Transcript Health Positioning Toolkit - e

CFPC CoI Templates: Slide 1
Faculty/Presenter Disclosure
Faculty: Ian Fish
Relationships with commercial interests:
• Other: Employee of Accenture
1
Health
Insight Driven Health
eHealth Conference 2013:
Accelerating Change
Creating True Continuity of Care:
An Innovative application of ICT to engage
patients and improve care coordination
Healthcare today
Two diametrically opposed worlds…
•Predominantly fee-for-service / global
funding
Provider
world
•Sick care focus, primarily single
channel (in-person @ clinical site)
•Fragmented, episodic care & data
•One size fits all
•Outcome/value focused
Consumer
•Wellness/prevention/care plan focused
•Multi-channel engagement
•Personalized experience
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•User-friendly apps; Highly-mobile;
Abundant data collected
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Healthcare today
Reforms have tended to be provider-centric
Health Reform Trends
Canadian Health Marketplace Examples
1. Move away from volume-driven, Fee-ForService to a payment structure based on
performance
2. Define “performance” in terms of both
clinical quality outcomes (effectiveness)
and utilization of services (efficiency)
3. More rigorously align payment for
healthcare services with performance, as
measured by:
• Clinical quality outcomes (effectiveness)
• Utilization of services (efficiency)
4. Expand “local” (e.g., provider)
accountability for the total cost of care to
drive improved performance and bend the
healthcare cost curve
5. Enable Improved Care Coordination
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“Alberta Family Care Clinics” - Clinics are staffed by a
multidisciplinary team of health care providers. As part of the
team, family physicians will provide care beyond the scope of
the other health care providers as well as provide advice as
required.
Accenture Connected Health Global Research
Three levels of IT value-creation were identified – Most of the IT
investment in Canada has been on Stages 1 & 2
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5
Accenture Doctor Survey 2012
Canada had the lowest HIE & EMR adoption although Canada did
experience an increase in adoption 2012 over 2011
Connected Health Maturity Index: Total Doctors, 2011-2012
Y Axis
60
2011
Canada 2011
2012
Canada 2012
Spain
Health information exchange
(% routine users)
50
Spain
US
40
England
England
Singapore
US
Singapore
30
Canada
20
France Australia
Germany
Germany
Australia
France
Canada
X Axis
10
10
20
Note: Unweighted Data
Base: All Qualified Respondents
Q705. How frequently do you use/perform the following functions/activities?
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30
40
50
60
EMR adoption and use
(% routine users)
6
Consumer access to electronic medical record data
Many doctors in Canada state that patients should be able to update
information in their EMR
Patient Updateable Information in
Electronic Medical Record
Patient Allowed Access
to Electronic Medical Record
Canada Total
8-Country Total
Lab test results
Canada Total
No
access
14%
Limited
access
57%
Full
access
29%
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45%
25%
54%
29%
22% 24%
Change in symptoms
23%
34%
44%
29%
35%
36%
New symptoms
23%
32%
46%
29%
34%
38%
New medications
21%
28%
50%
23%
Personal medical history
20%
33%
47%
24%
35%
42%
Medication side effects
19%
33%
48%
22%
37%
41%
Self-measured metrics
18%
37%
45%
23%
35%
43%
Allergic episodes
17%
28%
55%
Family medical history
15%
29%
55%
Demographic information 11% 24%
65%
Patient should not update
21%
31%
30%
16% 31%
10%18%
Some information
47%
49%
54%
73%
All information
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Healthcare tomorrow
Consumer-centric
• Leverages new care delivery
channels outside of clinical
establishments
Provider
“Increased
accountability for outcomes”
• Care coordination evolves to
include nonclinical
professional care givers,
patients and their family
members
• Creates new opportunities for
provider & consumer
incentives to focus more on
the quality of care, cost and
overall patient experience
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Consumer
“Increased accountability for
wellness, behaviour changes &
prevention”
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Healthcare tomorrow
A framework for consumer-centric collaborative care
Care Plan
Mobile
Clinical
Social
Game
SMS
Telephony
Kiosk
Multi-Channel User Experience
Genomic
Collaborative
Care Engine
Analytics
Process Transformation
Web
Data Integration
Social
Lifestyle
1
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9
Continuity of Care Demo – ED, PCP and Patient’s home
Use-Case Demonstration (Conceptual and Hypothetical)
Clinical Workflow Overview
1.
A 38 year-old male patient comes into the Emergency Department (ED) with fever, chills, and localized
pain on left side
2.
The ED clinician uses the Electronic Health Record (EHR) to obtain previous history, medications and
investigations
3.
The ED clinician creates a ED Physician Note (EDPN) to record the care delivered to the patient in the
ED
4.
The patient is discharged from ED and asked to visit his Primary Care Provider (PCP) next day for
follow-up
5.
The Patient visits his PCP’s office, where his PCP retrieves patient’s medical history and ED note
6.
PCP encourages patient to follow a healthy lifestyle and instructs him to proactively start monitoring his
physical activity and weight using Fitbit pedometer and A&D weight scale
7.
PCP monitors activity / weight based on defined exceptions
ED
Patient
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Patient at
Home
Post discharge,
Visits Primary
Care (PC)
Visits
Hospital
PCP office
Track activity
& weight at home
10
ED doctor uses Orion EHR system to check patient’s
medical history…
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11
…and procedure, lab and medication history
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12
After tests are done in ED, ED doctor uses ED Note portal to
update and submit ED Note for patient
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13
In ED Note, Discharge Instructions tell patient to visit PCP
next day. This emphasizes the focus on continuity of care.
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14
The ED Note after submission in ED portal, becomes part of the patient’s
Orion EHR patient record. So any doctor/nurse with the required access
controls can see it. Again this emphasizes Continuity of Care.
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15
PCP looks at patient’s medical record, PCP is using cloud-based EMR
system from HealthyCircles. PCP also clicks on Documents tab to see
patient’s ED Note, sent earlier from ED portal to HealthyCircles.
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16
PCP looks at Patient’s ED Note to get complete context of
the patient. Next PCP makes his recommendation to the patient.
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17
PCP asks patient to use Fitbit pedometer and A&D Weight scale
at home.
Data from both gets uploaded automatically
through Qualcomm Life’s 2Net device cloud
service to HealthyCircles’ provider and patient
portals.
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18
Patient portal (from HealthyCircles)
 showing patient’s pedometer tracker
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19
Patient portal (from HealthyCircles)
 showing patient’s weight tracker
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20
PCP’s provider portal (from HealthyCircles)
 showing patient’s pedometer tracker
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21
PCP’s provider portal (from HealthyCircles)
 showing patient’s weight tracker
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22
In conclusion
Pushing the needle forward requires technology innovation & industry
experience and input
Patient-Centered Collaborative Care
PoCs
Continuity of care
Pilots
Integrated HM
New Primary Care
Tech Labs-Led
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Industry-Led
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Health
Insight Driven Health
eHealth Conference 2013:
Accelerating Change
Supplementary
Continuity of Care Demo Architecture
Emergency
Department
PCP’s office
Patient’s home
Cloud
A&D
Weight
scale
Fitbit
pedometer
HIE
Provider
portal
Data
Provider portal
iPhone
app
ED Note
2net Hub
Data
Data
Qualcomm 2Net cloud server
ED Note portal
Data
Accenture cloud based Data
transfer app
Accenture’s role: Evangelize this conceptual idea,
Build some software components,
System Integrator for this demo
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Data
Patient portal