This presentation highlights some key considerations when building or integrating IT solutions for the emergent payment models evolving in Health Care. Population risk stratification, identifying patients to target for high success rate interventions, and tracking physicians adherence to evidence based medicine using key performance indicators are covered at a high level.
2. 1% of U.S. population consumes
20% of ALL HEALTH CARE DOLLARS
Source: National Institute of Health Care Management 2012
3. 1% of U.S. population consumes
20% of ALL HEALTH CARE DOLLARS
Source: National Institute of Health Care Management 2012
Total expenditure on healthcare:
per capita per year: $7,960
Source: Organization for Economic Co-operation and Development on global health issues: Michael B.
Sauter, Charles B. Stockdale, 24/7 Wall St. , 2012 - Countries that spend the most on health
care, NBCNEWS.com,
http://www.nbcnews.com/business/countries-spend-most-health-care-618241
Expenditure as percent of GDP: 17.4 percent
4. #3 Biggest Issue – Patient Safety & Quality
2011 Results - Biggest Issue Facing Hospital CEOs
Source: American College of Healthcare
Executives, Annual Poll – Top Issues
Confronting Hospitals: 2012
Annual Survey American College of Healthcare Executives
5. #3 Biggest Issue – Healthcare Reform
Implementation
2012 Results - Biggest Issue Facing Hospital CEOs
Source: American College of Healthcare
Executives, Annual Poll – Top Issues
Confronting Hospitals: 2012
Annual Survey American College of Healthcare Executives
6. •Hospital Readmissions– Hospital DRGs 1% in 2013 3% by 2015
•Medicaid DSH cuts - $18.1Billion 2014 – 2020 (Pres. Obama proposed delay to
2015)
•Value-Based Purchasing
•70% - Core Measures: Heart Failure, Acute Myocardial Infarction (AMI),
Pneumonia & Surgical Care
•30% - HCAHPS score: Patient Satisfaction
•Physician (SGR) Sustainable Growth Rate – 27%
Reduced Reimbursements
CMS & Commercial Carriers
•Accountable Care – Provider Risk Acceptance & Shared Savings
•Bundled payment for episodic care
Global Payments Innovations – CMS & Carriers
•Payers setting up Accountable Care Organizations
•Hospital Systems offering health insurance on public Health Insurance
Exchanges (HIX)
Payer/Provider Convergence
7. HHS & ONC BEACON
COMMUNITIES
HIE - HEALTH INFORMATION
EXCHANGES
SEMANTICAL
INTEROPERABILITY
MASTER PROVIDER INDEXES
MASTER PATIENT INDEXES
CONSENT MANAGEMENT &
RECONCILIATION
ILLINOIS - Care Coordination Programs
CCE - Seniors and Persons with Disabilities
CCMN - Children with Complex Health Needs
MMAI - Medicare-Medicaid Alignment Initiative
ICP - Integrated Care Project and Integrated Care
Expansion
8. ACO – ACCOUNTABLE CARE ORGANIZATIONS
BUNDLED PAYMENTS FOR CARE
IMPROVEMENT
PRIMARY CARE TRANSFORMATION
MEDICAID & CHIP POPULATION INITIATIVES
DUAL ELIGIBLES INITIATIVES
PAYMENT & SERVICES DELIVERY MODEL
ACCELERATION
BEST PRACTICE ADOPTION INITIATIVES
13. Managed Care and Value-Based Care has provided us the privilege and
responsibility to
Never Discharge a Patient.
We can dedicate our efforts to help them grow, contribute and then age
with dignity.
17. MOVEMENT AWAY FROM
CENTRALIZED FACTORIES OF CARE
Hospital
CONSUMER DRIVEN HEALTH CARE
Source: http://www.nytimes.com/interactive/2013/05/08/business/how-much-hospitals-
charge.html
18. COMPACT RADIUS OF
PATIENTS/COMMUNITY
DEFINED PAYER MIX
HOSPITAL PATIENT CAPTURE
CURRENT STATE
MOVEMENT AWAY FROM
CENTRALIZED FACTORIES OF CARE
Hospital
CONSUMER DRIVEN HEALTH CARE
Source: http://www.nytimes.com/interactive/2013/05/08/business/how-much-hospitals-
charge.html
19. SILVER TSUNAMI – Seniors Aging In Their Homes
78 Million Baby Boomers turned 65 in 2011
9 out of 10 seniors want to stay in the home they retied in
Source: AARP survey
REDUCED HOSPITAL READMISSIONS
REDUCED HOSPITAL (LOS) LENGTH OF STAY
+
__________________________________________
MOVEMENT AWAY FROM
CENTRALIZED FACTORIES OF CARE
Hospital
CONSUMER DRIVEN HEALTH CARE
Source: http://www.nytimes.com/interactive/2013/05/08/business/how-much-hospitals-
charge.html
20. SILVER TSUNAMI – Seniors Aging In Their Homes
78 Million Baby Boomers turned 65 in 2011
9 out of 10 seniors want to stay in the home they retied in
Source: AARP survey
REDUCED HOSPITAL READMISSIONS
REDUCED HOSPITAL (LOS) LENGTH OF STAY
+
__________________________________________
EXPANDED RADIUS OF PATIENTS
EXPANDED PAYER MIX
BIG DRIVE TIME TO REACH PATIENTS
MOVEMENT AWAY FROM
CENTRALIZED FACTORIES OF CARE
Hospital
CONSUMER DRIVEN HEALTH CARE
Source: http://www.nytimes.com/interactive/2013/05/08/business/how-much-hospitals-
charge.html
22. Source: Southcentral Foundation, “The Trust for
Health Excellence’s Better Health Initiative”
Influence the
RIGHT
PEOPLE
at the
RIGHT TIME
at the
RIGHT PLACE
by the
RIGHT
METHOD
USE PATIENT
OUTREACH TO
24. Looking “in” on the patient Looking “out” to the Health Care Environment
25. Looking “in” on the patient Looking “out” to the Health Care Environment
Patient-centered medical homes (PCMH) – Not necessarily a
“place” rather a central point from which assistance is provided
to navigate the fragmented healthcare system
Source: Oliver Wyman, Tom Main & Adrian Slywotzky
26. HEALTH PLAN CO-PAYs
All Metallic plans on Public Health Insurance Marketplace & SHOP Exchanges
DIRECT PAYMENT FOR E–CONSULTS
RANGE - $50 - $100
NO CLAIMS ADJUDICATION NECESSARY
CONVENIENCE OF ACCESS DRIVES PATIENT
ENGAGEMENT
STEERS ADOPTION OF ELECTRONIC PATIENT
PORTAL USAGE
29. Clinical Integration within IDNs
Clinical Registry Data – Reviewed by Physicians providing the care
ICD-9/10 & HCPCS from PMS and CPT/DRG Diagnosis from EHR
EHRs Capture the discrete data electronically
30. Clinical Integration within IDNs
Clinical Registry Data – Reviewed by Physicians providing the care
ICD-9/10 & HCPCS from PMS and CPT/DRG Diagnosis from EHR
Payer incentives to providers
PQRS, Tiered Narrow Networks, Core Measures, ACOs
EHRs Capture the discrete data electronically
35. Financial Savings Potential from Medication Adherence
Chronic Condition Savings Per Patient per Year
Congestive Heart Failure – CHF $7,823
Hypertension $3,908
Diabetes $3,756
High cholesterol $1,258
Source: CVS Caremark Research Partnership: Advancing Adherence & the Science of Pharmacy Care, Volume 2. Page 5
www.cvscaremarkfyi.com/sites/all/themes/cvs_theme/11-CVS-346-NPC_2012_compendium_final_web.pdf
36. Financial Savings Potential from Medication Adherence
Chronic Condition Savings Per Patient per Year
Congestive Heart Failure – CHF $7,823
Hypertension $3,908
Diabetes $3,756
High cholesterol $1,258
Source: CVS Caremark Research Partnership: Advancing Adherence & the Science of Pharmacy Care, Volume 2. Page 5
www.cvscaremarkfyi.com/sites/all/themes/cvs_theme/11-CVS-346-NPC_2012_compendium_final_web.pdf
We need to leverage New Methods to PROMOTE HEALTHY HABITS!
37.
38.
39. “As the rats were learning, the reinforcement signal goes
away, because you really don’t need it”
Source: Dr. Ann Graybiel, MIT: Brain rhythms are
key to learning New study from MIT neuroscientists finds that
brain waves shift frequency as a new task becomes routine.
Anne Trafton, MIT News Office, November 27, 2011
40. “As the rats were learning, the reinforcement signal goes
away, because you really don’t need it”
Source: Dr. Ann Graybiel, MIT: Brain rhythms are
key to learning New study from MIT neuroscientists finds that
brain waves shift frequency as a new task becomes routine.
Anne Trafton, MIT News Office, November 27, 2011
45. Realize you CAN’T REMEMBER the actual trip itself. As if in a Trance
Drive to WorkBack out of Driveway Get to the Office
46. Process of Emotional Eating Can be a similar experience
Realize you CAN’T REMEMBER the actual trip itself. As if in a Trance
Drive to WorkBack out of Driveway Get to the Office
50. You better cut the pizza in four pieces
because I’m not hungry enough to eat six.
~ Yogi Berra
51. $90,000
$41,000
$236
0
COST BREAK DOWN
Average Annual Healthcare Spend in USA
Per Person
Heart
Disease
Diabetes
Arthritis
Asthma
Source: National Institute of Health Care Management 2012
C
O
S
T
D
R
I
V
E
R
S
52.
53. Access to Discrete (Patient Identified) Claims Data of population
1. ASO (Self-Funded Plan) or ACO (Entitlement or Commercial)
2. HIE from Practice Management Systems or Patient Billing Systems
54. Access to Discrete (Patient Identified) Claims Data of population
1. ASO (Self-Funded Plan) or ACO (Entitlement or Commercial)
2. HIE from Practice Management Systems or Patient Billing Systems
Clinical Data – HIE from EHR or Clinical Integration Registry
55. Access to Discrete (Patient Identified) Claims Data of population
1. ASO (Self-Funded Plan) or ACO (Entitlement or Commercial)
2. HIE from Practice Management Systems or Patient Billing Systems
Medication Data
1. Claims from ASO (Self-Funded Plan) or ACO (Entitlement or
Commercial)
2. HIE from E-Prescribe system, E-Prescribe transaction hub
(Surescripts) or directly from the PBM (if permitted by plan design
and regulations)
Clinical Data – HIE from EHR or Clinical Integration Registry
60. RISK SCORES
Episode Risk Groups (ERGs)
Episode Treatment Groups (ETGs)
Hierarchical Condition Categories (HCC)
OLAP/SQL
61. Advanced Predictive Model Determines “Risk Index” and Care Method
Risk/Cost Profile: Total Population
Costs
62. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Risk/Cost Profile: Total Population
Costs
63. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Nurse Coach
• Team-based model targeted at high-
opportunity members
Risk/Cost Profile: Total Population
Costs
64. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Core Chronic Disease Management
• Program delivering disease-customized content for
disease-identified members
• Standards of care and HEDIS
Nurse Coach
• Team-based model targeted at high-
opportunity members
Risk/Cost Profile: Total Population
Costs
65. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Core Chronic Disease Management
• Program delivering disease-customized content for
disease-identified members
• Standards of care and HEDIS
Lifestyle Coach
• Members prioritized by Risk Profile severity
• Coaching based on modifying lifestyle risks that
lead to increasing medical costs
Nurse Coach
• Team-based model targeted at high-
opportunity members
Risk/Cost Profile: Total Population
Costs
66. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Core Chronic Disease Management
• Program delivering disease-customized content for
disease-identified members
• Standards of care and HEDIS
Lifestyle Coach
• Members prioritized by Risk Profile severity
• Coaching based on modifying lifestyle risks that
lead to increasing medical costs
Nurse Coach
• Team-based model targeted at high-
opportunity members
Risk/Cost Profile: Total Population
Self-Management (Web and Multi-Modal)
• Customized via members’ participation in the
WBA, a Well-Being Plan organizes web content to
serve the individual needs of the member self-
managing healthy behavior improvement
Costs
67. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Core Chronic Disease Management
• Program delivering disease-customized content for
disease-identified members
• Standards of care and HEDIS
Lifestyle Coach
• Members prioritized by Risk Profile severity
• Coaching based on modifying lifestyle risks that
lead to increasing medical costs
Surveillance
• Some members may not participate in the WBA
• Via routine Claims Analysis and Predictive Model
runs, 100% of the population is continuously
evaluated & re-prioritized for program
intervention
Nurse Coach
• Team-based model targeted at high-
opportunity members
Risk/Cost Profile: Total Population
Self-Management (Web and Multi-Modal)
• Customized via members’ participation in the
WBA, a Well-Being Plan organizes web content to
serve the individual needs of the member self-
managing healthy behavior improvement
Costs
68. Advanced Predictive Model Determines “Risk Index” and Care Method
Clinicians (PCP and Mid-Level)
• Targeted at very top ranked members
who benefit from intensive
intervention model by MD team
Core Chronic Disease Management
• Program delivering disease-customized content for
disease-identified members
• Standards of care and HEDIS
Lifestyle Coach
• Members prioritized by Risk Profile severity
• Coaching based on modifying lifestyle risks that
lead to increasing medical costs
Surveillance
• Some members may not participate in the WBA
• Via routine Claims Analysis and Predictive Model
runs, 100% of the population is continuously
evaluated & re-prioritized for program
intervention
Nurse Coach
• Team-based model targeted at high-
opportunity members
Risk/Cost Profile: Total Population
Self-Management (Web and Multi-Modal)
• Customized via members’ participation in the
WBA, a Well-Being Plan organizes web content to
serve the individual needs of the member self-
managing healthy behavior improvement
Costs
Readmission Avoidance Program
• Event-based rather than cohort-based
• The Discharge event and the member’s relative risk
index are considered in evaluating the need for an
outreach call
• Members’ transition from Hospital to aftercare are
coordinated to reduce readmission likelihood
69.
70. Source: Marc Prensky - Digital
Natives, Digital Immigrants published in
2001
Digital Natives born after 1996
Digital Immigrants born prior to 1996
Digital Nomads
Mobile Bohemian – Mobos
73. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
74. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Contact Information Directory
75. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Open Access platform for multitude of Caregivers
Contact Information Directory
76. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Open Access platform for multitude of Caregivers
Appointment Scheduling and Coordination
Contact Information Directory
77. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Open Access platform for multitude of Caregivers
Appointment Scheduling and Coordination
Escalation for unacknowledged messages or results
Contact Information Directory
78. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Open Access platform for multitude of Caregivers
Appointment Scheduling and Coordination
Escalation for unacknowledged messages or results
Nimble architecture – SOA based on Web Services
Contact Information Directory
79. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Open Access platform for multitude of Caregivers
Appointment Scheduling and Coordination
Escalation for unacknowledged messages or results
Nimble architecture – SOA based on Web Services
Middleware adapter and business logic for
outreach via text or IVR.
Contact Information Directory
80. Case & Disease Management – Workflow Mngt &
Assessments
Longitudinal Care Plans & Plan Adherence
Open Access platform for multitude of Caregivers
Appointment Scheduling and Coordination
Escalation for unacknowledged messages or results
Nimble architecture – SOA based on Web Services
Middleware adapter and business logic for
outreach via text or IVR.
Contact Information Directory
HIE protocol capabilities – HL7, SNOMED, LOINC
99. Recruit Individual into
Social Support Networks to
foster positive peer
awareness
Realign the FINANCIAL RI$K
shared among
Employers, Payers and
Employees toward a common set
of achievable goals
100. CARROTS
Commitment Contract - $$ gain for meeting period goals, $$ at risk for not
meeting goals
Daily Challenges – Organized daily or weekly challenges
among work peers (Biggest Loser), Pedometer competitions
STICKS
$500-$1000/yr Surcharge for non-participation in Biometric Screening
Tobacco usage – ranging around $2000/yr surcharge to Non-Hiring
policies of tobacco users
Thank you for attending this sessionTHE TOPIC this session is TECHNOLOGY CONSIDERATIONS FOR VALUE-BASED PAYMENTSMy name is John Squeo, TITLEVANGUARD HEALTH SYSTEMSInvestor Owned Health Delivery System28 HospitalsDOCTORS in 1000 Care settings across the United StatesInvestor-Owned Healthcare Service ProviderHeadquartered in Nashville VHS owns and operates acute care hospitals and outpatient facilities located in urban and suburban markets in the US28 Acute and Specialty Hospitals 40,000 Employees2012 Revenue $5,949 B2012 Adjusted Discharges 518,0002012 Adjusted EBITDA $575.7 MCurrently undergoing a major transformation in the way we are being compensated by the Payers such asMEDICAREMEDICAIDANDCommercial CarriersTHIS IS A BROAD TOPIC WITH A LOT OF INFORMATION SO PLEASE HOLD YOU QUESTIONS TO THE END UNTIL THE Q & A
According to the 2011 Annual Survey American College of Healthcare Executives – THE BIGGEST ISSUES FACING HOSPITAL CEOs
According to the 2011 Annual Survey American College of Healthcare Executives – THE BIGGEST ISSUES FACING HOSPITAL CEOs
Last week, Rep. John Lewis (D-Ga.) proposed the DSH Reduction Relief Act, which would delay Medicare and Medicaid DSH payment cuts until the government's 2016 fiscal yearIL Bill Status of SB2840 98th General Assembly Senate SponsorsSen. Heather A. Steans - John G. Mulroe"pay and chase" model to a prospective pre-payment model - Contains provisions concerning eligibility and payment verifications; data sharing; and the benefits of a pre-payment, post-adjudication, and post-edit claims system
YESTERDAY – MARILYN TAVENNER WAS CONFIRMED AS ADMINISTRATOR FOR CMS ON A 91-7 SENATE VOTEFIRST CMS ADMINSTRATOR SINCE DR. McCLELLAN BACK IN 2006
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
Big Box Concepts FAIL when competitors enter with better LOCALIZED Access & ConvenienceCONSUMER PRICE TRANSPARENCYThese amounts can vary widely. For example, average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Okla., to a high of $223,000 at a hospital in Monterey Park, Calif.Centers for Medicare and Medicaid Services, May 8, 2013
ACCESS TO A PROVIDER IS A KEY OPPORTUNITY TO REDUCE COSTSTORY - $150 OFFICE VISIT VS. $4000 ER VISIT FOR COPD PATIENT
ACCORDING TO THE US Agency for Healthcare Research and Quality
ACCORDING TO THE US Agency for Healthcare Research and Quality
ACCORDING TO THE US Agency for Healthcare Research and Quality
Dr. Ann Graybiel at MIT has performed research on the habits of RatsNerve fibers grow and strengthen creating Long-Term memory and behaviorsThe action becomes Hard Wired and mind has a tendency to use ROBUST neural linkages for instinctual or regular activitiesAnatomical Change versus Operational neural linkagesLike moving from doing things in flexible software to doing the task in a DSP or ASIC processor
Dr. Ann Graybiel at MIT has performed research on the habits of RatsNerve fibers grow and strengthen creating Long-Term memory and behaviorsThe action becomes Hard Wired and mind has a tendency to use ROBUST neural linkages for instinctual or regular activitiesAnatomical Change versus Operational neural linkagesLike moving from doing things in flexible software to doing the task in a DSP or ASIC processor
Dr. Ann Graybiel at MIT has performed research on the habits of RatsNerve fibers grow and strengthen creating Long-Term memory and behaviorsThe action becomes Hard Wired and mind has a tendency to use ROBUST neural linkages for instinctual or regular activitiesAnatomical Change versus Operational neural linkagesLike moving from doing things in flexible software to doing the task in a DSP or ASIC processor
Dr. Ann Graybiel at MIT has performed research on the habits of RatsNerve fibers grow and strengthen creating Long-Term memory and behaviorsThe action becomes Hard Wired and mind has a tendency to use ROBUST neural linkages for instinctual or regular activitiesAnatomical Change versus Operational neural linkagesLike moving from doing things in flexible software to doing the task in a DSP or ASIC processor
LEADS TO IRRATIONAL DECISIONS SUCH AS THIS PROVIDE COACHING TO PEOPLE TO HELP THEM RE-THINK THEIR OLD ASSUMPTIONSONE CLEAR OPPORTUNITY IS FOOD PORTION CONTROLREAL TIME TRIGGERS OR COACHING TO HELP THEM
LEADS TO IRRATIONAL DECISIONS SUCH AS THIS PROVIDE COACHING TO PEOPLE TO HELP THEM RE-THINK THEIR OLD ASSUMPTIONSONE CLEAR OPPORTUNITY IS FOOD PORTION CONTROLREAL TIME TRIGGERS OR COACHING TO HELP THEM
WHAT CAN TECHNOLOGY TELL US ABOUT POPULATION HEALTH?According to the National Institute of Health Care Management1% of Insured USED $90K per person in health care expenses in 20115% accounted for $41K per person50% of the insured average only $236 in health care expenses in 2011MAIN COST DRIVERS OBESITY RELATED HEART DISEASE Diabetes ArthritisOn Track in 2012 for !4,250 Transplants at average cost of $730K eachIF WE CAN IDENTIFY WHICH PEOPLE ARE HEADED TOWARDS THESE DISEASES, WE CAN INTERVENE EARLY ON AND AVOID THE HIGH EXPENSE
USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
USE PROBABILISTIC MATCHING ALGORITHMONLY IF NEEDED Hadoop HIVE Hbase for MAP REDUCE JOBS
Story of the new Apple IIc in 1984 for $1,550, that’s $3,450 (2012 dollars) Grandma asks me what I was going to use it for? My answer, I am going to do word processing and do spreadsheets. Grandma stated – That’s useless! For that much money! Where is the TV antennae? Can get the weather? Can it show me when things go on sale? We just laughed because clearly she DID NOT GET that this was something completely new and not a TV. Funny things is, I think I use my home computer to check the weather and buy things more than anything else. She was prophetic whether, intended or not. That story proves how hard it is to innovate or idealize a 3rd order horizon. Sometime is takes a person of incredible genius or incredible naivety to state a “game changing” prospect. “They did not know it was impossible, so they did it.” Source: Mark Twain Digital Natives 30 years old or youngerDigital Immigrants over 30Source: Marc Prensky - Digital Natives, Digital Immigrants published in 2001
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
Need for Semantical Interoperability
HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
HOW DO WE DO REACH THE PATIENT TO INFLUENCEGOOD HEALTH JUDGEMENTS?DIFFERENT METHODS OF OUTREACH WEB PORTALS EMAIL TEXTING SOCIAL MEDIA CALL CENTERS IVR INTERACTIVE VOICE RESPONSE SYSTEMS HOME HEALTH CARE – CASE MANAGERSPROMOTE EXERCISE AND DIETMEDICATION COMPLIANCESMOKING CESSATION PROGRAMS
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
Alan Snell CMIO – St. Vincent's’ Ascension Health, IndianapolisJacci Nickell, VP Development & Operations Delivery – Good Sam Society, Sioux Falls, SD
STORY OF REDUCING THE WEIGHT OF A PATIENT BY AN ACHIEVABLE TARGET TO REDUCE THE PROBABILITY OF ONSET OF TYPE 2 DIABETES
HABITS
QUESTIONS?>>>>>>>>>>>>>LISTEN TO AUDIENCE………..I WANT TO THANK YOU FOR ATTENDINGI CAN BE REACHED ON LINKEDIN by searching for JOHN SQUEO