Today we will explore the current state of the movement, to assess how Health 2.0 is beginning to change the actual delivery of health care. We will discuss the state of the art with current thought leaders - from small independent clinics to large integrated delivery systems - who are adopting and adapting to enabling technologies that are part of a larger transformation to a next generation health system. We will also see presentations from three different platforms, who based on their collective recent media blitz, are clearly at the bleeding edge of a brave new world full of possibilities.

1. Building Health 2.0
into the Delivery System
Scott Shreeve, MD
Chief Executive Officer
April 14, 2009

2. Agenda
/ Intro
/ Panelist
/ Discussion
/ Presenters
/ Discussion
Integrated/GH Academic/BIDMC Group/DHCM Independent/RenH
Integrated/Kaiser Interdependent/Myca Independent/Google

3. The Cathedral and the Bazaar
vs

4. Cathedral Care
Vertical Characteristics:
• Kaiser, Group Health, Geisinger, etc
Ancillary
• Optimization at the system level
Services
• Full coordination of care
• Information technology supports
Hospital
Services
• Incentives aligned for outcomes
• Reward for results
• Patient consumer for life
Physician
Services
• Consumer is guided through process
Patient
Services

5. Bazaar Care
Non - Integrated Characteristcs:
• Fee for Service
Ancillary
• Optimization at the component level
Services
• Disease Care
• Lack of coordination
Hospital
• No Accountability
Services
• Consumer left to navigate
• Incented for volume not value
Physician
Services
Consumer
Services
(None)

6. Transformation
Current Future
System System
H2.0

7. The Bazedral
Virtual Health 2.0 Opportunity:
• Software/services integration layer
Ancillary
• Coordinates patients, providers, and payment
Services
• Dramatic increase in health care value
Organizing Entity
Hospital
Key points of “Virtualization”
Services
• Financing (payment / business models)
• Delivery (new types of arrangements)
Physician
Services
• Incentives (increased $ for increased value)
Consumer
Services
(None)

8. Perspectives
James Hereford Dan Caruso, MD
• VP Quality, Group Health • Med Director, Dartmouth
• Integrated Delivery System • Community Group Practice
John Halamka, MD Rushika Fernadouplle, MD
• CIO, BIDMC • Founder, Renaissance Health
• Academic Medical Center • Individual Medical Clinics
Integrated Academic Group Independent

9. Cathedral or Bazaar?
vs

10. Ferrari Medicine

11. Ferrari Medicine

12. Independent or Systemic?
vs

13. Vertical or Virtual?
Vertical Virtual
Ancillary
Ancillary
Services
Services
Organizing Entity
Hospital Hospital
Services Services
vs
Physician Physician
Services Services
Consumer
Patient
Services
Services
(None)

14. On or Off the Grid?
vs

15. Presenters
Roni Zieger, MD
• Project Manager, Google Health
Sean Khoizon, MD
• Medical Director, Hello Health
Ted Eytan, MD
• Clinical Innovation, Kaiser Permanente
Independent/Google Interdependent/Myca Integrated/Kaiser

16. Free Flow or Gated Stream?
vs

17. Sustaining or Disruptive?
1. Enabling technology
Performance
2. New Business Model
3. Value Based Network
Incumbents win
New Measure of
Time
Performance
“Almost always,
disruptive innovations
such as these have
been ignored or
opposed by the leading
institutions in their
New Entrants win industries for perfectly
rational reasons”
Time - Clayton Christensen

18. Tethered or Untethered?
PHR
Phrm Provider
EHR vs PHR
PHR Payor Patient
PHR

19. Takeaway Memes
1.Health 2.0 from just Promise to the Practical
2.Innovation from Inside as well as Outside
3.Relationships from Paternalistic to Participatory
The enabling tools and technology of H2.0 are
creating the next Generation Health System NOW

20. Join In!