Transcript Transformation-of-Health-Care-Bill-Marsh-MD-Adams-County

Health Transformations: The future of the
physician-patient relationship
Bill Marsh, Vice President and Chief of Staff, Colorado Permanente Medical Group
Health Care is Unfrozen: Why now?
What does this mean?
Rapid Response
2 March 27, 2016
Rapid Learning
3
A Growing Network of Immediate Access Choices
Markets Responding to Unmet Needs
Consumer-Oriented Service Delivery Sites Filling the Gap
Traditional
Access
Points
ConsumerOriented Access
Points
Primary Care
Office
Low Acuity
High Acuity
Virtual
Visit
Urgent Care Center
Emergency
Department
Retail
Clinic
Driving Provider Questions:
• Should we partner to establish retail clinics?
• Should we build or expand our urgent care footprint?
• Is virtual care something that we should provide?
• When should we enter into partnerships to meet patient demands?
Source: Mehrota A et al, "Visits To Retail Clinics Grew Fourfold From 2007 To 2009, Although Their Share Of Overall Outpatient Visits Remains Low," Health Affairs, August 2012; Health Care Advisory Board interviews and analysis.
Providers Expanding the Applications of Virtual Care
From Administrative Transactions to Real-Time Care Delivery
Virtualize Care Delivery
• Asynchronous, messagebased visits
• Live, video-based visits
Streamline Clinical Transactions
Impact on
Access
• Prescribe new medications
• Receive lab results
• Deliver online education,
shared decision-making tools
Automate Administrative Functions
• View medical records
• Schedule in-person appointments
• Refill existing prescriptions
Pay bill
Rapid• Response
Rapid Learning
A Fast-Emerging Market Segment
$13.7B
Estimated revenue from
virtual visits in 2018, up
from $100M in 2013
220%
Projected increase in
households using virtual
care between 2013-2018
Source: Wang H, “Virtual Health Care Will Revolutionize The Industry, If We Let It.,” Forbes, 3 April 2014; available at:
http://goo.gl/oOJOCG, accessed May 9, 2014; Health Care Advisory Board interviews and analysis.
4 March 27, 2016
Market Forces Turning Patients into Consumers
Catalyzing a Shift in Network Demands
Rapid Response
Rapid Learning
Source: Health Care Advisory Board interviews and analysis.
5 March 27, 2016
Paradigm shifts happening:
Encounter based (visit)
Physician centered
Population-based care
Reactive care
Episodic care
Mass production
Physician delivered
Rear-view analytics
Silo care
6 March 27, 2016
To information based
Patient-centered
Personalized care
Proactive care
Continuous care
Mass customization
Team delivered (with patient)
Predictive analytics (“Big Data”)
Integrated care
Paradigm shifts continued:
Quality
Managing Disease
Unwarranted variation
Medical Team has info
7 March 27, 2016
Value = (Q/$)ME
Maintaining health
Warranted variation
Everyone has access to info
“ Spread health to all…………………
we meet people where they are.”
8 March 27, 2016
Where is Kaiser Permanente Colorado today?
• Received 1M patient emails in 2013
• Received 2M telephone calls for
clinical care in 2013
• Completed 200,000 “scheduled”
telephone visits.
• Advice referral with photo
9 March 27, 2016
Where are we going tomorrow?
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Video visits to home
Web chat and text
Self triage with intelligent routing
Member-generated data: questionnaires and remote monitoring
Social networking
Proactive outreach with personalized, individual care plans
Predictive analytics
Personalized genomics
10 March 27, 2016
Self-triage with Intelligent Routing
RN
Call center
MD
10-20 Acute
Conditions
My Team
11 March 27, 2016
MD, RN, NP/PA,
PharmD
Member Generated Data
Questionnaires
12 March 27, 2016
Patient self-monitoring
40% of your health is driven by what?
13 March 27, 2016
Personalized Genomics
14 March 27, 2016
What patients really want from health care =
care personalized to me!
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Restore health
Timely care
Kindness, empathy, and respect
Hope and certainty
Continuity, choice, and coordination
None or little out of pocket expense
Best medicine: testimonials
vs. statistics
Source: JAMA; Detsky
15 March 27, 2016
“It is not necessary to change,
survival is not mandatory.”
W. Edwards Deming
American Engineer & Statistician