university of-utah-health-care-3-revolutions-slides

the three healthcare

olutionsre

PUBLIC IMPERATIVE PRIVATE IMPERATIVE

• Affordable Care Act • Alternative Payment Models• Provider Payment Reform

• Move to defined contribution• High deductible health plans• Consumerism

Employers and EmployeesFacing Escalating Costs

Government FiscalChallenges

Two separate but related imperatives are Driving Change

BPCI IPPS

OQR

HCAHPSMU H-IT

PROs

PSIsVBPPPACAPSN HAC

CGCAHPsMIPS

P4P

ACOs

MOC PQRS

Change in Healthcare feels like an OOWAA… (Ocean of Words, Abbreviations & Acronyms)

Value, Defined By The Patient…

88% of Spending

30% is Waste

High-Value Outcomes

Value in Healthcare Population Health

Healthcare Revolutions…BIG IDEA: A VISION FOR REAL CHANGE

From volume to value…BIG IDEA: Patient level MEASUREMENT

Manage What You Measure…

V =Q + S$VALUE

QUALITY SERVICE

COST

2014 TODAY

Hospital Quality

Clinical Condition Quality

Hospital Quality + Service

Hospital Value

Clinical ConditionValue

Individual Patient

Value

2005 2010 2020+

PhysicianValue

Unit of Measurement Matters…

From episode to population…BIG IDEA: Longitudinal Care TEAMS

Med-ical Care Genes

Health Behav-

iors

Social/Soci-etal

Population Health Influences…

ACUITY/COMPLEXITY & COST PER UNIT SERVICE

Patient/Family/Society

Healthcare DeliveryINFL

UENC

ERS

OF

OUTC

OMES

100

0

Reorganizing to Advance Health…

INPATIENTCENTRIC

Acute Care Model

AMBULATORYCENTRIC

Chronic Care Model

MOBILECENTRIC

Wellness & Patient Activation Model

LOW HIGH

Requires new ways to organize TEAMS…

Team of Teams: new rules of engagement for a complex worldStanley A. McChrystal, Tantum Collins, David Silverman, Chris Fussell.New York, New York: Portfolio/Penguin 2015

TRAVEL BANKING HEALTHCARE

From Patient to Person…BIG IDEA: Power shift to the CONSUMER

86%OF PATIENTS CONDUCT

HEALTH-RELATED SEARCH BEFORE SCHEDULING

AN APPOINTMENT.1

33%OF AMERICANS USESOCIAL MEDIA TO RESEARCH HEALTH CONDITIONS.1

MORE THAN

41%SAY SOCIAL MEDIA IMPACTS THEIR CHOICE OFHEALTHCARE PROVIDERS.1

Patients are increasingly…EDUCATED & INFORMED BEFORESEEING A DOCTOR

1. Medcitynews/com/2014/03/healthcare-are-dr-google-2014-digital-patient-journeySource: http://www.cdwcommunit.com/perspectives/expert-perspectives/todays-digital-patient/

Patients are increasingly…EMBRACING MOBILE HEALTH

1. Mdlive.com/new/press_05142014b.html2. Alegohealth.com/mhealthh-stats-mobile-apps-devices-solutions/3. Blog.ecgmc.com/2014/04/02/promoting –engagement-through-patient-ortal-

adoption/Source: http://www.cdwcommunit.com/perspectives/expert-perspectives/todays-digital-patient/

82%AMERICANS AGES 18-34 WHO HAVE A DOCTOR PREFER CONSULTATION VIA MOBILE DEVICE.1

52%COMFORTABLE

WITH VIDEOCONSULTS.2

84%OF PATIENTS BELIEVETHEY SHOULD HAVE

FULL ACCESS TO THEIR MEDICAL RECORDS

ONLINE.3

Patients are increasingly…STAYING CONNECTED POST-VISIT

1. Medcitynews/com/2014/03/healthcare-are-dr-google-2014-digital-patient-journey2. Dicomgrid.com/patient-portal-adoption 3. Alegohealth.com/mhealth-stats-mobile-apps-devices-solutions/ Source: http://www.cdwcommunit.com/perspectives/expert-

perspectives/todays-digital-patient/

88%OF PHYSICIANS

WANT PATIENTS TO MONITOR THEIR

HEALTH ATHOME.1

HAVE USED A PORTALTO CONNECT WITHDOCTORS.2

1 OF 3

FIND PORTALS ACONVENIENT WAYTO COMMUNICATEWITH DOCTORS.3

70%

COMPLICATED COMPLEX

McChrystal et al. Team of Teams 2015.

3 Interrelated Healthcare Revolutions…BIG IDEA: From Complicated to COMPLEX

Lessons from the US Armed Forces:

A UVCCOMPLEXITY VOLATILITY

AMBIGUITY UNCERTAINTY

HOW

WEL

L CA

N YO

U PR

EDIC

T TH

E RE

SULT

S OF

YOU

R AC

TION

S?

HOW MUCH DO YOU KNOW ABOUT THE SITUATION?

+

+-

-

Bennett & Lemoine. HBR Jan-Feb 2014.

CLARITY VISION

AGILITY UNDERSTAND

The nature, speed, volume, magnitude

and dynamics of change.

The lack of predictability of issues

and events.

Confounding issues that disrupt

predictability of outcomes.

The mixed meaning of changing conditions.