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Judy Murphy, RN, FACMI, FHIMSS, FAAN Chief Nursing Officer IBM Global Healthcare & Life Sciences September 1, 2016 Patient Engagement to Promote Population Health Management

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Page 1: View webinar slides

Judy Murphy, RN, FACMI, FHIMSS, FAAN

Chief Nursing Officer

IBM Global Healthcare & Life Sciences

September 1, 2016

Patient Engagement to

Promote Population

Health Management

Page 2: View webinar slides

Housekeeping

1. Using the control panel - Use the control panel on the right side of your screen to minimize and expand this panel by clicking on the arrow in the upper right corner.

2. Ask Questions - You can submit questions using the Question section located near the bottom of the control panel. We will take time to answer as many questions as we can during Q&A at the end of the presentation. If your question was not answered, we will respond to you individually after the event.

3. After the webinar - We want your feedback! Please take the short survey at the completion of the webinar. Also, all registrants will receive a copy of the presentation, and the recording for on-demand replay.

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© Copyright International Business Machines Corporation 2016All Rights ReservedPrinted in the United States of America (September 1, 2016)

The following are trademarks of International Business Machines Corporation in the United States, or other countries, or both.

Other company, product, and service names may be trademarks or service marks of others.All information contained in this document is subject to change without notice. The products described in this document are NOT intended for use in implantation, life support, space, nuclear, or military applications where malfunction may result in injury or death to persons. The information contained in this document does not affect or change IBM product specifications or warranties. Nothing in this document shall operate as an express or implied license or indemnity under the intellectual property rights of IBM or third parties. All information contained in this document was obtained in specific environments, and is presented as an illustration. The results obtained in other operating environments may vary.

THE INFORMATION CONTAINED IN THIS DOCUMENT IS PROVIDED ON AN “AS IS” BASIS. In no event will IBM be liable for damages arising directly or indirectly from any use of the information contained in this document.

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What we will cover

• Evolving healthcare landscape – what is changing and

why we need to change too

• Population Health Management

• Reimagining Health and Healthcare with Mobile

• Population Health Management requires Patient

Engagement

• Emerging Consumerism and eCommerce

• The Need for Analytics

• The Era of Cognitive Computing

4

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Healthcare transformation is happening, driven by fundamental shifts

in expectations and critical drivers

Expectations for better

quality, value and outcomes

Escalating incidence and cost

of chronic disease

Changing demographics

and lifestyles

Globalization of health care

Critical resource shortages

Increased competition and

new entrants

Advances in technologies

and treatments

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Old Healthcare New Healthcare

Fee for service Pay for performance

Volume Value

Delivery Quality Outcome

Employer-centric Consumer-centric

Prices unknown Cost transparency

One way dialogue Engaged & mobile

Transactional Brand loyal

Data poor & disconnected Integrated rich “big” data

Reactive Predictive & prescriptive

Standards Personalized & optimized

This transformation is an evolution …to a new model for healthcare

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Healthcare is moving to a system focused on value, coordinated around

the individual, and integrated into our communities

Focus is on value, coordinated

around the individual and

integrated into communities

Emphasis is on proactive care

to help meet health needs

Payment will be based on

value and outcomes

Care is standardized

according to evidence-

based guidelines

We measure quality and will

make rapid changes to

improve it

Data and Information

Understand and

influencetheir

populations

Evidence-based andstandardized care planning

Coordinationacross

boundaries-- share care,

accountabilityand risk

Individualengagement

andempowerment

Quality measurement

andperformance

reporting

Social Worker

BehavioralHealth

Family

Community

Palliative Care/

Hospice

Rehabilitation

Home Care

Specialists Intensivist

Physical Therapist

Dietician

Case Manager

Caregivers

Transportation

Housing

Medications

Funding and

Payment

Primary

Care

7

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The new model is Value Based Care – centered around the patient

Value = ExperienceCost

Taking steps to achieve better results, and improve customer (patient) satisfaction

Reducing waste, reducing

errors, managing risk, improving efficiency and quality

Organizations

are on a journey to improve value

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Population Health Management

HEALTHY / LOW RISK CHRONICAT RISK

ACTIVE

DISEASE

No or very-low touchMedium to

high touchLow touch

High

touch

40-60% 5-15%20-25% 2-3%

60+

5-10% 30-40%15-20% 40-50%

RISK

STRATIFICATION

POPULATION

RELATIVE

COST

ENGAGEMENT

Fully automated

Validate from data

Blended -

retail outlet,

care mgt,

automated

Mostly automated

with email, call,

text, mobile app

Active

Case

MgmtOUTREACH

Capability Needs

• Data (internal-external)

• Scalable platform/data

management

• Risk analytics &

management

• Insight analytics

• Similarity analytics

• Cost of care analytics

• Actuarial analytics

• Marketing analytics

• Marketing management

• Predictive modeling /

next best action

• CRM

• Campaign

management

• Outreach advisor

• Remote data capture

• Mobile apps

• Network analytics

• Care coordination tool/

clinical integration

~20% of population

drives ~80% of cost

ENTIRE

POPULATION

9 http://archive.ahrq.gov/research/findings/factsheets/costs/expriach/expendria.pdf

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Reimagining Health Care with Mobile

1

0

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Mobile is being exploited to:

Facilitate anytime anywhere access to data and extend services beyond traditional settings

Develop new engagement techniques and health strategies with patients and consumers

Gain insights to provide more personalized, proactive interventions; bring analytics to the point of care

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Imagining Care Anywhere Vision

https://www.youtube.com/watch?v=UOMtWFeyscg

12

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The Power of Patient Engagement:

Population Health Management requires Patient Engagement

Capture and incorporate

preferences

Personalize offerings

and services

“Know me”

“Engage me”• What’s my history?

• What are my preferences?

• How will I respond?

• What will motivate me?

• Respect my privacy• Engage in the preferred dialog

• Be relevant (“right information”)

• Be consistent across touch points

• Show sincerity -- “you care”

Innovate to deliver quality,

convenience and total

experience

“Empower me”

• Give me the information I need

• Connect me with relevant communities

• Simplify control and access

• Enable action and convenience

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Trends Supporting Greater Patient Engagement

The way we pay for and deliver care is changing.

Health IT adoption has reached a tipping point.

Technology is getting better, cheaper,

faster and more ubiquitous.

Consumers increasingly expect online

engagement, in all aspects of their lives.

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Integration of health in our lives

https://www.youtube.com/watch?v=-zh9fibMaEk

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So what is driving “Consumerism” in healthcare?

• Cost shifting – “out of

pocket” costs are increasing

for individual healthcare

consumers

• There is an increase in the

use of High Deductible plans

and Health Savings Accounts

(HSAs), leading to more

consumer price sensitivity

• New business models for delivering care are emerging, providing people with more “choice”

16

http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/cvs-caremark/what-retail-clinic-growth-can-teach-physicians-about-pat

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Health Plan Engagement App Demo

https://www.youtube.com/watch?v=brtucoXRbTA

Consumer “Shop & Buy” activities

17

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Successful healthcare organizations thrive by using analytics

as a core strategic foundation

Early and accurate insights on member

health risk and utilization to inform Financial / Actuarial decisions

Patient-360 insights to inform Medical Management in

chronic disease & episode

management

Insights into referral patterns and

provider quality to support Network

Design and Management

Inform program design & operations for Marketing &

Sales and Customer Service with insights on consumer preferences &

triggers

PopulationHealth

Risk Management

ConsumerEngagement

ProviderRelations

Su

pp

ort

B

usin

ess

Fu

nc

tio

ns

Imp

ac

t C

on

tin

uu

m o

f C

are

Sample Analytics Applications

Facilitate insights exchange &

messaging across care team members. Inform

incentives design.

Enabling analytics to empower ACOs and

providers to succeed in value-based payment transformation

Next best action analytics leveraging

near real-time data to optimize omni-

channel consumer engagement

Provide tools to providers to enhance risk

stratification andclinical decision

making

Care Path Mining

Network Optimization

Personality Insights

Consumer Segmentation

RiskStratification

Utilization Prediction

Cost Patten Detection

Channel Optimization

Resource Allocation

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What are the treatment

options based on the

latest literature for my

patient’s clinical

profile?

Why is this the best

option?

Basic

Reporting

What

happened?

When and

where?

How much?

Foundational

Analytics

Who is at risk? What is happening? How can we improve? What is the Right

Data? What actions to take?

Enterprise –Wide Data InsightsRetrospective

Reporting

Proactive Interventions

Data Governance

Centralize Data

Structured and

Unstructured

Data Sharing

Cost of Care Intelligence

High latency

reporting

Spreadsheets

Limited view reports

Dept data marts

Population Health

Analytics

Evidence-based

medicine

Streaming Analytics

Similarity Analytics

Natural language

understanding

Guided consumer

experience

Watson Applications

Clinical Content Analysis

Personalized Healthcare

Dynamic Learning for Optimal Care Guidance

Predictive &

Prescriptive

What could happen? How can we pre-empt? What is the likely outcome?

Who would be best at

managing this patient?

What is the anticipated

response to potential

medications?

Cognitive The Healthcare Analytics Journey

19

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Analytics strategy must span both knowledge & data-driven methods

20

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Trusted Information Platform

Predictive

Dashboards

Natural Language

Cognitive Computing

‘Big Data’ Volume, Velocity, Variety…

Patient Similarity

Healthcare Analytics Progression

21

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Watson is ushering in a new era of computing

1900 1950 2011

22

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Cognitive Systems Era

Discover and Decide

Interact Naturally

Learn and Reason

23

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Questions?

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Contact Info:

Judy [email protected]

@JudyMurphyHIT

Thank You!

25

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THANK YOU!The recording and handouts will be sent to you via email within 2 business days

Questions? Contact Shawn Auer at [email protected]

Join us for our next IBM Watson Health webinar!

Quality Incentive Programs: Huntsville Hospital's Experience

Hosted by: Amy Yearwood, Quality Manager for the Physician's Network at Huntsville Hospital

Wednesday, September 14, 2016 | 12:00 - 1:00pm ET

Register here> http://watsonhealth.ibm.com/QualityIncentivePrograms-Sept14-Webinar.html