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Strategies for Startups to Partner with Healthcare Systems
A View from Geisinger
Gregory J. Moore, MD, PhD Chief Emerging Technology and Informatics Officer Director, Institute for Advanced Application Twitter: @GJMooreMDPhD
Geisinger Health System coverage area
Revised 7-‐25-‐12. Geisinger PR & Marke7ng Department
Geisinger Health System
• 3.5 million patients in service area • 1,120+ physician FTEs, 700+ advanced practitioners FTEs • 78 community practice sites • 7 hospitals • 480,000+ member health plan • Institute for Advanced Application Center for Reengineering Healthcare
Center for Emerging Tech and Informatics Center for Clinical Innovation
• Center for Health Research
GEISINGER–An Integrated Health Services Organization
Provider Facilities
$2.3B
Physician Practice Group
$1.2B
Managed Care Companies
$2.5B
Geisinger Medical Center & Geisinger Shamokin
Area Community Hospital
Geisinger Wyoming Valley Medical Center
Geisinger Community
Medical Center
Geisinger Bloomsburg Hospital
2 Nursing Homes
4 Surgery Centers
~80K admissions/OBS & SORUs
1,623 licensed beds
Multispecialty group
~1,120 employed physicians
~700 advanced practitioners
78 primary & specialty
clinic sites
~3M clinic outpatient visits
~420 residents & fellows
~490K members (including ~77K
Medicare Advantage members)
~112K Medicaid
Managed Care Projected Membership (GHP
Family)
Diversified products
~39K contracted providers/facilities
43 PA counties
Geisinger Institute for Advanced Application 3 Centers, 9 Labs, Informatics and Technology Trials Office, High Performance Computing Core
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Organized for Synergy: • Predictive Analytics • Human Factors Engineering • Diagnostics
A National Laboratory For Healthcare Transformation ($6B R&D Lab) Leading through continual innovation
• Novel data streams and big data analytics • Re-engineering via IsysE approach • Emerging technology and Informatics • Rapid clinical innovation • Remote assessment/diagnostics/treatment
• Transforming patient care
• Engaging patients
• Improving the healthcare value proposition
Center for Clinical Innovation
Center for Emerging Technology and
Informatics
Center for Re-engineering
Healthcare
Data Generation
Data Aggregation
Performance Measurement
Insight and Action
Clinical Transformation
and Reengineering
Knowledge Generation
• Care by- product
• Transactional
• Required for performance measurement
• Establishes current state
• Deployed as visualization,
alerts and reminders
• Basis for new models of care
delivery
• “What to do in a patient like
mine?”
Natural
Language Processing
Data
Warehousing
Dashboards
Anticipate
and Mitigate
Automation
Machine Learning
Enhancing the Data Value Chain
Six Drivers of High Cost, Poor Quality Care
• Mistakes • Unjustified variation • Fragmented care • Perverse payment incentives • Patient is a passive recipient of healthcare • Supply-demand mismatch
Patient Engagement Objectives
Understand My Health
Manage My Visit
Control My Condition
Patient Engagement
Value of Patient Engagement
Patients engaged in their health tend to have better outcomes and potentially
lower cost (Dentzer, 2013)
• Fairview Health Services study showed patients with a Patient Activation Measure (PAM) of level 1 were 21% more expensive than patients with a level 4 score (Hibbard & Greene, 2013)
• Shared decision making study of 60,000 patients showed patients participating had 5.3% in cost savings, 12.5% less inpatient admissions and 21% fewer heart problems (Veroff & Wennberg, 2013)
Using Technology for Patient Engagement
To activate patients, you have to meet them where they are.
(Hibbard, 2013)
“Only 1% of a person’s life is
spent with healthcare professionals”
(Chase, 2013)
Empowering Patients Through Transparency:
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Perspective The Road toward Fully Transparent Medical Records Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D. December 4, 2013 DOI: 10.1056/NEJMp1310132
Patient Portal Access to Providers’ Progress Notes
>85% of outpatient providers participating
• 90% of patients understand their health and medical conditions better
• 84% of patients take better care of themselves
• 91% of patients feel more in control of their healthcare
Regular Care
100% Care Processes and Protocols (Digital)
Automation Patient Activation
Populations
Workflow Modification
Patients and Conditions
Population Identification
Bundle Development
Delegation and
Algorithms
Low Efficiency and Reliability High
Reengineering and Disruptive Innovation
Healthcare Transformation: Empowering Patients
Potential Opportunities? • Enabling Data Sharing by Patients
• Patients and Caregivers as co-writers/editors of medical notes with healthcare providers
• Transparency in medical costs and outcomes
• Sharing Predictive Analytics with Patients How?
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Health Care Systems
Choose Your Partner Type Based on Needs/Goals
• Traditional Academic
• Hybrid Integrated-Clinic Model
• Provider Only Systems
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Know your Health System Partner
• Be aware of your healthcare system partner’s capital and budget cycles
• Be aware of your partner healthcare system’s pain points
• Be able to clearly articulate in a prioritized list what specific types of value you seek from your healthcare system partner including “must haves” and “nice to have”
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First Steps
• Getting the Opportunity-Contacts
• Getting the right people on the call/in the room
• Be Prepared-Anticipate Questions/Needs
• Be Respectful of Time
• Prompt/Relevant Follow-up
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The Perfect Pitch
• Clear and compelling vision
• Convey your team’s ability to deliver
• Highly relevant management team
• Strong/credible market opportunity (size and growth)
• Product Differentiation-better mouse trap or disruptive
• The Solution-solve real pain point/must have
• Financials-credible, clear, open, defensible
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Terms of Partnership - Part 1 of 2
Be clear on what value you are willing to bring to the table at time of first discussion:
• Cash • Non-Cash Equity Exchange • Technology • Services • Preferred Licensing • Future Royalties • Other?
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Terms of Partnership - Part 2 of 2
Be clear on your ask of the Healthcare System partner at time of first discussion:
• Determining the Value Proposition of the Intervention • Demonstrating Utility in a segment test-bed or “safe sandbox” • Utilizing Healthcare System Brand/Endorsement • Providing/Defining Market Opportunity (through Healthcare System
Dissemination Partnerships) • Co-Development & Integration assistance (EHRs etc) • Clinical Trial for regulatory clearance (FDA) • Demonstration Site • Future Customer relationship • Cash Investment • Other?
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Questions? Strategies for Startups to Partner with Healthcare Systems
Gregory J. Moore, MD, PhD Chief Emerging Technology and Informatics Officer Director, Institute for Advanced Application Twitter: @GJMooreMDPhD