tag luncheon: center for innovation
DESCRIPTION
TRANSCRIPT
TECHNOLOGY ALLIANCE GROUP
MARC PIERSON, MDPEACEHEALTH
Where we are going today:• CONTEX & CHANGES IN HEALTHCARE LANDSCAPE
– Changing financial incentives—How big an effect?• HISTORY OF HEALTH CARE INNOVATION WHATCOM
– CHR, HInet, Shared Care Plan, HIE– PURSUING PERFECTION
• Patient voice: Nav-Coach, SCP, Education & Training• Systems Dynamics Model
• INSIGHTS & OPPORTUNITIES for INNOVATION– Whatcom Alliance for Healthcare Advancement– P4Mi (Innovations in Biology & Behavior)
• Innovations in Systems Biology– Predictive and Preventive
• Innovations in Social Psychology– Personalization & Participation
– Innovation Ecosystems and SW Platforms--for Commercialization• On open opportunity
TAKEAWAYS
• Whatcom County is uniquely positioned today.• Medical business model is changing—creating
new technical opportunities• Technology needs &opportunities:
– Support individual behavior change• Use gamification: PERMA• Work for health both outside medicine and with the
medical system
– Support rebirth of vibrant neighborhoods
THE PROBLEM• COSTS are the highest in the world
– 2X Europe, Canada, Australia– Taking public funding from education– Putting US businesses at a severe disadvantage globally– Unsustainable
• POPULATION HEALTH has not been a major focus– 37th in the World– 5% of the money directed at 85% of the opportunity
• NOTE: NW US is more cost effective and higher quality than rest of the US but works under the same perverse incentives.
OURFUTURE
How to get upstream of illness?
WHATCOM--THE IDEAL PLACE & TIME forSYSTEMS INNOVATION
• Technology• Organization of healthcare delivery system
– With aligned incentives!• Public Health & Government• Systems Biology• Systems Medicine• Resilient Schools• Resilient Workplaces• Neighborhoods?
The Good News—A Technology Opening
• Historical focus on Consolidated-Monolithic organizations– Enterprise level transactional and analytical software
• Widening of focus -- include individual customers• New Opportunity for Application Development
– Congral’s Shared Care Plan Platform• Collection of personal data• Connection of all relevant actors• Coordination of action• Integrated with MS HealthVault (home monitoring, labs, meds, etc.)
– Supported Behavior Change (“compliance”)• “Games”, Gamification, PERMA, Jane McGonigal, SuperBetter
– Big Data• Todd Park, HealthData.gov & Overview Presentation
– Mobile health
THE KEY--Activated “Patients”
• The Critical Missing Players are:– Activated students– Activated workers– Activated patients– Activated citizens & families?
• What applications will help these actors be more successful?– SUPERBETTER?
The Bad News—Uncertainty about:
• Timing and location of the openings?– Innovation ecosystem matchmaker?
• Business relationships?• Access to healthcare delivery system?
• Interoperability with enterprise systems?– HealthVault certainly helps
• Customers for the applications?– Who benefits?– Who pays?
3 Big Changes
1. Baby boomers + Financial Crisis + Global Competition for Labor– ->Payment Reform
• From visits and procedures toward “Accountable Care”, Triple Aim
• 1) Population health, 2) Per Capita Cost, 3) Experience of Care
2. Networked & Activated Consumers– Global digital communication & information
3. Bioscience promise– Massive amounts of personal biologic data– Affordable, personal, trended data (4Ps)
TURNING POINT
(2001-2006)
--Accidentally through the eyes of “Patients”
• RWJF & IHI for 5 Years, @ $30M X 2• Europeans joined• Voice of Patients / Clients / Citizens changed the
possibilities dramatically• Three big ideas:
1. Navigator-coaches2. Web based personal health management platform3. On-going education and training of clients, often by
clients• Show stopper: Non-alignment of financial incentives
(winners and losers)
Redesign US Health Care System
SOURCE: We Can Do Better — Improving the Health of the American People,” Steven A. Schroeder, M.D., New England Journal of Medicine, 2007, page 1222.
The Case For More Active Policy Attention To Health Promotion, Health Affairs, 2002;21:78-93McGinnis
Proportional Contribution to Premature Death in USMORE THAN
MEDICINE IS NEEDED
Health & Wellness Require Social AND Technological Innovation
Peop
le in
Rel
ation
ship
Tec
hPractices (habits)
New Behaviors
Commitments
Conversations
Communication
Information
Data/ToolsPr
edic
tion
Prev
entio
n
Pers
onal
ized
Parti
cipa
tion
Resilience Training & Coaching
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Supporting the Communitythrough
Health Information Technology
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Shared Care Plan, Transitions of Care Module, Care Manager Workstation
A suite of tools for patients, their family caregivers,
and health professionals
The Shared Care Plan, a PHR connected to MS Health Vault, the State Immunization Registry , PH -SJMC EMR and more.
www.sharedcareplan.org
The Transition of Care Module – patient facing, interactive content designed to facilitate what should be happening post discharge, for chronic disease management and prevention.
The Care Manager Workstation – enter discharge or home care instructions, track a panel of patients, see
who needs encouragement and intervention
Transforming Healthcare in Whatcom County
W H ATC O M A L L I A N C E F O R H EA LT H C A R E A C C E S S
L A R R Y T H O M P S O N , E X E C U T I V E D I R E C T O R
T E R E S A L I T T O N , A C O D E V E L O P M E N T M A N A G E R
Health Advancement
Health Advancement
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A community-wide, level 4 ACO
Rippel Foundation: ReThink Health Simulation model of Whatcom County
Bridge Project Pilot
Dual Eligible Pilot
Dental/Primary Care Integration
Pilot
Advanced Care Planning Initiative
Project Impact: Care Coordination
Phase IIDevelopment Committees
Phase II & IIIPilots and Projects
Transforming Healthcare
Project
Whatcom Community
Health Association/
Steering Committee
Accountable Care
Organization Task Group
Health Home Collaborative
Behavioral Health &
Primary Care Integration Specialty
Provider Task Force
Whatcom Care
Coordination Advisory
Committee
Community Organizing Group for
Health
Health Information
Exchange Task Force
Integrated Health System
Whatcom Community Health Association
Accountable Care OrganizationPerson-Centered Wellness
Transforming Healthcare in Whatcom County
Whatcom Today
HInet: Hardware, Connective Wiring, and Communication/E-mail Platformand
Shared Care Plan: A Portable Community-Wide Personal Health Record
Pharmacies Physician Offices Hospital Systems Other ProvidersMental health, long term
care, Imaging, labs
Other ProvidersPublic Health, Social
Services, EMS
Practice Management Systems
Practice Management Systems
EMR systems (~20)and
Practice Management Systems (~20)
EMR systems (~20)and
Practice Management Systems (~20)
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
Enterprise Information Systems
Enterprise Information Systems
Care Coordinators
Care Management Systems
Whatcom Community / WCHA
Satisfaction Improvement
Quality Improvement
Cost PerformanceImprovement
ACO—Achieving the Triple Aim
HInet: Hardware, Connective Wiring, and Communication/E-mail Platformand
Shared Care Plan: A Portable, Community-Wide Personal Health Record
Pharmacies Physician Offices Hospital Systems Other ProvidersMental health, long term
care, Imaging, labs
Other ProvidersPublic Health, Social
Services, EMS
Practice Management Systems
Practice Management Systems
EMR systems (~20)and
Practice Management Systems (~20)
EMR systems (~20)and
Practice Management Systems (~20)
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
Enterprise Information Systems
Enterprise Information Systems
Care Coordinators
Care Management Systems
Health Information Exchange
Whatcom Community / WCHA
Satisfaction Improvement
Quality Improvement
Cost PerformanceImprovement
ACO—Achieving the Triple Aim
HInet: Hardware, Connective Wiring, and Communication/E-mail Platformand
Shared Care Plan: A Portable Community-Wide Personal Health Record
Pharmacies Physician Offices Hospital Systems Other ProvidersMental health, long term
care, Imaging, labs
Other ProvidersPublic Health, Social
Services, EMS
Practice Management Systems
Practice Management Systems
EMR systems (~20)and
Practice Management Systems (~20)
EMR systems (~20)and
Practice Management Systems (~20)
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
Enterprise Information Systems
Enterprise Information Systems
Care Coordinators
Care Management Systems
Health Information Exchange
Data Repository: Clinical and Claims DataReceipt and storage of data for look up and analysis
Whatcom Community / WCHA
Satisfaction Improvement
Quality Improvement
Cost PerformanceImprovement
ACO—Achieving the Triple Aim
HInet: Hardware, Connective Wiring, and Communication/E-mail Platformand
Shared Care Plan: A Portable Community-Wide Personal Health Record
Pharmacies Physician Offices Hospital Systems Other ProvidersMental health, long term
care, Imaging, labs
Other ProvidersPublic Health, Social
Services, EMS
Practice Management Systems
Practice Management Systems
EMR systems (~20)and
Practice Management Systems (~20)
EMR systems (~20)and
Practice Management Systems (~20)
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
Enterprise Information Systems
Enterprise Information Systems
Care Coordinators
Care Management Systems
Health Information Exchange
Data Repository: Clinical and Claims DataReceipt and storage of data for look up and analysis
Whatcom Community / WCHA
Satisfaction Improvement
Quality Improvement
Cost PerformanceImprovement
ACO—Achieving the Triple Aim
Analytic Systems: Software and personnel
HInet: Hardware, Connective Wiring, and Communication/E-mail Platformand
Shared Care Plan: A Portable, Community-Wide Personal Health Record
Pharmacies Physician Offices Hospital Systems Other ProvidersMental health, long term
care, Imaging, labs
Other ProvidersPublic Health, Social
Services, EMS
Practice Management Systems
Practice Management Systems
EMR systems (~20)and
Practice Management Systems (~20)
EMR systems (~20)and
Practice Management Systems (~20)
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
EMR systemsand
Practice Management Systems
Enterprise Information Systems
Enterprise Information Systems
Care Coordinators
Care Management Systems
P4Medicine InstituteISB, PeaceHealth, Ohio State University, others to be added
• Applied Genomics• Applied Proteomics• Personal data clouds• Resilience support
– Training– Coaching– Support applications (SUPERBETTER,
positivityratio.com,
TEDxRainier - Leroy Hood - Future of MedicineDanny Hillis talks Proteomics & Personalized Medicine
The Network of Networks
Scientists use network paradigms to organize, integrate and model data and enormously increase the signal to noise
• Unprecedented levels of education and access to information through the Internet
• Able to self-organize using new social networking tools
• Determined to better understand their own personal health situation / issues
• Able to find innovative solutions for better managing their own health and that of the people they care about
Networked and Activated Consumers
PersonalizedData Clouds
Genomics,Proteomics, etc
Medical history
Demographic
Environmental
Psycho/Social
Data analysis
Systems biology
Social science
Cultural expertise
ActionableInformation
New products
More cost-effectiveuse of existingproducts
Useful information not bundled with product
HealthcareStakeholders
Clinical service Physicians Coaches
Patients/consumers
Discovery scienceInstitutions
Actionable Information
Input Value Added Digital Product Used By
The P4 Innovation Cycle
Advances in Discovery Research
Comprehensive personalized data cloud
Personalized actionable information
New Data re Health outcomes
Improved healthcare
Intellectual Property
• Only a community can– Build a new value network based on monetizing
improved health (WAHA)– Implement new business models– Activate self-sustaining cycle of accelerating
innovation• The early community microcosms
– Whatcom County + P4Medicine Institute– Other NW communities and beyond
It Takes a Communityto integrate technological and social innovation
“PeaceHealth Center for Innovation”
• We have been exploring the possibilities for stimulating or creating a Health Innovation Network or Ecosystem
Big Idea—For LaterA Connected Health (Innovation) Ecosystem
(CHE)
• Components• Locale• Organizers• Funding• Mechanisms
THANK YOU
(360) 739-2728
IDEAS FOR A Connected Health Ecosystem
(CHE)
March 2011
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Connecting Health ventures and regional Health Communities
• The Vision is the Northwest as a leader in Connected Health innovation and commercialization for health and healthcare improvement across all populations
• The Mission is to develop and cultivate an ecosystem to accelerate the development and value of early stage companies
• Complementary goals are regional economic development, job creation, and return on investment
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Opportunity to bring needed Connected Health technology to market faster
• Aging population needs and wants– Doubling of 65+ population; aging in place and independently
• Regional representative demography & health conditions– WA and OR together are representative of the nation’s demographic and health
condition
• Demand from health communities (ACOs)– RWJF “Pursuing Perfection Grant” “Remaking American Medicine” patients as
teachers; Tech4Impact Grants
• Demand from government (ACOs)– Reform; Readmission Penalties; Accountable Care (ACO); CMS, VA and HHS innovation
initiatives
• Regional expertise– Microsoft, Intel, Philips, Healthcare Providers, Universities, Venture Community,
Technologists, Senior Care Companies
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Connected Health is Patient- and Consumer-Centric Approach to health & wellness
• Tech-Enabled tracking, communicating and managing of health data outside of traditional care venues
• Sharing care management information & support among networks-care providers, caregivers and peers
• Outcome oriented-drive preventive, promotive & curative outcomes
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CHE
Test Bed
B
Test Bed A
VCs
Connected Health
Solutions & Features
SOURCE MATCHM
ATCH
MAT
CH
CHEC sources from candidate pool
To meet the need we should assembled a unique resource – a health community test bed
PeaceHealth is initial health communityTRIAGE
Vetted solutions are piloted in the test
bed
CHE presents solutions based on needs
assessed for each test bed
CHE refers non-match but worthy deal flow
to capital sources
VET60-70% from
PNW
CHEC’s sweet spot is tech-enabled solutions that improve care delivery and quality, access and engagement
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VENTURELIFECYCLE Idea
Post Revenue
Consumer/Patient
SOLUTIONS FOCUS
HC Institution
CONNECTED HEALTH
MEDICATION ADHERENCE
ANALYTICS
REMOTE MONITORING
CARE NETWORKS
DISTRIBUTED CARE
DECISION SUPPORT
Congral, a healthcare applications development start-up, is proof of concept for CHEC’s process
Input from patients, practitioners and hospitals define initial needs and interest (PeaceHealth community)
Congral solution selected and test launched
Test launch yields 2nd level of user input:• Rules engine and care manager cockpit integrated with Shared Care Plan• Mobile access to online data added to roadmap
Acquisition of new clients following pilot illustrates viability of solution in other health communities
Congral primed for funding & partner development based on successful test and new customer interest
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Congral powers a personal health record (Shared Care Plan) and care management workflow system for 5,000 patients in Whatcom County, WA
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15
12
13
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NEEDS ASSESSMENT
PILOT LAUNCH
SOLUTION ENHANCEMENT
CUSTOMER DEVELOPMENT
FUNDING READINESS
TIMELIN
E
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CHE leverages partner contributions at multiple levels of commitment
INVESTOR
GOVERNANCE
PHILANTHROPIST
CONSORTIUM MEMBER
ADVISORY COMMITTEE
REFERRAL SOURCE
FOLLOW-UP SUGGESTION
• Local Seminar– Focus on intersections of
• Seed money• Health system access• Rapid cycle development and deployment
PERSON-CENTRIC RADICAL REORIENTATION FOR OUTCOMES
1. Coach and coordinate health care2. Improve routine preventive and chronic physical
illness care3. Provide adherence support for routine care4. Improve care for chronic mental illness5. Enable healthier behaviors6. Improve post-discharge care to reduce hospital
readmissions7. Extend the use of hospice care (end of life choice)
From ReThink Health, Fannie E. Rippel Foundation
Best Possible Outcomes at 2040
Best Possible Savings in Whatcom