Transforming Healthcare Through Connected Health Technology - A Story from the United States

Robert L. Jesse, MD, PhDProfessor, Internal Medicine – Cardiology

Virginia Commonwealth University Health Systemand

Chief, Office of Academic Affiliations

Veterans Health Administration

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Disclosures

Robert L. Jesse, M.D., Ph.D.

Has no financial interest or relationships to disclose

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Healthcare Will TransformMust

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Why Healthcare Must Transform

• Priorities are changing:– People will embrace health as a personal attribute– Cost to the individual will be an important driver– Commoditization will occur at multiple levels– Quality will be a given – Efficiency will be the rule

– Individuals will own and manage all of their data– Trusted health information will be the new currency– Access will be defined through engagement

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Re-Envisioning Healthcare

• Health care becomes personalized according to an individual’s needs and values – “Precision Health”– Still evidence-based care… but individualized for me– Quality for an ‘n of 1’ + safety and prevention of harm

• Control shifts from health systems to the individual – Individuals own the entirety of their health information• That record is agnostic to the source and inclusive of all

data generated by providers and by the individual– Access is defined by whom patients choose to help:• Support health promotion, prevention and well being• Navigate complex healthcare decisions

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• Team-based care - PCMH (VA calls it PACT)– Moving from encounters to sustained relationships

• Transactional coherent health information• Health Management Platforms vs EMRs• Data big and small

• Relationship-based care is Connected health

Innovations Driving Healthcare Change

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Connected Health

Connected Health is about sustaining the relationship between patient and healthcare system beyond the

traditional bricks and mortar walls and thus empowering patients to manage their own health

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VA Connected Health TechnologiesProudly Serving Veterans since 1984

Telehealth Services •Clinical Video Telehealth•Home Telehealth•Store and Forward Telehealth

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My HealtheVet Patient Portal •VA Secure Messaging•VA Blue Button•Veterans Health Library•Rx Refill/TrackingVA Mobile Health

•Patient Mobile Apps•Provider Mobile Apps/ Devices•Annie – Text Messaging

The Phone The Smart Phone The Dumb Phone !

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Telehealth ServicesServices Provided in 2014:2.1 million episodes of care to 717,000 VA patients 45% of these patients live in rural areas– 150,000 patients case-managed by home telehealth – 250,000 patients used clinical video telehealth between

VA clinics– 4,000+ received clinical video telehealth visits directly

into their homes– 380,000 used store and forward telehealth technology– 75,000 implanted devices monitored remotely

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Connected Health Technologies - FY14

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VA App Store http://mobile.va.gov/appstore

VA Mobile: There’s an App for That

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Telehealth Services - Impact

Travel Reduction Savings:Clinical Video Telehealth $34.45 per consultationStore and Forward Telehealth $38.81 per consultation

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Home Telehealth 54% reduction in bed days of care32% reduction in hospital admissions$2,000 savings per annum per patient

Video Tele-Mental Health35% reduction in acute psychiatric bed days of care

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VA TeleMental Health Services FY 2003-2014

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The Health Care Reality

Health care is an information business• It’s increasing - and increasingly complicated• Most of which patients can’t access

…or understand

The current Healthcare industry thrives on information asymmetry

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• Patients engage (us) as partners in their care

– We focus on preventive health – We focus on chronic disease management – We focus on patient outcomes

– They demand convenient, local and timely care– They demand complementary/alternative care – They demand readily available information• including the ability to contribute to that data set

Changing Dynamics of Healthcare

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What Will Healthcare of the Future Be?

Healthcare is an information businessCoherent and transactional - Logistics and scaleData big and small – not just in the EMR

As information asymmetry is reduced then Commoditization accelerates - the role of AI

Managing data and information exchange is the new value proposition in healthcare

Connected Health is the platform for this 16

Better Information

Better Decisions

Better Health

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END

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