Croke Park, 14th February 2017

Transforming Health through Innovation and Digital Dr. Robert Williams, MD Life Sciences & Healthcare, Deloitte Consulting

What are the outcomes that we want to improve?

What some folks have said about making better decisions . . .

‘I never guess. It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.’ -Sir Arthur Conan Doyle

‘Facts do not cease to exist because they are ignored.’ -Aldous Huxley

‘If you don’t know how to ask the right question, you will discover nothing.’ -W. Edward Deming

Delivering safe and effective care

First,

Do no harm.

Do things well.

Do the right things

well.Provide optimal care and

service to patients,

families, and care givers..

Safety

EffectivenessStandard

order sets

Evidence-based

practice

Culturally

appropriate

Protocols

Length of

stay

Demand

matching

Avoid overuse

Avoid misuse

Avoid under-

use

Timeliness

Measurement &

feedback

Pharmacy &

therapeutics

Hospital-acquired

infection

prevention

VTE prophylaxis

Medication

reconciliation

Pressure sore

avoidance

Medication error

reduction

Mortality

reduction

Elimination of

wrong surgery

Fall prevention

Financial Stability

CitizenSatisfaction

Patient experience

1

1

2

3

2

3

Acute Care Primary Care Population Health

Selected examples of what can be achieved

• Safety, effectiveness and efficiency

• Medication management: prescribing, dispensing, administering

• Patient-centred, effectiveness, timeliness

• Prevention

• Chronic disease management: medical and behavioural

• Big bucket opportunities: analytics: financial and clinical

• Individuals at higher risk: stratification and targeted interventions

• Effective, efficient, equitable, patient-centred, timely

• Chronic disease management: care coordination

• Social determinants of health

http://www.edenmedicalcenter.org/yourstay/medication.html http://www.libdems.org.uk/investing-2-5bn-in-providing-patient-care-closer-to-home http://health.gov.ie/publications-research/statistics/statistics-by-topic/demographics/

What other folks have said about making better decisions . . .

‘Data! Data! Data! I can’t make bricks without clay!’ -Sir Arthur Conan Doyle

‘Errors using inadequate data are much less than those using no data at all.’ -Charles Babbage

‘A point of view can be a dangerous luxury when substituted for insight and understanding.’ -Marshall McLuhan

In-home sensors monitor activity levels for people with functional impairment in order to identify potential problems and adverse events earlier

Remote monitoring options for extending Care Management

Motion or “Activities of Daily Living”

Monitoring of vital signs to assess status of a particular illness in members with high disease burden

Interactive Voice

Response [IVR]

Telephonic and/or web-based health survey questions to elicit self-reported symptoms & biometric readings

Biometric Video Visit

Two way audio-video communication in order to interact with sickest members as an adjunct to home visits

Personal Emergency Response

[PERS]In-home emergency response system for people who live alone or with limited caregiver support

Passive monitoring Active monitoring

Monitoring activities of daily living:

Health sense’s eNeighbor System

• 11 sensors and a home/away pendant installed in member home

• eNeighbor analyzes sensor data using algorithms to detect abnormalities in member home

• Alerts generate recommended interventions

Call pendant

Contact sensor

Motion sensor

Bed sensor

Toilet sensor

I’m okay sensor

What other folks have said about making better decisions . . .

‘The value of an idea lies in the using of it.’ -Thomas A. Edison

‘If you can’t explain it simply, you don’t understand it well enough.’ -Albert Einstein

‘An idea not coupled with action will never get any bigger than the brain cell it occupied.’ -Arnold Glasow

Other future technologies, but core first

• Research• Omics• Personalised /

Precision Medicine• Advance care

management • Apps

Population Health

The broader opportunity for integrated care . . .

•Big bucket opportunities: analytics: financial and clinical•Individuals at higher risk: stratification and targeted interventions•Effective, efficient, equitable, patient-centred, timely•Chronic disease management: care coordination – INTEGRATED CARE•Social determinants of health

http://health.gov.ie/publications-research/statistics/statistics-by-topic/demographics/

In Sum, digital alone is insufficient . . . it’s not about the shiny objects

There are hosts of failures to learn from, as well as successes.

It should be clinically and operationally led, enabled by technology.

Change and engagement: doctors, social care, other clinicians and citizens are paramount

Focus on core components of electronic medical and social records in all settings and integrate them.

Then based on data, use core analytics and in the future more advanced analytics.

Acute Care

Primary Care

Population Health

‘Once we know something, we find it hard to imagine what it was like not to know it.’ - Chip & Dan Heath, Authors of Switch

Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited (“DTTL”), a UK private company limited by guarantee, and its network of member firms, each of which is a legally separate and independent entity. Please see www.deloitte.co.uk/about for a detailed description of the legal structure of DTTL and its member firms.

Deloitte LLP is the United Kingdom member firm of DTTL.

This publication has been written in general terms and therefore cannot be relied on to cover specific situations; application of the principles set out will depend upon the particular circumstances involved and we recommend that you obtain professional advice before acting or refraining from acting on any of the contents of this publication. Deloitte LLP would be pleased to advise readers on how to apply the principles set out in this publication to their specific circumstances. Deloitte LLP accepts no duty of care or liability for any loss occasioned to any person acting or refraining from action as a result of any material in this publication.

© 2017 Deloitte LLP. All rights reserved.

Deloitte LLP is a limited liability partnership registered in England and Wales with registered number OC303675 and its registered office at 2 New Street Square, London EC4A 3BZ, United Kingdom. Tel: +44 (0) 20 7936 3000 Fax: +44 (0) 20 7583 1198.