Rigney DolphinConnected Health & Assisted Living Symposium

‘Positioning within an Eco System’

Conor O’ByrneConnected Health Director

History

Established in 1990 grown to become one of Ireland’s most successful BPOs

BPO service offering includes Customer Service, Telesales, CRM, Back Office Services

Some of our BPO Clients – Vodafone, UPC, 3, Airtricity, PTSB, BMW, Hyundai, CPW,

Meteor, Quinn Direct, NCA, Central Statistics Office

1100 employees across Ireland

Centres in Waterford & Derry

Deloitte best managed company 2009 – 2011

ISO 9001 & 27001 accredited

Rigney Dolphin Overview

Connected Health Journey

Research into emerging opportunities led to Connected Health Division formed in 2009

Employ a team of US and Irish/UK qualified nurses in Waterford

Target customers across the eco system include healthcare providers,

insurers, community groups, individuals and their caregivers

Operating Growing Telehealth & Telecare programmes

Developing Evolving Solutions in Clinical Nurse Triage, Remote Patient

Monitoring & Chronic Disease Support

Also Offer Professional Services (Patient Access & Experience – leveraging BPO Experience)

Part of EI/PA Connected Health Program

Utilising existing state of the art contact centre & IT infrastructure

Part of Enterprise Ireland Connected Health Programme

Extensive knowledge of domestic & international connected health environment

US based (Cleveland Clinic) Business Development Resource

Academic partners (CASALA – Dundalk IT, Waterford IT School of Nursing)

Overview Continued …..

Some Eco System Engagements

Rigney Dolphin’s Connected Health Program Outcomes

Maximizing an individuals chances of living independently Monitoring early indicators of decline Preventing unnecessary admission & readmission to hospital Supporting timely discharge following an acute hospital admission Preventing premature admission to long-term residential care Increasing Patient Satisfaction & Experience Increasing Efficiencies & Generating Savings Help manage ongoing health and wellbeing within the community

and primary health care setting

• Who is going to pay?• Is there enough clinical evidence?• What’s the best business model?• Can and should I take on another pilot or trial?• Who should we partner and collaborate with?• What market/markets should we focus on?• How can there be so many experts?!!!

Everyday Challenges & Observations

Exploring the Telehealth Opportunity

The medical conditions that can be addressed successfully by technology-enabled home care meet three criteria:

• They are chronic — persisting for years rather than days or months.• They can be prevented or addressed by protocols — repeatable and standardized

step-by-step instructions executed by non-physicians.• They are non-intensive — there is no requirement for round-the-clock face to face

human monitoring and presence.

Aim: slow down the gradual decline which pushes individuals further down the care phases

At HomeAssisted

Living Facilities

Acute Care Long Term Care

Feedback from Telehealth deployments suggest a strong desire towards a managed service propositions

· Packages built around clinical services and outcomes, not technology· Packages combine:

• Proven clinical service models• Proven but useable technology • End to end service delivery• Proven Benefits Tracking

“The technology has only been one element. Other factors have also proven to be key, including communications, working together, listening to and consolidating varying requirements, and ensuring consistency of service delivery.”

WSD Programme Manager Tim Ellis

Proven Telehealth packages are multi-faceted and include:

· Evidence base · Referral/eligibility criteria · Referral processes · Installation · Operational structure templates · Alert processes · Education and training

· Removal criteria · Removal processes · Governance and risk arrangement · Evaluation and audit templates and

processes · Cost-effectiveness calculator · Examples of funding arrangements · Technology product specifications

Providing this type of turnkey service requires multiple and diverse capabilities

1. Patient Selection and Recruitment

2. Data Collection and Communication

3. Data Interpretation

4. Service Response

5. Service Management

Select Patients

Deploy Equipment

Engage Service

Collect Transmit Store

Technical Triage

Clinical Triage Alert

Remote Support

Field Support

Urgent Response

Patient Support

Billing + Support

1.

2.

3.

4.

5.

6. Business as Usual Service Governance6.

· Which elements can you deliver currently?· Which elements would it be desirable for

you to deliver in the future?

Telehealth Components – Need for Partnership/Collaboration?

1. Patient Selection and Recruitment

2. Data Collection and Communication

3. Data Interpretation

4. Service Response

5. Service Management

Select Patients

Deploy Equipment

Engage Service

Collect Transmit Store

Technical Triage

Clinical Triage Alert

Remote Support

Field Support

Urgent Response

Patient Support

1.

2.

3.

4.

5.

6. Business as Usual Service Governance6. 6. Business as Usual Service Governance

3. Data Interpretation

4. Service Response

5. Service Management

Technical Triage

Clinical Triage Alert

Remote Support

Urgent Response

PatientSupport Billing +

Support

Benefits Tracking

Rigney Dolphin’s Capability

Eco System Collaboration

Avoid the Pitfalls……

Be careful when choosing partners and ensure organisational alignment and fit

Different capabilities are required in implementation vs. ongoing service delivery

Be mindful of what is required to influence payors, shape the offering and sell the

service

Solutions should fix complex problems but not necessarily be high tech

Engage Clinicians early in the process

Agree a partner framework

Once Partners have been identified it is important to choose the right business model

Financial Factors

Alignment between payers and providers

Remunerative whereby return on investment is clear (seems worthwhile

and value to patients is evident)

Accessibility Factors

Usability for the right users at the right place and time

Repeated Use – frequent use generates good habits among users who

are more likely to use them.

Choosing the right business model;

Effectiveness Factors

Has significant impact to affect the patient’s course of care – more than simply

generating information

Actionable when an intervention is required – procedures or protocols back up

the technology e.g. to alert a nurse

Timely response to be reliable and useful in guiding decisions and initiating

interventions

Closed Feedback Loop which measures progress against goals to measure

effectiveness and improve services

Cleveland Clinic

Rigney Dolphin

Forging Genuine Partnerships with large Healthcare Providers - Cleveland Clinic example

Nurse on Call – Jan 2011

• Cost Savings

• Improved Service Metrics

Post-Discharge Support – Feb 2011

• Reduced Readmissions

• Improved HCAHP Scores

Appointment Outreach - Aug 2010

• Improved Patient Attendance

• New Feedback Channels

Professional Services – Oct 2009

• Standardization & Efficiency

• Technology Utilization

Value Add

Forging Genuine Partnerships with Healthcare Providers

Maximising the Opportunity

• Get right under the skin of how the organisation works

• Find how their staff work (Clinical & Administrative)

• Always ‘Put patients first, not savings first’

• Help Identify what they could be doing differently to provide a better service

• Gain a deep understanding of patient care challenges

• Find out how to release staff from the burden of unnecessary administration

• Deliver the Business Case

• Invest up front

In Summary

• The sector remains a very challenging market place

• New entrants can still enter successfully

• Financial and operational barriers do need to be overcome

• There is a strong desire for turnkey solutions

• There is a healthy Irish eco system

• Partnerships/Collaborations are key

• Large Health Providers are realistic target customers

Thank You

Rigney Dolphin LtdUnit 10/11IDA Industrial EstateCork RoadWaterford

Conor O’Byrne - Connected Health Director

00 353 85 158 323000 353 51 59000conorobyrne@rigneydolphin.ie