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The Path To The Internet of
Everything
Albert Chan, MD
CMIO, Palo Alto Medical Foundation
Stuart James
COO, Sutter Health Information Services
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Sutter Health System
Serving more than 100 Northern CA communities with:
• 5,000 physicians
• 26 acute care hospitals
• Approximately 48,000 employees
• Home health and hospice services
• Outpatient surgery and specialty care centers
• Medical research and medical education/training
• 24 fundraising organizations
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Sutter Health
5 Medical
Foundations
26 Acute
Care
Hospitals
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Our Mission and Vision
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Living Our Mission
• One of the largest Medi-Cal providers in CA
• One of the largest Medicaid providers in the country
• Commitment of quality and patient safety
– One of only three healthcare organizations in the
U.S.to win the 2013 Baldrige Award
– Recognized for work to combat sepsis and improve
obstetric care
• Launch of Sutter Health Plus
• Investment in next generation patient engagement tools
(e.g. MD Live, My Health Online)
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Strategy…
We are focused on:
• Quality & cost of care for our populations
• New alliances, technologies and care models to advance
our transformational work
• Development of tools, technology and personalized
practices to create an unmatched customer experience
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One Sutter
One team, living the We
Plus You partnership
promise to provide an
exceptional,
compassionate
experience to
everyone we touch.
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Accomplishments
• 2009: Ranked as California’s top health system in heath care
quality by The Lewin Group
• 2012: Leadership Gold Award for MyLifeStages.org by
eHealthcare Strategy & Trends magazine
• 2013: Top 20 health care systems for quality in the U.S. by
• Truven Health Analytics
• 2013: Epic Physician of the Year, David Butler, MD
• 2013 and 2014: Top Rated Physician Groups by Consumer
Reports
– Palo Alto Medical Foundation
– Sutter Gould Medical Foundation
• 2014: Epic Physician of the Year, Albert Chan, MD
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Changing
Competitors
• Consolidation and
expansion
• New providers
• New types of services
Accelerating Pace
of Innovation
• New care models
• Evidence-based medicine
• Better data and analytics
• New technology (social, mobile, virtual)
Changing Patient
Population
• Expanded access
• Different coverage
• More individual responsibility
• New priorities and expectations for care
experience
Changing Payer &
Employer Environment
• Reimbursement pressures
• More risk shifting
• New payer-provider partnerships
• Employer direct contracting
Keeping Pace with New Customers, New
Competitors and New Expectations
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Focus on the market, and enhance our presence
Focus on the future – innovation and growth
Focus on continued operational excellence
Focus on the holistic patient experience
Four Major Themes
Foundational
Functions HR OGC IS S3 Finance
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OneSutter
Emerges:
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Sutter EHR Highlights • Largest single instance Epic
implementation of software
• 23 hospitals live on Sutter
EHR
• Over 55,000 users
• Over 8,000 providers
• Over 3 million active patients
Module
Year Implemented
Number of Users
Ambulatory EHR 1999
My Chart 2001 Over 1 million users – My Health Online
Inpatient EHR 2009 - roll out through 2015
Referring Physician Portal 2011 Over 7000 users, 1400 providers
Sutter Community Connect
2011 Over 1800 users, 400 providers
• Over 10 million patient records
• Over 1 million logins to My Health Online
• 4.3 million data accesses per second
• 5,559,788 inpatient medical orders
• 10,442,953 outpatient medical orders
• 38,533,266 total patient interactions
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13
Summer
2013
Ian on top of
Mt Lassen
One Week
Later
Ian suffers a
cardiac
arrest
Two Weeks
Later
Ian on the
first day of
school
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Dad’s Epiphany
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Intranet of Things
Philips IntelliVue Monitor
Integration
Wireless Alaris Pumps – Integration
Draeger Ventilator – Integration (OR live;
ICU and ED in progress)
Continuous Renal Replacement
Therapy (CRRT) – Non-Integration
eICU Integration
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What About Outside Sutter?
• We don’t capture all patients’ data
– Other hospitals
– Clinics
– Retail
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Health Information Exchange Impact
2011 – 2014
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Interoperability
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Great! Now what about everything else?
• Non “Care Delivery” Settings
• Smart Devices/Home Monitors
– Fitbits/Tracking Devices
– Watches
– Scales
– Phones
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Internet Of Everything?
• IOE = Internet of Everything
• IOT = Internet of Things
• IORT = Internet of RELEVANT Things
– Information provided in context
• Place of need
• Time of need
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Does Every Technology Have a Purpose?
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How does this relate to our health?
Dr. Albert Chan
CMIO, Palo Alto Medical Foundation
Medical Director, My Health Online, Sutter Health
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Before we get to that, what do we
expect as consumers?
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Apple II Plus
Purchased in 1979 for ~USD$2,000
6502 Chip with 8-bit architecture
16 Kilobytes (103) RAM
Floppy Disk Drive (Disk II), 140 kb / disk
iPhone 6+
Purchased in 2014 for USD299
A8 chip with 64-bit architecture
M8 motion coprocessor
16 Gigabytes (109 ) RAM
1080p HD video recording
My First
Computer
My Latest Computer
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How does this relate to our health?
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“Healthcare =
May Be @ Inflection Point
- Mary Meeker”
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My Health Online
91.40%
% Messages Answered Within 1 Business Day
>80% PAMF
• >1,000,000 patients
• 25 million lab results released
• 4 million secure patient messages
• 1 million appointments made online
62.8%
% Enrollment – Sutter Health
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• Triggered by knowledge of the patient
• Automated email reminder that the
patient has an order to complete
• Patient can head straight to the lab
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The-Patient-To-Consumer-Revolution, Oliver Wyman, October 2014
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The Patient Friendly Note
• Office visit notes serve multiple purposes:
– Communication between clinicians
– Documentation of care for payment
– Communication to patients?
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Sutter Health
MPOWER – Breakthrough Consumer Digital Engagement
Y O U R H E A L T H
Context
Matters
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How Works
Plan
Track
PROPRIETARY & CONFIDENTIAL
Create
personalized
shared care plan
Track progress
through ecosystem
of apps and
devices
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Driving outcomes through active personal engagement.
The “Me” in Mpower
“Your program has
positively impacted my
life in ways that you
can't measure.”
“The Mpower program
certainly allows me to
be more effective as a
provider.”
“Using the feedback,
I increased my exercise
and lost 10lbs within 6
weeks. I feel so much
better!”
INDIVIDUAL
ENGAGEMENT
DRIVING SUSTAINED
OUTCOMES
MANAGING
POPULATIONS
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Your itinerary for today
-9:00 Dr. Shafaie
-10:00 MRI Shoulder
-11:00 Dr. Frank Chen
-12:00 Nutritionist
Would you like me to guide
you to Dr. Shafaie’s office? . . .
Don’t forget to get your 10,000
steps in today.
Kelly prepared your healthy
eating plan. Send it to your
local grocery store? Or order a
healthy meal tonight?
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What I hope for from
Internet of Everything
• Analyze the data that is ALREADY around us … that we
don’t pay attention to in a meaningful way today
• Understand all of the factors that influence my health
and well-being
• Make it easier for me to do the right thing
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