Health innovation think tank key takeaways
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The document provides key takeaways and best practices for value-based care, connected health, and virtual care from a health innovation think tank. It discusses transitioning to value-based models, using data to address chronic conditions, connecting patients to community resources, and taking on appropriate levels of risk. It also emphasizes integrating connected health strategies and designing virtual care as part of the overall care model. The document outlines future goals of improving communication across organizations, enhancing patient engagement through technology, and reimbursing telehealth services.
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Health innovation think tank key takeaways
- 1. HEALTH INNOVATION THINK TANK Key Takeaway’s & Best Practices Justin Barnes Co-Founder Directly and unscripted from thought leaders on the front lines of healthcare
- 2. Value-based Care Key Takeaway’s • Begin to strategize about an organization-wide glidepath to transition from fee-for-service (FFS) to a value-based care model – When possible, start small with a portion of patient base or disease state – Scrutinize cost vs reimbursement, update policies, review business models • i.e. Quality Payment Program (QPP) is 95% FFS and only 5% VBC – Pay close attention to find proper alignment between acute and ambulatory incentives – Understand the tipping point when it makes sense to serve all patients through a VBC “lens” to reduce administrative complexity and better serve the patient. • 80/20 Rule – Success relies on 80% process, 20% technology and 100% on culture • Be cognizant of barriers to portability and scalability of best practices – Culture, Human Behavior, Policies, Incentives, Payer Mix, Patient Population, Technology, etc.) 2
- 3. Value-based Care Key Takeaway’s • Use data and allocate assets to address topologies of chronic diseases – Example – UPMC uses claims and other data to determine the topology of chronic conditions in specific geographic areas, enabling leaders to determine which locales have a high prevalence of chronic conditions (cancer, CHF, diabetes, etc..) and deploy proactive (instead of reactive) care engagement strategies to meet patient needs – Area deprivation index (ADI) – “colder” areas have higher health-spend rates • Claims/ transactional data is “old” so be cautious of basing VBC programs on transactional data. • For advanced VBC models, discuss managing disease at the household level rather than individual level; effects of all household members (Opioid example) 3
- 4. Value-based Care Key Takeaway’s • Leverage community resource to facilitate patient needs – i.e., community wellness programs and local grocery store nutritionist for diabetic care • Payer models need to reimburse more openly outside of their network to rightly support the patient and their needs (Best practice for both Value-Based and Virtual Care) • Research how the Direct Primary Care model is evolving locally and regionally • Examine reward and penalty system for physicians to improve outcomes – lead physicians to explore their office team structures – shared savings and shared risk (CPC+) • Watch the evolving trend of hospitals/health systems becoming “payers” • Be clear of patients’ end of life decisions (CPC+) 4
- 5. Value-based Care Key Takeaway’s Future Best Practice Goals • Some recommend providers be willing to take on more risk, others recommend providers hire appropriate staff/services to help address and assess risk • Additional physician and provider-led organization recommendations: – Take on more risk (a “best practice” recommended by most) – Learn to modify work flows to support value-based care and be in the “wellness business” – Create enhanced teams to delegate simple patient care, office management, patient care management (i.e., patient navigators, behaviorists, HIT-enhanced support), etc., to ensure that physicians maximize their time • Need to understand resource expenditures to produce true facility/ practice “costs” and not just what payers reimburse (Financial visibility and transparency across organization) • Wearables/IoT need to improve provider workflows and create actionable data 5
- 6. Value-based Care Key Takeaway’s Future Value-Based Care Best Practice Goals • Recommend both physician-led (bottom up) and health-system led (top-down) components to healthcare business models that offer the right input and flexibility • Recommend that physicians think in terms of value, as employers and not employees… this should start in medical school • Improve inter-organization communication, i.e. discharge summary to PCP same day of hospital discharge and schedule follow-up • Recommend that C-Suite members better leverage each other and work seamlessly together as one unit; one goal for organization. 6
- 7. Connected Health Key Takeaway’s • A successful Connected Health strategy includes three main components - Risk stratification, supportive technology and process redesign • Numerous recommendations that Patient ID matching across systems is imperative • Recommendations for Open Platform and open API infrastructures • Integration of disparate care into larger healthcare systems (minute clinics, etc.) • Understand total cost of ownership (TCO) for any possible solutions (5-year +) • Implement gamification to enhance usability and engagement (Patients, providers, etc..) • Patient interaction with the healthcare system is not linear. It is circular, continuous, and complex. 7
- 8. Connected Health Key Takeaway’s • UPMC - Driving vision of “bedless hospitals” • Healthcare is evolving to a collaborative care model • Understand how best to take on more risk for your entity and care strategy • Discharge patients with technology-enabled follow-up as well as support care (Best practice for both Connected and Virtual Care) 8
- 9. Connected Health Key Takeaway’s Future Connected Health Best Practice Goals • Recommend that organizations rearchitect the way they provide care: – Reduce the levels of “friction” in the system – i.e., efficient procurement of supplies, improved patient engagement – Think about “bedless” hospitals – allow folks to continue their lives outside the hospital while managing their care – “manage towards wellness” – Build trust and loyalty around innovation (“People buy into trust, not into products.”) – Connect consumer needs to easy-to-deploy solutions. Leverage technological advances whenever possible to reduce “friction” • Need privacy/security regulations that enhance the trust framework without stifling innovation 9
- 10. 10 Voice Assistants are Invading the Practice New research from DRG Digital/Manhattan Research suggests that physicians are already beginning to use voice assistants like Apple's Siri and Amazon's Alexa at work. In the company's annual "Taking the Pulse" survey of 2,784 physicians, 23 percent said they used a voice assistant "for professional reasons” VIRTUAL CARE & CONNECTED HEALTH Vital sign monitoring platform • Heart Rate • Respiratory Rate • Pulse Ox (SpO2) • Temperature • Blood pressure
- 11. Virtual Care Key Takeaway’s • Ask what does your organization want out from a virtual care strategy? – Attract customers, expand reach, reduce cost, enhance access, 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” • 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 11
- 12. Virtual Care Key Takeaway’s • 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) • Orbita example – How Amazon’s Alexa can be enabled with “Health Skills” and made HIPAA-compliant • 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 12
- 13. Virtual Care Key Takeaway’s Future Virtual Care Best Practice Goals • Understand how the new CMS CPT codes for telehealth can be used to support for virtual care strategy • Work towards all payers reimbursing and incentivizing for telehealth • Create “on-demand care” vs web-based physician appointment strategy • Have the mindset that telehealth is a solution and not a technology • Build telehealth into the fabric of health system and not as a stand-alone item • Provide adequate time for telehealth to have proper buy-in to support successful change management 13
- 14. Virtual Care Key Takeaway’s Future Virtual Care Best Practice Goals – Cont’d • Direct-to-consumer is the last mile of virtual care – the success of virtual care is based on the care model and how virtual care is integrated into every element of care…it’s so much more than the technology • Recommendation to properly educate C-suite/ leaders on definition, timing, development and financial models of virtual care. Misunderstanding with organization leadership can halt progress and encumber outcomes. • To make a timely impact with the release of telehealth products, must have mind set that “perfect can be the enemy of the good.” • Successful telehealth models will be patient-driven with telehealth being a “digital front door.” 14
- 15. Think Tank Collaborators • UPMC • Northwell Health • Thomas Jefferson University • University of Virginia Health System • Duke Health • Partners Healthcare • Resurgens Orthopaedics • Christus Health • UT Southwestern Medical Center/ Parkland Health • Boston University School of Medicine • Florida Association of ACOs • Children's Integrated Center for Success 15 • HHS/ ONC • Meditech • Cerner • Allscripts • CPSI • NextGen Healthcare • Change Healthcare • Philips Healthcare • Qualcomm Life • McKesson • MedAllies, Inc. • New York eHealth Collaborative • Practice Fusion • HIMSS/ HIMSS Media • VVVital • NeHII • Livongo Health • CURA Management • Orbita Inc. • WallerMD • Peerbridge Health • Commonwealth Health Advisors, LLC • LenovoHealth • Center for Connected Medicine (CCM) • Justin Barnes Advisors • Elevation Health Consulting • Sythios *Sampling of collaborators