the human diagnosis project€¦ · mission impossible: why the health center mission is not enough...

THE HUMAN DIAGNOSIS PROJECT

Mission Impossible: Why the health center mission is not enough to sustain your staff.

Seiji Hayashi, MD, MPH

Director of Medicine, Human Dx

October 20, 2017

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AGENDA

Meaning, mastery, and membership

Human Dx: Enhancing access, quality, and affordability

How the clinician community is leading innovation

Workforce Implications

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PROFESSIONAL FULFILLMENT & BURNOUT

Personal Resilience

Culture

of Well

ness Efficiency of PracticePROFESSIONAL

FULFILLMENT

Meaning, mastery and membership Well MD Center, Stanford Medicine,, 2016

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WHY PHYSICIANS JOIN HUMAN DX

• Human Dx unifies many sources of value for the doctor, increasing happiness and reducing burnout

• Multiple needs served in a single, simple activity that takes minutes

• Write once, write everywhere

Intrinsic rewards - Meaning - Mastery - Membership

Extrinsic rewards - CME - MOC - Peer review

Loan repayment

Meaning, mastery and membership

AGENDA




Workforce implications

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THE HUMAN DIAGNOSIS PROJECT.

A worldwide effort created with and led by the global medical community to build an online system that maps the best steps to help any patient.

Human Dx is a tandem 501(c)(3) tax-exempt nonprofit corporation and public benefit corporation registered in the State of Delaware.

Human Dx: Enhancing access, quality and affordability

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WHY WE’RE HERE


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PROBLEM: LACK OF ACCESS TO MEDICAL EXPERTISE

• 65 million Americans live in health professional shortage areas.

• 30 million receive primary care in the safety net system.

• 91% of safety net clinics report difficulty obtaining specialty care.

Source(s): US Census Bureau; HRSA Bureau of Primary Health Care; Commonwealth Fund


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SOLUTION: ALL OF US

Source(s): www.udsmapper.org


1,367 Health Centers

10,000 Sites

207,000 Staff

12,400 Physicians

11,500 NP, PA, CNM

6,700 Dentists, Hyg.

10,000 BH Providers

http://www.udsmapper.org

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SOLUTION: EXPAND PHYSICIAN ACCESS

• Increase specialty access through electronic consultations (eConsults)

• Strengthen primary care through training

• Increase availability of physicians by reducing burnout and administrative burden

Source(s): New England Journal of Medicine; Commonwealth Fund; Health Affairs

Monthly dispositions of primary care providers’ eConsult requests, by quarter, 2014-15

Num

ber o

f req

uest

s

0

500

1,000

1,500

2,000

2,500

2014-2015

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Resolved with no visitSpecialist visit scheduled


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VISION: TO EMPOWER EVERY PCP

Plan

CHECKLIST

Assessment

CHECK

SolveCreate


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SOLUTION: EXPAND PHYSICIAN ACCESS

• Increase specialty access through eConsults

• Improve quality through prospective peer review

• Strengthen primary care through education and training

• Increase availability of physicians by reducing burnout and administrative burden


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MISSION: MORE ACCURATE, AFFORDABLE, AND ACCESSIBLE CARE FOR ALL

=+ +

CROWDSOURCING

HUMANS

ARTIFICIAL INTELLIGENCE

MACHINES

DATA AND ANALYTICS

ORGANIZATIONS

COLLECTIVE SUPERINTELLIGENCE

HUMAN DX


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BENEFITS TO COLLECTIVE APPROACH

Source(s): BMJ 2015;351:h3480. “Evaluation of symptom checkers for self diagnosis and triage”, BMJ, 2015. Note(s): As of February 18, 2016. The human solve match rates represent the performance of HDx contributors (who have solved at least five cases and are 4th year medical student or higher) on ~121 cases that have been solved a minimum of ten times. The best symptom checker solve match rate (Symcat; 71% performance on BMJ cases) is based on a sample of 20 cases that the average contributor correctly solved 67% of the time. For this analysis, a case is correctly solved if the correct diagnosis is included in the final differential’s top three ranking. BMJ cases were omitted because of their lack of difficulty and clinical relevance. For comparison, Symcat correctly diagnosed 71% of the BMJ cases (95% confidence interval ~57% to ~85%), the average human ~80% (95% confidence interval ~75% to ~85%), and Human Dx ~92% (~80% to ~98%).

Best machine symptom checker Average doctor Physicians + Machine Intelligence

Solve rate (correct diagnosis in top three)

~20%

~67%

~93%


http://www.bmj.com/content/351/bmj.h3480

AGENDA





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HUMAN DX ALLIANCE FOR THE UNDERSERVED

How the medical community is leading innovation

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HUMAN DX ALLIANCE FOR THE UNDERSERVEDH U M A N DX N O N P R O F I T CO R P O R AT I O N ( N P C )

S A F E T Y N E T C L I N I C S S P E C I A L I ST S DATA + T E C H N O LO GY

NACHC:

Represent 1,300 clinic organizations

Reach over 90% of safety net clinics

Association of Clinicians for the Underserved

Migrant Clinicians Network

AMA:

Represent 800,000 doctors

Reach 25% of specialists

American Board of Int. Med

American Association of Medical Colleges

American Board of Medical Specialties

Human Diagnosis Project PBC:

Built eConsult system

Provide AI approach

Massachusetts Institute of Technology

Carnegie Mellon University


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IMPLEMENTATION PLAN

• National learning collaborative by NACHC

• Implementation toolkit developed for clinicians by ACU


2020

PUBLICLY ANNOUNCED THE ALLIANCE


AGENDA





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NONPROFIT BOARD MEMBER: DR. DON BERWICK

Workplace implications

“I recall many visits in my career to remote settings where capable and dedicated community health workers, nurses, and physicians were doing their best to bring high-quality care to desperately poor patients and families.

What each of these people needed was real-time access to advice, guidance, and team-based thinking to supplement and energize their strong motivation to do the right thing for their patients. They needed access to the best knowledge, no matter where it happens to reside. Absent modern technologies, it was hard to get that supply to them.

Now, it is possible.”

WORKFORCE IMPLICATIONS

TRAINING BURNOUT WORKFLOW SCOPE OF PRACTICE

• How will education, licensing and accreditation change to meet the new competencies required?

• Human Dx is being integrated into the education, licensing and accreditation process

• How will these tools increase or decrease burnout and physician satisfaction?

• Human Dx decreases the marginalization of physicians, while increasing physicians’ ability to uniquely impact current and future generations

• How will these tools increase or decrease physician productivity and impact physician workflows?

• Human Dx intends to become the system of record for physicians, a fast/intuitive/engaging interface for clinical documentation, billing, education, licensing and accreditation

• How will these tools change the nature of practice for physicians and non-physicians?

• Human Dx will enable physicians to manage more complex medical needs in primary care, allowing specialists to focus on rare and procedural cases

23Workplace implications

the human diagnosis project€¦ · mission impossible: why the health center mission is not enough...

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