Health IT Summit Chicago – 2014 – Keynote presentation “Consumerism and Connectivity” with David Levin, MD, CMIO, Cleveland Clinic Health System

1. mHealth: Consumerism & Connectivity
Dave Levin, MD
CMIO, Cleveland Clinic
CEO, Tres Rios Group, LLC
Dave@TresRiosGroup.com
@DaveLevinMD
©2014 Tres Rios Group. All Rights Reserved.

2. The Perfect Storm
• Value-based Care
• The Rise of Consumerism
• Explosion of Mobile Devices

3. At The Breaking Point ?
• US spends approximately 2.4
Trillion annually.
• US health care expenditures
expected to account for 17% of
GDP
• Expected to increase 2% above
economic growth rate
• Chronic Disease accounts for 70%
of health care costs
“Health Spending Projections Through 2019: The recessions impact continues,” Health Affairs. Feb 4, 2010

4. Health IT: The Story So Far…
• We have $pent a lot of
money.
• Adoption has increased
substantially for both MD
practices and hospitals.
• Mixed results for ROI/VOI
• Rising Financial challenges
• Increased scrutiny of HIT
expenditures
• Users and HIT
Professionals are
frustrated
No one is giving us 10’s …

5. Rx: From Volume to Value
• Volume: Today we get
paid to do stuff. Do more
stuff; get paid more
regardless of results.
• Value: Tomorrow we will
be paid based on the
actual results, not for
just doing stuff.
“If you can’t explain it to
your mom and dad, you
don’t really understand it.”

6. Volume Based Value Based
Provider Incentive Activity Clinical Results & Cost
Provider Payment Fee for Service Outcomes
Patient Role Passive ; Dependent Active; Engaged
Partnership
Care Model Acute; Episodic; Individual
Patients.
Continuous; Chronic
Disease; Prevention;
Individuals and Populations
Provider Role Silos of individual providers
or groups
Collaboration; Medical
Home; Teams; ACO’s
Analytics Retrospective; Fragmented;
Administrative
Real Time & Predictive;
Integrated; Clinical,
Operational & Administrative
Technology Stand-alone EMR; Enables
existing care models (cow
paths)
EMR-HIE; Enables new
care models; Virtual care

7. The Challenge: Living in Two Worlds
Fee for
Service
Pay for
Performance
Bundled
Payments
Full Risk
Models
Less than 11% of payments to hospitals and providers are Value based. The Catalyst for
Payment Reform has set a goal of 20% of payments to be value based by 2020
Source: Catalyst for Payment Reform

8. Delivery of Clinical Services: The Three “P’s”
Personalized (Zoom In)
•Highly customized for each individual
•“Omics”, Real Time Info, Individual Needs &
Tastes
Population-based (Zoom Out)
•Systems designed to care for large groups of
similar patients
Pervasive (Zoom Everywhere)
•Ubiquitous; Everything connected

9. “Every day I work in healthcare and then I go home
and live in the 21st Century.”
- Dave Levin, MD
Keynote Address, Healthbeat 2013
D

10. mHealth is the use of mobile and wireless devices to
improve health outcomes, healthcare services and
health research.
- National Institutes of Health Consensus Group
mHealth: Bringing Healthcare To People
www.mhealthbook.info
C
Global mHealth market estimated value at
6.6 billion in 2013. Expected to reach 20.7
billion by 2018 at a healthy CAGR of
25.5%.

11. Consumerism & Patient Engagement

12. Patient or Consumer?
• Transparency
• Transactions
• Trust

13. Should Patients Contribute
Data to their Record?
• Types of Data
- Demographic/Financial
- Status
- Clinical Outcomes
• Potential Benefits
- Engagement
- Efficiency
- Enhanced research
• What’s the down side?

14. Caregivers Are Consumers Too!
• ~40% of Adults are
Caregivers
• The “Panini
Generation”
• Caregivers affect
patient outcomes.
• Patient outcomes
affect Caregivers
too!

15. Case Study
A. Don’t forget
your
appointment
on Tuesday
with Dr. Smith
B. Did you have
any side effect
with your
meds
Patient’s
Daughter
Patient
Healthcare
Professional
All sharing
the same
view!
As ExperiencedAs Observed

16. Barriers
Privacy & Security
Infrastructure
Shifting Reimbursement Models
Culture
Design
Delivering REAL VALUE
EMR Integration

17. Apps or CrApps ?
 Secure and private
 Interactive
 Intuitive to use
 Portable across platforms
 Integrated into EHR /PHR
 Transmit data wirelessly
 User perspective
 Tested with intended audience
 Designed to meet personal need
 Designed to become part of
ecosystem (like Facebook)

18. ©2014 Tres Rios Group, LLC. All Rights Reserved.
Implementation
• New
• Replacement
• Deeper Clinical Impact
Transformation
• New Delivery Models
• Physical
• Virtual
• IT Enabled
• Analytics
• Transactional
• Mobile
Optimization
• Benefits Realization
• Planned?
• Measured?
• User (Dis)satisfaction
Skill / Demand
Tech IQ Hi Med Low
Operations IQ Low Med High
Strategic IQ Low Med High
Leadership Challenge Low Med High
Emotional Intelligence
(EQ)
Low Med High
Overall Benefit
(ROI/VOI)
Low Med High
Frustration Level High Med Low
Typical Path Towards HIT Benefits
©2014 Tres Rios Group, LLC. All Rights Reserved.

19. ©2014 Tres Rios Group, LLC. All Rights Reserved.
Implementation
• New
• Replacement
• Deeper Clinical Impact
Transformation
• New Delivery Models
• Physical
• Virtual
• IT Enabled
• Analytics
• Transactional
• Mobile
Optimization
• Benefits Realization
• Planned?
• Measured?
• User (Dis)satisfaction
Skill / Demand
Tech IQ Hi Med Low
Operations IQ Low Med High
Strategic IQ Low Med High
Leadership Challenge Low Med High
Emotional Intelligence
(EQ)
Low Med High
Overall Benefit
(ROI/VOI)
Low Med High
Frustration Level High Med Low
Typical Path Towards HIT Benefits
©2014 Tres Rios Group, LLC. All Rights Reserved.
Great Technology is Not Enough…
We Need Great Leadership!

20. Case Study
http://www.healthcare-informatics.com/blogs/david-levin/can-propeller-health-propel-us-future

21. Discussion
Dave Levin, MD
CMIO, Cleveland Clinic
CEO, Tres Rios Group, LLC
Dave@TresRiosGroup.com
@DaveLevinMD