Surgery in the 21st Century

Evolution or Revolution?

Peter DorisSQAN 2013

System Redesign?

Operating Room of the Future

What’s a Surgeon?

What’s an Operation?

Who will monitor?

Overview

Market Innovations in an Era of Unprecedented Reform

Course Three – April 8, 2011Presented by Patrick Gauthier,

Director

What is Innovation?Two Types:

– Sustaining Innovations allow you to make incremental changes in order to do what you’ve been doing more efficiently or to produce a better outcome doing it. Adding correction ribbon to the typewriter is an example. Also allows you to maintain market share.

– Disruptive Innovations are fostered by outsiders who want to upend markets and the way things are done thereby totally transforming the business model. Napster (pre-iTunes), NetFlix, and Craigslist are good examples.

Elements of Disruptive Innovation

• Technology simplifies what has previously been complex

• Lower-cost financial model

• Value Network is economically coherent (mutually reinforcing)

Source: C. Christensen

The Act Does Several Things:•Expands Insurance Coverage•Institutes Insurance Reforms•Builds Infrastructure to Provide Improved Health Outcomes•Puts In Motion Structural Changes to how Healthcare Delivery is Structured & FinancedGoals of the Act:•Increase Access•Provide Comprehensive Care Better Health Outcomes•Control Costs

Patient Protection and Patient Protection and Affordable Care Act (ACA)Affordable Care Act (ACA)

One of the Most Important Innovations you can Implement this

Year (if you haven’t already)

The market not only

supports this change,

in many cases it will be required

Background: The Triple Aim

1. Improving health (outcomes)

2. Improving patient experience

3.Reducing per capita costs

Value

Goals & Objectives

Improve InpatientCare Efficiency

Use Lower CostTreatments

Reduce Adverse Events

Reduce PreventableReadmissions

Improve Prevention& Early

Diagnosis

Improve PracticeEfficiencies

Reduce Unnecessary

Testing & Referrals

Reduce PreventableER Visits &Admissions

Hospitals & Specialists

Primary Care

Improve Management of Complex Cases

Use Lowest-CostSettings and

Providers

Lower TotalHealthcare

Costs

Improve HealthOutcomes

Operating Room – Present?

SMH – recent OR Renovation

Operating Room of the Future

ORF – not just technology

ORF

• Cognitive Simulation• Informatics• Smart Image• Ergonomics/Human Factors

Pillars of a Smart, Safe Operating RoomF. Jacob Seagull, MD; Gerald R. Moses, PhD; Adrian E. Park, MDUniv of Maryland

| Workflow Times

Ten Cate et al J Vasc Surg 2004

What’s a Surgeon?

Data………BIG DATA

Wal-Mart knows more about it’s customers than we know about our patients

Driving by Looking in the Rear View Mirror

© 2009 IBM Corporation22

A Yottabyte?

What is a Yottabyte?

1000 GB = 1 Terabyte (TB)1000 TB = 1 Petabyte (PB)1000 PB = 1 Exabyte (EB)1000 EB = 1 Zettabyte (ZB)1000 ZB = 1 Yottabyte (YB)In other words, a Yottabyte = 1,000,000,000,000,000 GB.

© 2009 IBM Corporation23

Next wave content-centric web Apps---Massive Mashups

Semantic Web

Text Analytics, Sentiment Analysis,

Stream Processing Engines

Space Time Travel Data – The SuperFood of Analytics

Context Engines

Sensemaking Infrastructure

Data finding Data …..Relevance finding the User

Agenda

© 2009 IBM Corporation24

Advanced Analytics Focuses on the Prescriptive & Predictive

Degree of Complexity

Com

petit

ive

Adv

anta

ge

Standard Reporting

Ad hoc reporting

Query/drill down

Alerts

Simulation

Forecasting

Predictive modeling

Optimization

What exactly is the problem?

What will happen next if ?

What if these trends continue?

What could happen…. ?

What actions are needed?

How many, how often, where?

What happened?

Stochastic Optimization

Based on: Competing on Analytics, Davenport and Harris, 2007

Descriptive

Prescriptive

Predictive

How can we achieve the best outcome?

How can we achieve the best outcome including the effects of variability?

Why do companies need BI?

ANALYTICS(Tactical & Strategic)

What’s the best that can happen?

What will happen next?

What if these trends continue?

Why is this happening?

What actions are needed?

Where exactly is the problem?

How many, how often, where?

What happened?

Sophistication of Intelligence

DATA ACCESS & REPORTING(Operational)

Optimization

Predictive Modeling

Forecasting/extrapolation

Statistical analysis

Alerts

Query/drill down

Ad hoc reports

Standard reports

Co

mp

etit

ive

Ad

van

tag

e

© 2008 Accenture. All Rights Reserved.

Examples- Walmart

• Average daily sales of American Flags = 6,000 • September 11th 2001 • All competitors ran out of flags • Nearest rival sold 20,000 • Walmart sold 116,000 flags on that day alone

“Put the Power of Predictive Analytics in the Hands of Clinical Researchers”

Filippos KatsampourisMarketing Manager

Healthcare & Pharmaceutical Accounts

Leading clinicians have 4 tasks

1.Goal is shared & the action needed is collective

2.Ensure clinical microsystems can achieve the goals

3.Monitor system performance

4.Improve performance