Do we REALLY want Patient Centered Care? When Putting the Patient FIRST, Makes the Provider LAST

8/11/2019 Do we REALLY want Patient Centered Care? When Putting the Patient FIRST, Makes the Provider LAST

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2014 The Advisory Board Company advisory.com

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Do we REALLYwantPatient

Centered Care?When Putting the Patient FIRST, Makes the Provider LAST

Global CampusTalent Development


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2012TH

EADVISORYBOARD

COMPANY-260

86A

We Love Technologywith a PRICE

Innovations to Come Will Take Very Different Form

Source: Hotz RL, Printing Evolves: An Inkjet for Li ving Tissue, Wall Street Journal,

September 18, 2012; Pollack A, Mice as Stan-Ins in the Fight Against Disease, NewYork Times, September 25, 2012; Advisory Board interview and analysis.

Technology in Brief: Mouse Avatar

Researchers are implanting mice "avatars" with a patient's

tumour or part of the patients anatomy

Different treatments are then tested for effectiveness on mouse

In one test, 12 out of 14 test patients successfully shrank theircancerous tumours with fewer side effects using drug tested

first on mouse avatar

Technology in Brief: Bioprinting

Building on 3D printing technologies, researchers in multiplelocations working on ways to print living human tissue

Replacing ink with living cells, scientists printing tailored tissues

suitable for surgery and organ transplant

Simplest experimental prototypes ready for clinical testing in

five years

IMAGECREDIT:AUDREY_

SEL.

IMAGE

CREDIT:MAYBEMEME


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2012TH

EADVISORYBOARD

COMPANY-260

86A

What if Better is CHEAPER?

6

Is There Anything Duct Tape Cant Do?

Source: Focht, D.R., Spicer, C., Fairchok, M.P., The Efficacy of Duct Tape vs Cryotherapy in the Treatment

of Verruca Vulgaris,Archives of Pediatrics & Adolescent Medicine 2002; 156 (10):971-974; Cost Helperavailable at http://health.costhelper.com/wart-removal.html; Advisory Board interviews and analysis.1) Cryotherapy: Liquid nitrogen applied by doctor over 3-6 visits

Cost Comparison of Wart Treatments

Study in Brief: Duct Tape

Treatment of the Common Wart

2002 study assessed effectiveness

of duct tape occlusion versus

cryotherapy1for treating common

warts

Results found duct tape at least as

effective a treatment as more

expensive cryotherapyIMAGE

CREDIT:SYIBUS2003.

4

488

Duct tape Cryotherapy

Efficacy Comparison of Wart Treatments

85%

60%

Duct tape Cryotherapy 1
http://health.costhelper.com/wart-removal.htmlhttp://health.costhelper.com/wart-removal.htmlhttp://health.costhelper.com/wart-removal.htmlhttp://health.costhelper.com/wart-removal.html


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2012TH

EADVISORYBOARD

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86A

New Model for Patient Services

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Innovators Unrestricted by Current Delivery, Payment Models

Iora Health Contracts Directly WithEmployers to Deliver Primary Care

1) Per member per month.

2) 2009; relative to control group created using propensity

matching; gross spending dropped 18%.

Source: Iora Health, available at: www.iorahealth.com;Advisory Board interviews and analysis.

Case in Brief: Iora Health Operating the Dartmouth Health Connect clinic for Dartmouth College in Hanover, New

Hampshire, and the Culinary Extra Clinic for the Culinary Health Fund in Las Vegas, NV

Manage top 10 percent of sickest patients using comprehensive, team-based approach

Achieved 12.3 percent decrease in total spending for patients enrolled in 20092

Iora Health Local Employer GPs, contracted specialists

provide care to employee population

Employer pays fixed PMPM1fee, clinic

reports outcomes at monthly meetings

Iora doctors coordinate care with

hospitalists; hospital provides data back

Weve been worrying about the impact of

our decisions on physicians and hospitals,

but its time to worry about the impact onthe patient. The hospital perspective is not

our problem, its creative destruction.

Rushika Fernandopulle, MDIora Health

Putting the Patient First
http://www.iorahealth.com/http://www.iorahealth.com/http://www.iorahealth.com/


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2012TH

EADVISORYBOARD

COMPANY-260

86A

Are we willing(and ready) to

Abate Our Profits?

AbandonOur Comforts?



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eAdvisoryBoardCompany27852

Not Just One Service, But Many

9Health Care Advisory Board CONCLUSION

High-Risk

Patients

Rising-Risk Patients

Low-Risk Patients

60-80% of patients;

any minor conditions

are easily managed

15-35% of patients;

may have conditions

not under control

5% of patients;

usually with complex

disease(s), comorbidities

Managing Three Distinct Patient Populations

HIGH SERVICE

and LOW COST

HIGH EFFORT

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8/432012TH

EADVISORYBOARD

COMPANY-260

86A

1440 Minutes Per Day

24 Hours a Day / 365 Days Per Year

On Demand Technical Help

Initial Help FREE of Charge

Online / On Phone / In Store


9/432014 The Advisory Board Company advisory.com 28600A

1111

Source: PINGMD, available at: www.PINGMD.com,accessed

October 1, 2013; Health Care Adv isory Board interviews and analysis.

1) Proprietary.

2) Documented exchanges reduce physician liability; patient acknowledges disclaimer describing proper platform use.3) 100% HIPAA compliant secure communication,100% of the time.

Health care technology startup located in New York, NY

Online platform enables efficient care network communications through secure text,

picture, and video messaging; mobile app notifies user when communications are

sent, received and resolved

Platform reports 100% improvement in customer satisfaction

Real-Time Patient Access to

Physician, Care Providers

Patients submit clinical

questions via mobile wizard1

or web application

Photo or video attachments

provide detail on ailment2,3

Physician or care provider

recommends next care step

Case in Brief: PINGMD

Point, Click, and Heal
http://www.pingmd.com/http://www.pingmd.com/http://www.pingmd.com/



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On the Phone, All the Time,

Source: Creswell J, Start-Up Health Insurer Finds Foothold in New York,

The New York Times, March 28, 2014, available at: www.nytimes.com ;Health Care Advisory Board interviews and analysis.

Fastand FREE

Case in Brief:

Prepaid healthcare

offers free televisits,

free generic drugs, and

a limited number of free

PCP visits per year

SCREENSHOT:OSCAR

Average televisit

response time

7 min

Promises response time

of less than one hour
http://www.nytimes.com/http://www.nytimes.com/



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Catering to an Unmet Need

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Patient Portal Access Increases Engagement with Health System

Source: McCarthy D, et al., Kaiser Permanente: Bridging the Quality Divide with Integrated Practice, Group Accountability, and HealthInformation Technology, The Commonwealth Fund, 2009: 1-28; Kaiser Permanente Careers: Hawaii, available at:

http://www.kaiserpermanentejobs.org/hawaii.aspx,accessed April 30, 2013; Health Care Advisory Board interviews and analysis.

Case in Brief: Kaiser Permanente Hawaii

Branch of Kaiser Permanente based in

Honolulu, Hawaii; cares for 229,000 members

across the state

Piloted Kaisers patient portal in 2005

Region experienced a 26% decrease in

doctor visits in the two years following

portal implementation

8%Despite a 26% drop in doctor visits post-portal

implementation, Kaiser Permanente Hawaii

experienced an 8% increase in total patient contact

2003 2007

Secure messaging

Scheduled telephone visits

Office visit

Distribution of Patient Contacts

at Kaiser Permanente Hawaii

5.215.61

Contacts

per

member

26%
http://www.kaiserpermanentejobs.org/hawaii.aspxhttp://www.kaiserpermanentejobs.org/hawaii.aspxhttp://www.kaiserpermanentejobs.org/hawaii.aspx


12/432013TheAdvisoryBoardCompany27505B


Abate Our Profits?

Abandon Our Comforts?

AbdicateOur Positions?



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N L R t d?


14/432013TheAdvisoryBoardCompany27505B

UnpopularEven When Right

No Longer Respected?


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AbateOur Profits?





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Three Unique Roles for Us To Play

1) Servants to Exceed Expectations



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Far Beyond Our Work Alone


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Treating the (Obvious) Symptoms


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Far Beyond Our Work Alone


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Treating the (Obvious) Symptoms


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Service Happens in the White Space


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Addressing Needs Not Activity


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Patient Experience Simulations


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Patient Experience Simulations


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2) Gamers to Encourage Behavior



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Profuse apologies for the realities of life, making

amends for service slips, and trying to placate

frustrated patients

Encouraging patients to face

reality and accept care plans

via honest conversations

Celebrations and token

gestures to boost spirits

and reward compliance

Convincing patients that

hard choices and trade-

offs are the best course

of action for their care


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Counterintuitively, passiveacceptance is not what we want. We

need patients to be activated,

motivated, and involved in their care

The very uncertainty and lack ofcontrol that causes grief is also the

necessary ingredient for triggering

action!


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2) Gamers to Encourage Behavior

3) Entrepreneurs to Envision the Future



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AbateOur Profits?





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Are we willing(and ready)to become

1) Servants to ExceedExpectations

2) Gamers to

Encourage

Behavior

3) Entrepreneurs to

Envision the


Are we willing(and ready)to

AbateOur Profits?

AbandonOur

Comforts?

AbdicateOur

Positions?

Documents

Do we REALLY want Patient Centered Care? When Putting the Patient FIRST, Makes the Provider LAST