peers!

0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
0
5
10
15
20
25
30
35
2011 2012 2013 2014
Calendar Year Cross Section Patient Visit Cohort Control PHO Cases
Index year
Growth in lower-risk patients’ rates of STI since
Pap Policy Change

Leveraging Connectivity
Better Patient Care
Affordable Health System
Improved Access
Improved Quality
Lower Costs

Improving Access to Care

Challenging Assumptions

Basic Communication Model

What is it about Health Care that
makes it so Slow And Expensive?

The Media Has Improved
The Processor Has Not.

Barriers to Access:
• Distance
• Time
• Matching Supply to Demand:
– Services Match
– Talent Match
– Cultural Preferences
• Costs
• Language
• Self Interest Groups

Bringing Supply and Demand into
Balance:
How much Efficiency do you need
to Shrink a line-up in Half?
How Much to Shrink it 90%?

Length of Line:
Relationship to Capacity Utilization

Basic Economic Research Reveals:
• Doctors Lose 60%
of their time to non-
clinical activities:
ie. Administration
• Wait Times only spiral
when demand is over
85% of system
capacity.

Adminisitrative solutions
• Division of Labour
– Delegation of simple tasks
• 45 triage scenarios cover 80% of presentations, saving an
average of 6 minutes per visit
– Centralization of Admin tasks
• Call Handling, Scanning, Claims management
– Automation of Logical Repetitive Workflows
• Cut staff expenses from 18% to 10% of productivity
– Load Shifting through Patient Engagement
• Wait Time tools, Patient Portals, Remote Check in
• Remote Data Capture

Connecting Services and
Automating Workflows
• The benefits:
– Lower costs
– Fewer errors
– Faster turnaround
– Less rework
• The challenges:
– Reduced staffing, changed roles
– Increased onus on efficient design
– Your processes become visible, including your errors

Patient Care Transfer Process

Doctors to FTE’s - Before
80 Doctors 12 FTE’s

Doctors to FTE’s - After
175 Doctors 2.5 FTE’s

www.appletreemedicalgroup.com | www.appletreetoronto.comwww.appletreemedicalgroup.com | www.appletreetoronto.com
Improvements
By Connecting Patients
Our experience:
• Dramatic reduction in Line ups
• Timely Care
• Higher patient satisfaction
• Higher physician satisfaction
• Reduced Costs at all levels

Examples of Patient Connectivity
Kiosk
Wait Time Tools
Telemedicine
Remote Data Capture for Pre-Triage
and Preventive Care Activities

Patient Engagement via
Self Registration Kiosks

Patients: Real-Time Wait Time Tools

Patient Engagement Through
Mobile Portal Access

Mobile Apps & Remote Check-In

Remote Date Capture:
On phone, tablet or desktop
eg. Injured Patient
Computer Assisted History
(Any Language)

The Pinnacle of Leveraging
Real-Time Patient-Doctor Connectivity?
• Bidirectional Patient Communications Automated
by Predictive Analytics
– Eg. Strep Throat, scripted automated follow-up
bi-directionally, with audit trail and MD notification
– ANY DATA TRIGGER CAN BE USED:
• Lab Results,
• Rx Patterns,
• Home Diagnostics,
• Preventive Care Demographics
• Patient Request

Targeted
Cancer
Screening
Breast
Cancer
Colon
Cancer
Osteoporosis
STI
Screening
Cervical
Cancer

Real World Outcomes: Ottawa
• Population 950,000
• 10% of Doctors are in our group, but delivering 15-
20% of all community care.
• See a Doctor within 1 hour 7 days a week
• See a Specialist within 2 weeks
• City of Ottawa Sun-setted its physician recruitment
committee in 2013—Projecting MD ‘surplus’ 2017
• No net increase in MD/Population ratio over the
past 20 years.
Better-Quicker-Less Expensive!

IoT, Big Data Healthcare Summit Western Canada - Increased Connectivity: Improving Community Healthcare Provision - Dr. Thom Tyson

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