the new healthcare model - collaboration is key

© Polycom, Inc. All rights reserved.

ACO’s, Care Collaboration, EHR -the role of Collaborative Video Solutions

Dr. Deborah A. Jeffries, Director US Healthcare

© Polycom, Inc. All rights reserved. 3

future

1990s 2000s 2009-2010 2011 2012 2013

Milestone

• Multi Million dollar PACS• Early Telemed Adopters• T1 lines• Expensive Equipment• Spotty coverage• Quality sketchy• License & Reimbursement issues

• Move to IP and WEB based• Browser based PACS 500K • Expansion of grant based telemedicine• Chronic DZ monitoring pilots

• Economy tanks• Baby Boomer Age• Doc shortage• Stimulus PKG• Affordable Care Act• 2 Billion to CHC• Billions from ONC• 7.2 Billion for Broadband• EHR

• Peer to Peer• Mobility• Cloud• 2-10 billion Innovation• Prevention Wellness• ACO• RE-Admits• EHR Roll out• Care Coordination• Payer/Provider

• PCMH• CMS Telemedicine

Codes Expanded• Grant funding for

collaboration• 11.5 Billion CHC• Accountable Care

Polycom Open, Standards Based, Scalable, Most Cost Effective, Customer focused

Polycom Tablet, CloudAxis

HD, RMX, DMA

CMA 100k licenses 1st month

History: Collaborative Video for Healthcare

Large Room Based Sys

POCN, Intelligent Core

Go to a special room for scheduled video

Video where and when you need it, desk, room, home, on the go


� ACO’s (Accountable Care Organization’s)− Medicare Model, Private Model, New Payment Models

� Care Coordination− Prevention and Wellness, Population management, Decreasing Readmits

� EHR: − Select/Plan/Implement/Support/Maintain

across orgs and geography

� All Require Collaboration/Coordination

HC Reform


ACO’s (Accountable Care Organizations)• Newly formed collaborative business model that

focuses on population management, and new payment models

• Comprised of Providers, Payers, Public Health, Health systems, Community members, Long Term Care, Patients, and families

• Goal is to keep patients healthy and to reduce cost of care and reward practitioners for best practices and patient outcomes

• Challenge is to collaborate across businesses, and geographic locations to optimize resources, including knowledge, expertise, and the power of peer to peer, face to face influence.


ACO’s (Accountable Care Organizations)• Payment Models

• Recent Health Innovation Grants:− 2012 Billion dollars for innovation: focused on inpatient, and heavy

focus on reducing emergency room visits, and enabling models similar to Coaching model

− 2013 Billion dollar innovation grant: focused on out patient, new payment models, and prevention and wellness

− Future 8 billion more? Are you ready? Reach out now, line up your relationships now

• Some thoughts:− Payers and providers partnering: predictive analytics and

population management, outreach, transitions of care, care coordination, telehealth

− Payers offering bonuses for better patient health, and outcomes

− Payers and providers partnering for population management


Care Coordination• Coordination/collaboration across

− Specialists

− Tumor Boards, Multi-disciplinary teams

− Organizations

− Hospitals, Primary Care Groups, Specialists Groups, Payers, Labs, Community Centers, Long Term Care, Public Health, Centers of Excellence

− Communities

− Schools, Community Centers, Churches,

− Populations

− Chronic disease, aging in place

− Care Teams

− Home care, Case Management, Discharge Planning, Hospice

• Benefit: better outcomes, more cost effective utilization of resources, decreased unnecessary readmits


Care Coordination Goals• Prevention and Wellness

− Target chronic disease

− Patient enablement

− Population management and outreach

− Avoid unnecessary costs

• Decreasing Readmits− Care coordination

− Regionalization of resources

− Case managers

− Education and safety programs

− Transitional care


Populations Management

� Disease Management− Diabetes

− CHF

− COPD

− Mental Health

� Nutritional Education− Childhood Obesity

− BP, HTN

� Public Service Updates− Cardiac and Pulmonary

Education

− Smoking Cessation

Prevention and Wellness: Community/Patient Education


Population Outreach• Are mailers effective?

• Do you change your behavior when someone sends you something in the mail? Or over email? Or just because your doctor says so?

• Peer to Peer medical education … − You want to lose weight, you doctor has told you that proper diet, and

exercise is the best approach… and given you a brochure..

− You meet with your friends for a card game, and several tell you that they have started walking 5 days a week and feel great, and have lost 10 pounds in the last 5 months,, without a diet change.. One mentioned getting a puppy and how much fun it is to walk, take to classes, and how she is getting out of the house more.. Another mentions that actually now that she is more active with her dog, she really isn’t eating as much and thinking about food as much…

• Why not the best of both worlds??? A live multipoint video for those interested in weight loss or smoking cessation with a healthcare expert supervising the discussion?


Decreasing Readmissions• Law went into effect Oct 1, 2012

• “About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates” (1).

• (1) RICARDO ALONSO-ZALDIVAR | October 1, 2012 04:27 AM EST | Associated Press


Re-Admits, Why are they high?• An avoidable re-admit could have been prevented

by:− (1) the provision of quality care in the initial

hospitalization− (2) adequate discharge planning− (3) adequate post-discharge follow up− (4) improved coordination between inpatient and

outpatient health care teams. (1)

• (1)Norbert I. Goldfield et al. Identifying Potentially Preventable Readmissions, Health Care Financing Review, Fall, 2008.


Re-Admits, Why are they high?

• Medicare Hospital Readmissions: Issues, Policy Options and PPACA (1) lists:

− An inadequate relay of information by hospital discharge planners to patients, caregivers, and post-acute care providers

− Poor patient compliance with care instructions− Inadequate follow-up care from post-acute and long-term

care providers− Insufficient reliance on family caregivers− The deterioration of a patient’s clinical condition− Medical errors

(1) Medicare Hospital Readmissions: Issues, Policy Options and PPACA Julie Stone, Specialist in Health Care Financing Geoffrey J. Hoffman, Analyst in Health Care Financing September 21, 2010


Collaboration is Key, B-to-B, B-to-C

• Case Management− Bring everyone to the table

• Discharge Planning− Live video discussion, written plan + video tips, video recorded

supportive education

• Post Acute Care− Live video to Case Manager or coach once home

− Follow up with Primary Care over live video

− Tablet accessible educational material on web portal

• Prevention and Wellness Programs− Live multipoint, interactive peer to peer educational sessions

− Stored version available

− Support patient wellness programs


EHR Electronic Health Record

• Early: The Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. Eligible professionals can receive up to $44,000 through the Medicare EHR Incentive Program and up to $63,750 through the Medicaid EHR Incentive Program

• Now: Medicare eligible professionals who do not meet the requirements for meaningful use by 2015 and in each subsequent year are subject to payment adjustments to their Medicare reimbursements that start at 1% per year, up to a maximum 5% annual adjustment.

• Eligible hospitals and CAHs that do not successfully demonstrate meaningful use of certified EHR technology will be subject to Medicare payment adjustments beginning in FY 2015


EHR: Collaboration is Key, B-to-B, B-to-C• Project Plan and Management

− Bring everyone to the table over video

• Selection− Live multipoint video for discussion, demo

• Implementation− Live video hand holding− Video Recorded FAQ’s and guidance

• Training− Live multipoint, interactive educational sessions− Streamed video− Stored version available− Consistent, timely, avoid travel, repeatable, easily tracked

• Support and Maintenance− Video interactive support, introduce changes more easily


HealthcareCollaboration

ONE-TO-ONE ONE-TO-MANY MANY-TO-MANY AD-HOC

• Case Mgr to Patient• Peer to peer• Patient to family member

• IT to End User

• Community health education

• Specialist to many patients

IT to Many for EHR

• ACO meetings• Community center to commuinty center

• Hospital to hospitalgroup meetings

• Virtual HC teams• Discharge Planning• Follow up calls• Transition support• IT to End User


Making Collaboration Available to Everyone

Content sharing with just a click and can be initiated by anyone in the meeting

All participants experience a secure, high quality experience

All have a secure high quality experience

Diabetes Exercise


Requirements

ACO’s, Care Coordination, EHR

All require collaboration across physical boundaries


Solution: Collaborative Video for Healthcare

Home Hospital Clinic Long Term Care

PatientMultipoint

Video

Education

One-to-one Video

Practitioner Consultation

Video Care Coordination

Family Video

Support

Video Health

Coaching

Recorded Video

Education


Polycom® RealPresence™

Platform

Community Health Center

Remote Medical Specialists

Physicians Office

PACS EHR

ITHospital Center of Excellence

Rural Treatment Center

Mobile

Desktop Room based

Telepresence

Collaborative Video for Healthcare

Practitioner Cart

RealPresence CloudAXIS


• ACO Operation and prevention and wellness programs can be enabled with collaborative video.

• Collaborative ubiquitous video can support continuum of care, case management, and discharge planning to extend care to the patient as they transition back to long term care or home and reduce Re-admits

• EHR can be rolled out with focus on user satisfaction and better utilizations using collaborative video

• Collaborative video solutions enable continuous patient centered care, and assist in reducing the cost of healthcare

Summary:


Polycom Grants Assistance Program (PGAP)

Grants for Healthcare


Who? What? When? Why? How? Who? Team of experienced grant managers What? Providing grant support to customers and grant projects When? Now! Grants pop up every day! Why?

• Why not? • Grants can fund major

initiatives that would be otherwise unaffordable!

How? Contact us to get started!


Spanning the Gamut of Telehealth

Rural Healthcare Healthcare Innovations & Research

Health Professions

Home Health & Health Outreach

RUS-DLT Healthcare Innovation (HCI)

HRSA - NEPQR MIECHV

Rural Health Network Development

PCORI DOL/ED H-1B Youth Career/Connect

Eliminating Disparities in Perinatal Health

Delta State Rural Network & Delta Health

NIH – Health Disparities grants

HRSA – Advanced Nursing Education

School Based Health Centers


New Grant Announcements • New grants pop up constantly!


Grant dollars often follow reform trends…. • HCI focuses on healthcare transformation –

• Keeping patients well • Reducing readmissions • Including the Continuum of Care • Creating a new payment model with incentives for

wellness/prevention • Rural Healthcare grants focus on equalizing access to all types of

healthcare resources • Healthcare patient wellness and prevention education • Access to specialty and sub-specialty care • Delivery of behavioral health services

• Health Professions grants focus on the need for a skilled workforce • Providing HC professions training to all areas (rural, suburban

and urban) all socio-economic groups and all ethnicities • Address the lack of qualified HC workers, and focus on

collaborative opportunities that take a “grow your own” workforce approach (H-1B YCC, H-1B and TAACCCT)


It’s not about the grant, or the technology….

It’s all about the application! • Identify your specifics need • Quantify your needs • Design a Project to address those needs • Articulate general benefits • Project specific outcomes

Most importantly… find a grant that’s the right fit for you!

Adam Kaiser AVP, Corporate Marketing

631-707-7428 [email protected]

www.ivci.com

http://www.ivci.com/

the new healthcare model - collaboration is key

Health & Medicine