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Philips - Disruptive Change: How to save the healthcare system
The document discusses strategies for transforming healthcare delivery through population health management, care coordination, and virtual care technologies. It provides examples of how partnerships between healthcare organizations and technology companies have implemented programs utilizing telehealth, remote patient monitoring, and digital platforms to improve outcomes, lower costs, and enable aging in place. Case studies demonstrate how these approaches have reduced hospital admissions and lengths of stay, ICU transfers, mortality rates, and costs while improving quality of life.
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Philips - Disruptive Change: How to save the healthcare system
- 1. Hospital of Tomorrow Disruptive Change: How to Save the Healthcare System October 2014
- 2. Hospital of Tomorrow Align, Engage, Integrate, Enable and Partner Across the Health Continuum Amy Andersen Healthcare Transformation Services October 2014
- 3. Philips Population HealthManagement Prevention Diagnosis Treatment Recovery Wellness Population Health
- 4. Focusing on humanand cultural elements for better alignment, communication and collaboration. Align Driving patient activation and shared decision-making for better outcomes at lower cost. Engage Building highly coordinated multi-disciplinary teams for patient-centered care across the health continuum. Integrate
- 5. Align: Transforming toPeople-Centered Neonatal Care Philips Wee Care®: Creating developmentally supportive care environments Altimier LB, Tedeschi L., Developmental care: changing the NICU physically and behaviorally to promote patient outcomes and contain costs, Neonatal Intensive Care Vol .17 No. 2 Our approach • Engage staff in redesign of environmental and clinical practices • Educate multidisciplinary team to deliver the best evidence-based care • Coach staff to encourage/support family participation in baby’s care • Implement and monitor core measures for sustained performance People-focused outcomes • ↑ parent satisfaction • ↓staff turnover from 15% to 2% • Improved compliance to outcomes-driven practices – Sound levels reduced from 95 to 55 dB – Light levels reduced from 150 to 50 FC • ↓LOS from 22 to 32%* * LOS dependent on gestational age category
- 6. Engage: Patient ParticipatoryDecision-Making Prostaid®: Shared decision-making program for prostate cancer patients People-focused outcomes • Choice of treatment in the hands of the patient and his family • Closer collaboration between patient and physician • Improved patient’s sense of control and satisfaction with choices The challenge • Give patients clear, personalized information about treatments and side effects • Ensure patient’s pathway choices align with quality of life values • Reduce patient stress and anxiety Our approach • Facilitate shared decisions for patients, family, and physician as part of clinical workflow • Create a clear, simple-to-use, web-based encryption-secured tool • Combine patient’s values, preferences and clinical data with evidence-based medical guidance Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, et al. “Decision aids for people facing health treatment or screening decisions,” Cochrane Database Syst Rev. 2011; (10):CD001431;/www.nashp.org/sites/default/files/shared.decision.making.report.pdf
- 7. Integrate: A holistictransformation of the Stroke Continuum Multidisciplinary, end-to-end care for vulnerable patients People-focused outcomes • Scaled scarce expert resources in a cost effective manner • Exceeded core measures performance exceeding AHA GWTG benchmarks • Enhanced recovery, treatment compliance and healthy lifestyles with end-to-end patient-tailored support The challenge • Improve quality of stroke care and outcomes across care settings • Reduce care fragmentation that drives estimated $95B projected cost (2015) • Support patients in return to a new state of wellness and healthy lifestyles Our approach • Connect pre-hospital providers with experts for rapid assessment/treatment • Connect patients, family and providers to share information through mobile and app-based technologies • Design interactive adaptive healing environments tuned to patient’s needs hospital through rehabilitation Westerberg, H., Jacobaeus, H., Hirivikoski, T., Cleverberger, P., Östensson, M.-L., Bartfai, A., & Klingberg, T. (2007). Computerized working memory training after stroke – A pilot study. Brain Injury, 21 (1), 21-29.; Lisbeth Claesson, Thomas Lindé, Ingmar Skoo, Christian Blomstrand, Cognitive Impairment after Stroke –Impact on Activities of Daily Living and Costs of Care for Elderly People, Cerebrovasc Dis 2005;19:102–109
- 9. Partnering with theHospitals of Tomorrow Sweden 15 years USA 15 years Netherlands 10 years Belfast 15 years KUBIN CLINIC Austria 8 years Types of partnering and innovation Care transformation and care redesign Enterprise quality and care management Consumerism and patient engagement Co-develop and pilot new technologies Collaboration for higher equipment utilization Managed services and business model Shared performance metrics and risk sharing
- 10. Hospital of Tomorrow Jane Lucas, Health Policy Counsel, Office of U.S. Senator John Thune
- 11. Coordinated Telehealth & Care Transformation “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change”. Charles Darwin Brian A. Rosenfeld, MD VP & Chief Medical Officer, Hospital to Home October 2014
- 12. Quality of Life H2H: Higher Quality of Life at Lower Cost Assisted Living $1 $10 $100 $1,000 $10,000 Estimated Cost of Care / Day ACUTE CARE ED/OBS Medical/Surgical Intensive Care Unit RESIDENTIAL CARE Skilled Nursing Facility HOME CARE Independent, Healthy Living Aging in Place Hyper-Chronic Disease Mgmt 12
- 13. $40 – $100k $9 – $30k $2,583 $248 Healthcare Cost Segmentation Segmentation based on healthcare spending Percentage of total expenditure Average expenditure per patient per year 50.6% 23.7% 22.6% 3.1% 5% 6-20% 21-50% 50-100% 13
- 14. Coordinated Telehealth Acrossthe Care Continuum Home Emergent care Home Perpetual chronic care Post discharge care Aging in place Hospital ICU, Med Surg, LTACH, SNF Telehealth Center Digital Health Platform EMR HIE 14
- 15. 15 Virtual CareCenter 15
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- 17. Healthcare Productivity: DoMore With Less Wages for Health CareWorkers 56% $1.45 Trillion Other 44% $1.15 Trillion Intensivist (1) Critical Care Nurses (2-3) Computer Intelligence eICU: 130-150 ICU beds “…Unlike virtually all other sectors of the U.S. economy, health care has experienced no gains over the past 20 years in labor productivity, defined as output per worker.” Kocher, M.D., Nikhil 17 R. Sahni, B.S. NEJM: 365;15, 1370-1373.
- 18. eAcute Care Program • Monitor high acuity patients to prevent avoidable complications – reducing hospital LOS and cost • Use centralized resources to drive best practices (sepsis, falls) • Video-visitation: Increase patient/family satisfaction • Facilitate transitions from hospital to home/SNF Virtual Sepsis Unit 18
- 19. Hospital in Home:Enabling Technology Home Environment • Tele-station in the home feeds patient data real-time • Temperature, heart rate, blood pressure, oxygen saturation • Weight Scale • Point of care testing: – Glucose – WBC • Wound photos 19
- 20. Patient Engagement: OneSize Doesn’t Fit All Driving behavior change and enabling Team Care Phenotype for patients & families Patient Portal – Greater self care Outcome = ET × A(P+F) Their Health Team Their Family The Person Multiple chronic illness Aging in place Wellness 20
- 21. 211 21 IntensiveAmbulatory Care Program
- 22. Fall Prevention andDetection Lifeline AutoAlert & GoSafe Senior Mobility Monitor Focused Rehabilitation 22
- 23. 23 “Vision withoutaction is just imagination”
- 24. Robert Groves, MD,Vice President, Health Management Banner Health
- 25. Banner Health ata Glance • 25 Acute care hospitals • Over 35,000 employees • Over 450 bed tele-ICU • 55 bed Simulation Medical Center • Truven Top 5 large health systems 3/5 yrs • $5 Billion in revenue • Over 1,000 employed physicians 25
- 26. Banner’s 2020 Vision 26 Population Health Management Company Clinical Quality Company Acute Hospital Company “Our Steps to the Future” Industry Leadership 2016-2020 Innovation 2016-2020 Growth 2007-2010 Performance 2003-2006 Turnaround 2000-2002 LEAD IT! CHANGE IT! GROW IT! DO IT! FIX IT!
- 27. Working Harder Isn’tAlways the Answer… 27
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- 29. 1. Identify adversetrends and intervene before they become adverse outcomes 2. Respond quickly to requests for help 3. Monitor and assist with “evidence-based practice” and reliability 4. Measure performance across the system 5. Use data (real time and retrospective) to drive performance improvement Five Areas of Focus… 29
- 30. Longitudinal ICU &Hospital Mortality 30
- 31. eAcute Pilot Results “ Application of the eICU care model to the medical surgical patient population reflects an impact on patient outcomes, throughput and costs…” Baseline eHospital Average LOS 3.96 days 3.30 days Cases / month 307 389 Cost / case $6161 $5166 ICU Admissions from general ward First 24 hours 0.9% 0.8% After 24 hours 1.1% 0.6% Discharge status Death or hospice 2.7% 2.0% Home 84.1% 86.5% Falls per 1000 days 3.3 2.1 31
- 32. Banner iCare AcuteCare ICU 2013 • >20,000 fewer ICU days than predicted • >50,000 fewer Hospital days • >$68,000,000 • >2,000 lives saved (APACHE 0.42) eHx • ICU Transfers dropped from 1.1% to 0.6% • $4.5 M saved 32
- 33. Remote Skilled NursingFacility Care 33 Telehealth Center
- 34. Home: Higher Qualityof Life at Lower Cost Quality of Life Assisted Living $1 $10 $100 $1,000 $10,000 Estimated Cost of Care / Day ACUTE CARE Specialty Clinic Community Hospital Intensive Care Unit RESIDENTIAL CARE Skilled Nursing Facility HOME CARE Independent, Healthy Living Comfortable Setting Chronic Disease Mgmt. Cost Effective 34
- 35. Banner Health NetworkSolution BH 35 Future - Fourth Network
- 36. Integrated Population HealthManagement Health Management Delivery System Care Mgmt/ Corp Svcs Banner Health Network 36
- 37. Enabling Technology IntelligentMonitoring Population Management Continual Surveillance Mobile Care Tools Event Management Web-enabled Remote 2-Way Video with Audio Consult 37
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- 39. Data Overview 55members: 3-month follow-up Months -12/0 -11/1 -10/2 -9/3 -8/4 -7/5 -6/6 -5/7 -4/8 -3/9 -2/10 -1/11 Pre 2443 2941 4601 2488 1965 2704 2547 2278 2200 2675 3009 1627 Post 2395 840 972 729 627 491 0 0 0 0 0 0 39 Banner iCare™ period
- 40. Member Needs AssessmentCenter 360 Omni-Channel Health Management 40
- 41. Population Management &Coordinated Care Center 41 41
- 42. Any Patient, AnyProvider, Any Time 42
- 43. “If you don’tlike change, you will like irrelevance even less.” Eric K. Sinseki, Former U.S. Army General Chief of Staff 43
- 44. Question & AnswerSession Brian A. Rosenfeld, MD
- 45.