Transcript PowerPoint - Healthcare Experience Design Conference

Life Planning /CHCF
Philip Lisagor, MD, FACS
 www.TheROYL.com
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Where Are We?
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10,000 Americans turn 65 every day and this
will continue until 2031
This encompasses 78 million Americans born
between 1946 and 1964/ aka Baby Boomers
Baby Boomers are currently taking care of their
parents and often of their children in today’s
economy
One in 5 Americans have advanced directives,
and 1 in 5 of them have it available for 1/25
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Where Did We Come From?
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Egyptians, at least the wealthy, planned
for their deaths in advance
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Ancient Hebrew Patriarchs
So did the Hebrew Patriarchs: Abraham,
Isaac and Jacob
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Greek Thoughts
Greeks had Hades, abode of the dead
 Charon, ferryman, for the River Styx
 Coin placed in mouth of the dead to pay
Charon
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How Did We Get to Today?
Dissolution of extended family
 Belief in science and medicine
 Evolving complexities of everything!
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How Did I Get Involved?
MD 72, University of Chicago
 Career in surgery/ general, thoracic,
cardiac including thoracic oncology
 That means lung cancer!
 Long trip to actually talking with patients,
their families and loved ones
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Why Don’t Doctors Talk to
Patients?
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Not trained
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Uncomfortable
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Had seminar with Elizabeth Kubler-Ross in Medical
School, “Of Death and Dying” 5 steps of Grief
Dealing with failure
Dealing with their own mortality
Feeling they have nothing to offer
Takes time and isn’t included in government or
insurance billing codes
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Ostrich Effect
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Development of ROYL
Rest of Your Life planning
 Toolkit for Doctors
 Aimed an End of Life Planning
 Expansion to Stakeholders
 Expansion to Rest of Your Life planning
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What is ROYL
1. comprehensive and integrated web app to facilitate
Rest of Your Life planning
2. built in logic and knowledge to allow two year
community college grad to assist
3. focused on HOME
a. advanced care planning
b. home modification
c.home health monitoring and pharma compliance
d. earlier home hospice as indicated
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How Does ROYL work?
1. increase patient engagement and autonomy
a. ROYL family conference
http://www.theroyl.com/planning-rest-oflife/medical/family-conference/
b. open dialogs and facilitate advanced care planning
2. Develop cadre of ROYL health assistants at each SNF,
will interact upon admission for advanced care planning
and at discharge to promote home modification, home
health monitoring and pharma compliance and educate
about real benefits of home hospice
a. increased patient satisfaction
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b. decreased cost
ROYL and Cultural Change and
Paradigm Shifts
1. Cultural shift is possible, US birth
experience
a. needs health care and economic engines
b. both currently exist in US Health Care
2. Paradigm Shift-needn’t have doctors,
nurses and social workers do the patient,
family, loved one interactions about ACP
3. ROYL is totally PATIENT CENTERED!!
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Benefits of ROYL
Improved quality
 Improved patient/family/loved ones
satisfaction
 Reduced cost of health care
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US #1 in cost
 US #7 in benefits
 Growth not sustainable (16% GDP currently
 Decrease hospital admissions and
readmissions
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Risks of Failure to do ROYL
Decreased quality
 Decreased satisfaction
 Increased costs-50 billion/year
 Someone will do planning for you, loss of
patient autonomy
 Patient Fears
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Death panels argument
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Why?
Who?
Unnecessary Medical Treatments
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ROYL
Legal documents
 Personalized information sheets
 Personalized process action check list
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Cultural Change-possible with current
economic imperative of the graying of the
boomers!
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WWW.TheROYL.com
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