m-health for cost savings and care management
TRANSCRIPT
M-health for cost savings and care management
Andy Arends
Managing PrincipalHealth Plan Innovation & Consulting, Dell
Phil Patterson
Executive Vice PresidentHealthNetConnect
2
Ag
en
da
Introductions
M-health – what are we really talking about?
What are we trying to accomplish?
What is keeping us from being successful?
A case study of success.
What is the path forward?
3
What does Dell know about healthcare?
Services
4
Dell health plan strength and numbers
Working with Top Health Plan Organizations
ACO StrategyA marketplace where provider and Payer can communicate through our secure hosting of provider records and payer claims –improving transparency for ACO adoption
Dell Private Exchange:Leveraging our learning's from the countries first exchange that is run by us at Massachusetts
Consumerism Assess and spread your reach to consumers through digital experience and mobility. Use Social Media to reach individuals for both sales and improving a payer’s brand image.
Everest GroupPositioned as Leader and Star Performer in Payer ITO Service Provider Landscape (2013)
Strength and Focus Dell Health Plan Facts and Figures:
More than 500technology partners
14,000+ Healthcare associates
globally. 6,000+ Healthcare
Payer associates globally
Serving 100+ insurance
organizations, Support for
100+ million policy holders
1.3M enrollments per annum,
98% of changes processed
within 48hrs
11M+ calls handled annually,
310k items audited
approximately each year
96M+ claims processed
annually, 99% of claims
processed within SLA
• Kaiser Permanente
• WellPoint
• Aetna
• CIGNA
• Humana
• Harvard Pilgrim Healthcare
• IEHP
• Emblem Health
• Blue Cross Blue Shield of Rhode Island
• UnitedHealthGroup
• Massachusetts Connector
• Community Health Plan of Washington
• Physicians Plus Insurance Corporation
• WellCare
• CareSource
• NAMM California
• WPS
• Delta Health
• Kern Health
• Blue Cross Blue Shield of Michigan
Horses for Sources (HfS)High Performer in the 2013 Blueprint Healthcare Payer Report
5
Dell remote & tele-health
6
Sources of innovation @Dell
Our customers’ most important challenges: clarity of strategy and sequencing of solutions
New offeringsLeveraged across multiple platforms and models
Hardware, infrastructure, and cloud computing
Software and integration Services
Dell’s domain expertise
Our work in other industries
External inputs and ideation
Our work with our healthcare clients
7
M-health—what are we really talking about?
Services
“(T)he use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status. Telemedicine includes a growing variety of applications and services using two-way video, email, smart phones, wireless tools and other forms of telecommunications technology.”
~American Telemedicine Association
9
Intel global innovation survey
10
Commercial Clinical
Pe
rso
nal
Pro
fess
ion
al
Personal activity tracking Blood testing
Mobile diagnosis
Retail clinic
Retail weight / BP High-risk pregnancy
Web appointment
Home fetal monitor
CHF readmission
Weight / sleep monitor
Where m-health is deployed today
Web coaching
11
Commercial Clinical
Pe
rso
nal
Pro
fess
ion
al
Apple
12
How are you using m-health today?
Remote visits2
Wellness support
3
Retail visits4
Remote monitoring1
Incentive programs
5
Not using at all
6
Poll the audience
13
Goals of m-health
Services
14
Goals of m-health
Economics
• Readmission reduction
• Reimbursement maximization
Quality
• More accurate / appropriate monitoring
• More proactive interventions
• More successful interventions
Engagement• HEDIS / CAHPS score improvement
• Member churn reduction
• Health / wellness engagement
Access
• Rural / provider constrained areas
• Efficient specialist access
• Timeliness / persistence of access
15
Poll the audience
What are the barriers m-health usage?
Technology platforms2
Cost3
Interoperability/integration
4
Provider engagement1
Lack of proven outcomes
5
16
Case study
Services
17
Deliver easy to use technology that empowers patients and healthcare professionals to collaborate on the management of the their health…while lowering costs and increasing the availability of healthcare.
Our VideoDoc solution provides an innovative virtual clinic that goes beyond video conferencing and consumer devices. VideoDoc is HIPAA and HITECH compliant and FDA and CE registered.
Healthcare Delivery, ReimaginedOur Mission / Our Solution
18
CMS 2015 COVERAGE FOR REMOTE MONITORINGPENALTIES FOR READMIT 2-3%
HEALTH PLAN AND PROVIDERS ROLE IS BLURRED
# OF PATIENTS INCREASING, # OF FACILITIES
INFLECTION POINT IN THE INDUSTRY
Why telemedicine?The time is now
19
Use Cases
Remote Medicine
• HC professional to HC professional
• Triage and/or Urgent Care
Remote Medicine
• HC professional to HC professional
• Triage and/or Urgent Care
Remote Patient Monitoring
• Patient to Healthcare Professional
• Uses: Chronic Disease Management
Remote Patient Monitoring
• Patient to Healthcare Professional
• Uses: Chronic Disease Management
20
• 11” Tablet given to patients for home use
• HIPAA and HITECH compliant videoconferencing solution
11” Venue VideoDocTM
VideoDocTM
• All-in-One Medical PC• Touchscreen• Perfect for physician
offices and hospital settings
23” VideoDocTM Cart
21
Handheld ECG
A Pilot Study of Integrated Tele-monitoring and Virtual Provider Appointments Department of Internal Medicine, Section of Cardiology, Providence Hospital and Medical Centers, Southfield, Michigan
23
Heart failure in the United States
*Centers for Disease
Control & Prevention
Point 4About half of people who develop heart failure die within 5 years of diagnosis.
Point 1About 5.1 million people in the United States have heart failure.
Point 2One in 9 deaths in 2009 included heart failure as contributing cause.
Heart failure costs the nation an estimated $32 billion each year.3 This total includes the cost of health care services, medications to treat heart failure, and missed days of work.
24
CHF study
Group 214 received standard care but added:
• Daily remote monitoring of blood pressure, heart rate, oxygen saturation, and weight via the Health Net Connect telemonitoring system for 3 months
• Received weekly video calls to discuss care issues, answer questions, and monitor compliance with medication regimens and office visits
Group 114 received standard care
28 patients enrolled in study, randomized 2 groups
There were no statistical differences in baseline clinical characteristics, laboratory characteristics or
heart failure medications between both groups
25
CHF study results
26
Addressing the barriers
• Collaborate in developing and rolling out the program• Provide additional support (e.g., clinical and member welcome
outreach / help desk)• Link to pay for quality
Provider Engagement
• Focus on clinical grade equipment and “light” platform that integrates• Simple reporting / registries that align with existing efforts• Create API / web service integration points for connectivity to health
plan and provider care management / EMRs
Technology Platforms / Integration
• Shared economic model integrated with other pay for quality efforts• Sufficient scale to spread costs across volumes• Integration with existing care management efforts• Outsource low value-add support
Cost
• Rewards & gamification• Clinician encouragement• “Out of Box” experience
Member / Patient Engagement
• Pilot and fail fast• Focus on the simple measures and programs
Proven Outcomes
27
Where to next?
Services
28
Where we’re investing
Care ManagementAnywhere deliveryLicensed and credentialed MDs and Nurses to provide care
Remote monitoring and care deliveryCutting edge remote monitoring and telemedicine solutions to ensure quality of care
Coordination of careHIE solutions to provide comprehensive view of patient care
Wellness and disease managementPatients take action on their own health through online tools
What about you?
