May 1, 2019 University of Toronto, Dalla Lana School of Public Health, The Institute of Health Policy, Management and Evaluation (IHPME) Keynote speaker Justin Barnes, a health innovation strategist and co-founder of Health Innovation Think Tank, will provide yet another integral perspective focused on the ways in which we can scale up and implement evidence-based changes in health care technology on a global scale. Having testified before Congress on more than twenty occasions delivering statements on virtual care, alternative payment methods, consumerism, connected health and the globalization of healthcare, Justin offers thought leadership for the university, the healthcare community as well as other key stakeholders. Consumer Driven Health – IHPME Research Day Looks to the Future of Health Care The trend towards consumer driven health, whether it be mobile apps, wearable devices, or easy access to electronic health records, is changing the landscape of our health care system and the way we think about care.

1. Consumerism, Innovation and
Best Practices to Thrive in the
Future of Health
JUSTIN T. BARNES
CO-FOUNDER, HEALTH INNOVATION THINK TANK
CHAIRMAN EMERITUS, HIMSS EHR ASSOCIATION

2. About Justin T. Barnes
Justin is a healthcare innovation executive, corporate advisor and
industry strategist. In addition, he’s co-founder of the Health Innovation
Think Tank where he assists with industry strategy, collaboration and
leadership. Justin is also the host of healthcare’s most popular weekly
syndicated radio show “This Just In” as well as the voice of HIMSS Radio.
Justin has formally addressed and/or testified before U.S. Congress as
well as the last three U.S. Presidential Administrations on more than
twenty occasions with statements relating to alternative payment &
care delivery models, virtual care, innovation, interoperability,
consumerism and much more. Barnes is a regular public speaker on
these issues and has appeared in more than 2,000 journals, magazines
and broadcast media outlets.

3. A few themes
for today…
The “Consumerism" of Global Health
Trends
Virtual Care
Innovation
Best Practices
Why to be excited!

4. The Global
Consumerization of Care

5. Healthcare
Practices
Consumer
Trends/Techs
Healthcare
Delivery
Patient Experience
A baseline for the
ethos and
convergence
of Consumerism…
C
o
n
s
u
m
e
r
i
s
m

6. Puts you in the middle of your care
Improves access to care – primary, specialty & advanced care
Improves care collaboration
Improves access to information
Offers access to (global) expertise
Access to better cost structures
Improves care (and pricing) transparency
Why Consumerism
(and the innovation behind it)
is so exciting…

7. Survey
Question..
Do you search or “shop”
for a care provider based
on quality, access and/ or
cost?

8. The Global Consumerization of Care
42%
Patients more likely to follow
treatment protocol
if they received
encouragement
from doctors
between visits
75%
Hospital readmissions
that are preventable
50%
Consumers willing
to pay more
for customized
health plans
60%
Adults that track their
weight, diet, or exercise
routines
“Nothing would result in improving the health of the population
(and decrease healthcare costs) more than having greater
involvement/engagement by individuals in the healthcare process.”
e-patient petition to the ONC
7,000,000
2013 2018
350,000
Telehealth Use Worldwide
52%
Believe mobile health
would make healthcare
more convenient
7,000,000
Patient Engagement Preventable Readmission
Value / Quality /
Outcomes / Cost
Patient Adherence Access / Convenience
Brand Loyalty
Source: Perficient, Health Innovation Think Tank

9. Innovation and Trends
Inside Consumerism

10. Macro Trends Driving Virtual Care
- World Is Facing A -
Challenging Future
- In -
Healthcare
Longer Life Span
80years
Average life expectancy in OECD countries in
2012 was 80 YEARS, an increase of 5 years
since 1990. 1
10%
Meet the over 65s – estimated
~10% of the global population. 2
382
million
Rising Chronic Disease
The number of people with diabetes
globally is >425 million, est 114 million are
Chinese.2
19%
fewer
Physician Burnout/Shortage
Shortage of 13.7k physicians in 2010 and
projected to be well above 140k or about 19%
fewer doctors than are deeded by 2025, in US. 3
shortage of more than 4 million doctors, nurses,
midwives and others 4
4.9%
North
America
Higher Cost
Growth in average annual healthcare
spending is expected to range from 2.4%
in Western Europe to 4.9% North America;
and from 8.1% in Asia and Australia to
8.7% in the Middle East and Africa. 2
Growing Population
9.6billion
Global population has grown from 1 billion
in 1800 to 7.7 billion in 2018, and
projected to 8.5 billion by mid-2030, and
9.7 billion by mid-2050.4
Aging Population
Source: Health Innovation Think Tank

11. Components of Virtual Care
Secure eVisit
Communications
(Voice, Video, Text,
Data…)
Chart Review
(Labs, Meds, Appts,
Consent etc.)
Remote Device
Monitoring (Blood
Pressure, Heart Rate,
PillBox,SpO2,
Glucometer,
Scale…)
Patient Family
Member Access to
Patient and Info
Supplementary
Immersion
Technologies (VR /
AR) for VC
Patient Educational
Libraries
Device as single
point interface for
Patient Interaction
Light Artificial
Intelligence (Chat
bot, Care Plan
Compliance)
Back-end IOT /
Advanced Analytics
Care Plans
(Diabetes,
Hypertension,
COPD, CHF,
Asthma…)
Back-end EHR
Integration (Omni
vs. bi-directional)
Nurse On Call -
Command Center
A.
B.
C. M.
E.
F.
G.
H.
I.
J.
K.
D.
Next Gen
Nurse Call to
Manage
Remote
Patients
Automated
Patient
Decision Aids
(Pt Empowering)
Eldercare
Assisted
Robots
TBD…
N.
Regulatory Strategy
/ Reimbursement
Mgt
O.
P.
Q.
R.
Eldercare
Devices
L.
Source: Health Innovation Think TankProprietary to HIThinkTank. All Rights Reserved.

12. 12
Voice Assistants are
Invading the Practice
(and Home)
New research from DRG
Digital/Manhattan: In the
company's annual "Taking
the Pulse" survey of 2,784
physicians, 23 percent
said they used a voice
assistant "for professional
reasons”
Vital sign monitoring platform
• Heart Rate
• Respiratory Rate
• Pulse Ox (SpO2)
• Temperature
• Blood pressure
• Glucose
• Nitric Oxide (NO)
Innovations Impacting Care…

13. Survey
Question..
Do you use innovation such as
telehealth, remote monitoring
or virtual care with your
current care providers?

14. Innovation Best Practices for Virtual Care
Virtual Patient Advocates – “Louise” by Dr. Jack and BU School of
Medicine
◦ Emulate face-to-face communication
◦ Develop therapeutic alliance-empathy, gaze, posture, gesture
◦ Teach After Hospital Care Plan (AHCP)
Alleviate hospital overcrowding & “hallway” care issues
Use technology to help discharge patients with accurate/
comprehensive info, continuity of communication, solve fragmentation,
decrease variability, provide clear med/ Rx instructions, reliable contact
information & post-hospital information
Virtual Assistant-enabled post-acute care in the home setting
◦ Amazon, Google & Apple are the leaders today
Source: Health Innovation Think Tank

15. Personal Blueprint and Strategy for Collaboration,
Co-opetition & Consensus Building
Brought together leading global health IT companies to advance healthcare
Engaged & educated policymakers who were making healthcare decisions
for our state, region & country
◦ Visited offices, testified over 20 times on healthcare, innovation and best practices
◦ Traveled to and studied a dozen other countries to learn their best practices
◦ Created and shared global innovation & strategy best practices
Ended up co-founding 6 industry associations that all included key
stakeholders from every aspect of healthcare (inc. government)
◦ Electronic Health Records (EHR Association)
◦ Value-based Care (Accountable Care Community of Practice)
◦ Interoperability (Carequality & CommonWell Health Alliance)
◦ Mobile Health (Mobile Health Consortium)
◦ Innovation & Strategy Best Practices (Health Innovation Think Tank) Proprietary to Justin Barnes, LLC. All Rights Reserved.

17. Think Tank Collaborators
• Atrium Health
• Partners Healthcare
• Northwell Health
• UPMC & UPMC Health Plan
• Thomas Jefferson University
• University of Virginia Health System
• Duke Health
• Resurgens Orthopaedics
• Christus Health
• UT Southwestern Medical / Parkland
Health
• Boston University School of Medicine
• Tahoe Forest Hospital District
• Pratt Regional Medical Center
• Nemaha County Hospital
• Florida Association of ACOs
• Children's Integrated Center for Success
• Reliant Medical Group
• Nemours Children’s Health
System
• Dartmouth-Hitchcock
• Sturdy Memorial Hospital
• Phoenix Children's Hospital
• Lima Memorial Health
• OhioHealth
• Covenant Health
• Halifax Health
• HCR ManorCare
• FastMed Urgent Care
• UNC/ Rex Institute for Family
Health
• IHPME, University of Toronto
• MedAllies, Inc.
• HHS/ ONC
• Intel
• Philips Healthcare
• Qualcomm Life
• McKesson
• Notable Health
• Meditech
• Cerner
• Allscripts
• CPSI
• NextGen Healthcare
• Change Healthcare
• New York eHealth
Collaborative
• Practice Fusion
• Connection
• CDW
• Qure4U
• HIPnation
• NeHII
• Livongo Health
• LifemedID
• WallerMD
• Call9 Inc.
• eviCore healthcare
• Commonwealth Health
• Insight Enterprises
• HealthEC
• Lenovo Health
• Center for Connected
Medicine (CCM)
• Justin Barnes Advisors
• Elevation Health
• StudioNorth
*Sampling of collaborators

18. Consumerism:
A Global Think Tank
Perspective

19. 19
• Large Medical Group strategy for patient engagement and navigating consumerism
– “We achieved our goals by focusing on the 3 U’s => Useful, Usable and U have to develop trust!”
– Everyone must find value in the technology and strategy.
– It must fit into natural workflows – don’t ask them to change. Deliver services as a byproduct of normal
activities.
– Trust is so important. Patients need to trust that they’ll get quality care – their data is safe – and the doctor
is who they say they are…and the patient is who they say they are.
• Telehealth survey introduced by health system regarding “video visits”.
– On a scale of -5 to +5, are you interested in video visits with your physician. Patients gave concept a +3.5
– What about video visits with another physician who has your record but is not your primary doctor: -0.6
– What about a video visit with a physician who can’t see your medical record: -5.0 (minus 5)
– Best practice: Patients want telehealth/ video with their physician, not a random care provider.
• What is stopping people from using telehealth –
– Need to look at value, usability & trust, including trust in the care provider, data and privacy.
Key Findings from Think Tank IV www.HealthInnovationThinkTank.com #HIThinkTank
Consumerism Best Practices

20. 20
Consumerism Best Practices
• Key hospital survey introduced:
– 80% patients cared about the hospital’s brand/expertise in 2005; In 2015, only 42%.
- Convenience is now more important than a “brand”.
– Research dug deeper: 33% said, looking for whether a clinic has virtual visit offerings. In 2018, new
patients look for virtual care options before they sign up with their doctor.
• Research if/ how “virtual visits” can be implemented into care strategy. They tend to be shorter,
physicians can work from home one day a week to take virtual visits and still comprehensively
manage care. Several new models of care align with this.
• Watch how patient engagement decisions are being made with factors of cost, access and trust
– in that order.
• The Alexa Factor – It’s not hype
www.HealthInnovationThinkTank.com #HIThinkTank

21. 21
• Consumer-facing product and solution best practices for innovators and vendors:
– Solution must adapt to patient
– Apps and products must be simple and intuitive; education for patients is key
– Platform needs to work on all tech platforms…not just one
– Generation gap on using technology is closing
• Best Practice: Getting people engaged on the portal is key
– At registration/check-in - show patients how to access App and exam follow-up
• Best Practice: important to have one solution for patients and one for physicians/ care providers
– Create customized and segmented role-based products and solutions
– To maximize engagement and usability, innovators must consolidate functionality and achieve
necessary platform integration so you do not force clinicians and patients to use multiple solutions or
platforms. Look at the PHR failures scattered across healthcare.
Key Findings from Think Tank IV www.HealthInnovationThinkTank.com #HIThinkTank
Consumerism Key Takeaways

22. 22
• Strategic ideas shared for increasing engagement
– In lower income areas, research shows that some lower income households are higher
adopters of smartphones b/c they may have their phone as their only connection point (not a
computer or cable or other connection).
– One large health system shared that they have a program that uses Facebook to share “non-
PHI” patient education and management communications with the homeless because many
homeless use Facebook and free Starbucks wireless to stay connected with family & friends.
– Phone numbers specifically have shown to be useless at time for the homeless although
some states now give away smartphones to the homeless to help them stay connected.
– 40% of homeless may not have steady phone numbers but use steady Facebook accounts
to keep in touch
Key Findings from Think Tank IV www.HealthInnovationThinkTank.com #HIThinkTank
Consumerism Key Takeaways

23. A final few
best practices…

24. Innovation Best
Practices for
Virtual Care
Ask what does your organization
want out of a virtual care
strategy?
Attract customers, expand reach,
reduce cost, enhance access, triage for
ER/ ED, etc..
Virtual care will suffuse every
element of care
For success, must be integrated into
care design with proper change
management
“It’s the care model that matters”
When possible, start your virtual care strategies small with a
portion of patient base (100, 500, 1,000) or a single disease
state
Understand how voice-enabled technologies and innovations
can support your advanced care delivery
“Voice First, not Voice Only” –
Reduce friction in these
transformational strategies
Voice has shown to lower the friction
with patients and post-care
instructions
Source: Health Innovation Think Tank

25. Questions?

26. Thank You
To contact our speaker, Justin Barnes, email him at: Justin@JustinBarnes.com