Presentation deck accompanying my keynote talk at the Great Lakes Health Connect HIE Fall Summit Detroit on August 23, 2016. Content covers the health information exchange landscape and untapped opportunities from the context of Jess Jacobs, a healthcare industry insider and friend who recently died. Full video of the presentation is archived here: https://www.youtube.com/watch?v=5X69nAUF9PI

1. WHAT THE HIE?
#UnicornJess
#GLHCSummit16
Mandi Bishop
@MandiBPro
Unicorn Use Cases and Untapped Market Potential

2. 2
Mandi Bishop on Healthcare
There’s gold in that there claims data:
Blues National Data Warehouse, BHI, IPP
…gemstones in clinical encounters:
Clinically-integrated networks, HIEs
Patients should benefit from the mines.
Society for Participatory Medicine
• “Most Powerful Women in Healthcare IT” in 2016 by Health Data Management
• #1 on 2016 #HIT100 crowdsourced list of top healthcare IT thought leaders
• Rock Health’s “State of Women in Healthcare 2015” report “Role Model”

3. 3
THIS ISN’T THE TALK
I PLANNED TO GIVE.

4. 4
Unicorns I Had
In Mind
• HIE driving
behavior
modification to
$48B opportunity
• HIE as essential
asset in sharing
economy for
payers, providers,
caregivers,
patients

5. 5
INSTEAD, I AM GOING TO TALK ABOUT
HEALTHCARE’S
HUMAN UNICORNS:
THE 1% PATIENTS
WHO DRIVE 20% OF COST.

6. 6
Jess Jacobs,
#UnicornJess
• Twitter:
@jess_jacobs
• Web:
JessJacobs.me
• Died 8/14/16,
Age 29

7. 7
Jess Jacobs,
Healthcare Insider
• Director of
Innovation at Aetna
• Fellow at FDA
• ONC policy analyst
• HRSA’s Text4Baby
• White House
advisor

8. 8
Jess Jacobs,
Chronic Patient
• Elhers-Danlos
(EDS)
• Postural
Orthostatic
Tachycardia (POTS)
• Cyclic Vomiting
Syndrome (CVS)

9. 9
CARING FOR A COMPLEX
PATIENT: #TEAMJESS
Extended
Social
“Watch”
Clinicians +
“First
Responders”

10. 10
#TEAMJESS NEEDED HIE.
HIE FUNDAMENTAL.
VALUE-BASED CARE, BUNDLED PAYMENTS, MACRA, MIPS
START WITH HIE.
HIE DEFINITIONS VARY, BUT SHARE COMMON GOAL:
LONGITUDINAL MEDICAL RECORD, SECURELY SHARED
AND ACCESSED IN TIMELY MANNER.

11. 11
Jess Jacobs on
Basic HIE
• Carried paper
copies of complete
medical record in
binders – when
records provided
• Caregivers carried
paper HIPAA
release forms

12. 12

13. 13
Jess Jacobs on
Personal Health Record
• Social media posts
and cell phone
notes essential
medical records
supplements
• Diligent personal
medication
reconciliation was
life-saving

14. 14
Jess Jacobs on
MU and HIPAA
• Patient portals
meaningless use
across dozens of
doctors and
facilities
• HIPAA excuse
barring HIE
frequently
attempted

15. 15
WHAT IF?
#TEAMJESS COULD ACCESS HIE
#TEAMJESS COULD SHARE RECORDS VIA HIE
#TEAMJESS COULD SEARCH ENCOUNTER DATA TO
INFORM HIE DATA-SHARING

16. 16
Jess Jacobs on
Health Education
• MU EHR-driven
education
materials
insufficient
• Complex disease
and drug
interactions not
explained in a
packet - or by doc

17. 17
Jess Jacobs on
Patient Safety
• Prescription
medication errors
• Unsanitary
conditions and
JCAHO violations
• Unnecessary,
dangerous tests
and procedures

18. 18
Jess Jacobs on
Patient Experience
• LEAN analysis =
98% “waste”
• Negligible care
coordination
• Abuse from staff
• ADA compliance
failures

19. 19
WHAT IF?
HIE DATA ANALYTICS COULD AUGMENT CLINICAL
DECISION SUPPORT AND SUGGEST EDUCATION
HIE DATA COULD INFORM GRAND ROUNDS ACROSS
INSTITUTIONS TO IMPROVE CARE
HIE DATA COULD PROVIDE PATIENTS WITH PERSONAL
“PATIENT SAFETY ORGANIZATION” CAPABILITIES

20. 20
Jess Jacobs on
Authorization
• Rigid auth process
inadequate for
complex patients
• Unconscious
patient cannot
choose ER
• Appeals deadline
inflexible

21. 21
WHAT IF?
HIE DATA COULD BE USED TO DISRUPT AUTHORIZATION
AND CERTIFICATION – SAVING $BBs ANNUALLY
INSURERS COULD USE HIE DATA TO AUTOMATE
REFERRALS, AUTHORIZATIONS, CERTIFICATIONS
…WOULD REQUIRE INSURERS TO ESTABLISH AND SHARE
CLEAR SYSTEM-LEVEL BUSINESS RULES FOR DECISIONS

22. 22
EVEN WITH ALL THE HORRORS
SHE EXPERIENCED, JESS LEFT A
LEGACY OF LOVE AND
HEALTHCARE ADVOCACY.

23. 23
Jess Jacobs on
Advocacy
• Member, The
Walking Gallery of
Healthcare
• Designed “Port
Pegasus” to build
trust for children
• Gave instructions
for improvement

24. 24
HEALTHCARE COULD NOT KEEP JESS ALIVE.
THE UNTAPPED MARKET OPPORTUNITY IS IN
LEARNING FROM HER EXPERIENCES.
IN DEATH, SHE WILL FINALLY BE HEARD.
WE MUST DO BETTER.
FIRST, WE MUST DO.

25. Thank You.
Mandi Bishop
Mandi.Bishop@aloha.me
@MandiBPro