health authorities & cost drivers: the vch perspective mary ackenhusen president & ceo...
TRANSCRIPT
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Health Authorities & Cost Drivers:the VCH perspective
Mary Ackenhusen
President & CEO
Vancouver Coastal Health
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The Iron Triangle of Healthcare
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Our Current State
• Growing demand on the system with status quo models of care
• Default into acute and residential care in the face of few viable alternatives
• Uneven resource allocation with over-served and under-served populations
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• Lack of integration between services and providers reinforcing a provider centric approach
• Cost and process pressures from advancements in clinical technology and procedures
• Underinvestment in technology and data analytics
Our Current State
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5
Technology/data investment
VCH
US HealthcareProviders
UniversityHealth Network
UK Healthcare
Calgary Regional Health Authority
Professional Services
US Banking/Financial Services
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$9 billionRegional Health Authorities
$1 billionPharmacare
$2.5 billion Ministry of Health & PHSA
$4 billionMSP/Physicians
Fiscal year 13/14
Provincial health funding
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Corp, Benefits, IT 7.5%
VCH Budget allocation
Acute Care 60.5%
Residential Care 13%
Population Health & Wellness 3%
*2014/15 – 2016/17 Service Plan (includes Providence Health Care)
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OECD Healthcare comparison
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“The way our system is funded – predominantly with block transfers to hospitals and fee for service payments to physicians – encourages volume of procedures and status quo. It does not reward quality of care, or responsible stewardship.
In fact, when an individual or a program goes out on a limb and makes changes to improve efficiency and cost effectiveness, the benefits often accrue to others; perverse incentives are commonplace and counterproductive.”
Andre PicardJuly 28, 2015
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IncrementalChange Transformation
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System Enablers
• Modern and open information management systems
• Good analytics (big data)
• Good supports for clinicians to learn/adapt to new IM systems
• An open mindset to innovation and outside partners
• A skunk works/test bed infrastructure tasked to introduce new technology and ideas.
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Pacific Health Innovation eXchange (PHIX)
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Attributes of innovation?
• Largely funded outside the global health budget
• Can be proven to save money or align with mandated quality improvement goals
• True partnership, often with shared financial risk
• Credible, influential champion
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Funded through philanthropy Reduction of c-difficile was mandated Championed by physician lead for
Infection Control
UV Disinfection
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Funded through philanthropy Majority of costs were paid by Masimo Championed by the Senior Medical
Director
Patient Safety System
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Funded by vendor as a value add innovation fund in provincial contract Proven to save money Partnered to provide resources to develop, implement and evaluate Championed by the Ministry of Health
Home Health Monitoring
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Funded through philanthropy and CESEI Reduces costs Championed by partnership between
clinician & operations lead
Online Therapy
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Remote Cardiac Monitoring
Funded by vendor Reduced cost of patient surveillance Championed by cardiac leadership
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Funded by vendor Reduced costs Shared financial risk Championed by VP and physician partner
Renal Disease Management
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Email: [email protected]
Tel: 604-875-4721
Blog: http://vchblogs.ca/
Podcast: http://vchblogs.ca/tag/podcast/