winds of changecahsah.org/asp/conferencehandouts/2017/m1400.pdf · · 2017-04-20winds of change...

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CAHSAH® Annual Conference & Home Care Expo April 25‐27, 2017 – Rancho Mirage, CA

2017 California Association for Health Services at Home

Winds of Change

Greg Walton

HFIMSS, CHCIO

Advisor

Next Wave Health Advisors

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Winds of Change

Part 1 ‐ Forces

• Types of Growth – Change

• Boomers – People

• Economy – Debt & Costs

• % of US Economy going to Health Care

• 4 Chronic Diseases

• Innovation Types

More Change coming, US Economy still needs a great deal of cost reduction from Health Care

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Changes and Trends

• People

• Economic

• Health Care

• Diseases

• Innovation

Discussion Topics

• Changes and Trends

• Inevitable Forces

• Emerging Realities

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Two Types of Growth – Grasping the differences & implications

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That level of health spending relative to GDP is about 50 percent more than any of the countries studied for the report, which are Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.

U.S. health care spending grew 5.8 percent in 2015, reaching $3.2 trillion or $9,990 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 17.8 percent. Dec 6, 2016

The report also noted that "despite spending more on health care, Americans have fewer hospital and physician visits" than most of the other countries. But, "Americans appear to be greater consumers of medical technology," which includes diagnostic imaging like MRIs and CT scans as well as pharmaceuticals.

Common Wealth Fund 2015

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% GDP Spent on Healthcare

Life Expectancy

World Health Organization Global Health Expenditures ‐ 2014

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Chronic Diseases: The Leading Causes of Death and Disability in the United States. Chronic diseases and conditions—such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis—are among the most common, costly, and preventable of all health problems. Feb 23, 2016

https://www.cdc.gov/chronicdisease/overview

The top 10 death‐causing chronic diseases in the United States as of 2012 included heart disease, cancer, respiratory disease, Alzheimer's and diabetes, states CNNhealth.com. Additional conditions in the list were kidney disease, mental illness, liver disease, hypertension and Parkinson's

Lack of physical activity, poor diet, tobacco use and alcohol abuse are the four factors that the CDC cites as major contributors to the prevalence of chronic diseases

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Innovation

Incremental Disruptive

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Inevitable Forces

• Becoming• Cognifying• Flowing• Screening• Accessing• Filtering• Remixing• Interacting• Questioning• Beginning

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Inevitable Forces

as is nearly always the case in healthcare, correlation is easy to observe but causation is nearly impossible to prove.

"Correlation is not causation" means that just because two things correlate does not necessarily mean that one causes the other. As a seasonal example, just because people in the UK tend to spend more in the shops when it's cold and less when it's hot doesn't mean cold weather causes frenzied high‐street spending. A more plausible explanation would be that cold weather tends to coincide with Christmas and the new year sales.

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10 key challenges facing IT leaders in 20161. Quality ReportingIT leaders may be tasked with regulatory compliance for programs that involve clinical quality measurement. They will be well‐poised for the challenge when they align program reporting; assign staff to monitor for policy changes; and evaluate readiness for electronic measure submission.2. EMR OptimizationTo avoid getting stuck in an ongoing cycle of technical optimization that consumes all available resources, target a few strategic outcomes that can be achieved with the help of the technology and shift the majority of your resources as rapidly as possible to a focus on those outcomes.3. InteroperabilityInteroperability standards continue to evolve to support a growing need for open data access between diverse systems and active (often mobile) users in an ever‐more complex health care ecosystem.4. Population Health ManagementProvider organizations assuming financial risk are being forced to choose between the functionality of their EMR versus niche applications to accomplish all of the processes necessary to succeed with population health management.5. TelemedicineLead by direct‐to‐patient virtual care, telemedicine will evolve to become the glue that holds together care continuity across the continuum.6. Consumer LoyaltyIn many cases IT is required to give customers what they really want from their care experience and move them beyond satisfaction to gain their lasting loyalty.7. MobilityMobility and the Internet of Things (IoT) are starting to give us health care data for unprecedented presence and context – and with it, the challenge of ensuring that this outburst of technological advance does not turn into an outbreak of unsecured, autonomous and potentially harmful devices.8. Business IntelligenceNew business and clinical challenges associated with population health management, consumerism and margin management will require organizations to move beyond the fragmented or enterprise phases of our maturity model and develop more advanced analytics and big data capabilities.9. Digital Health SystemsDigital health systems will take full advantage of digital technologies and IT‐related capabilities to redefine business models; improve processes, quality and their cost structure; and identify and address customer or patient needs.10. IT Cost and Performance ManagementAs providers become ever more reliant on IT to thrive in this time of health care transformation, they must invest in optimizing their IT cost structure and performance management capabilities to ensure an optimal return.

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What New and Traditional Patients (Consumers) Want• Accessibility

• Reliablility

• Affordability

• Loyality (Programs)

Part 3 ‐ Emerging Shelters – The Third Era

• IoT

• Voice, Mobile, Video & Cloud

• AI, Machine Learning and Robots

• Big Data, Analytics and Consumer Insight

• Tele‐Health

Google Glass & A2

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Internet of Things

• The Cloud

• The Fog

Ages in the Human Experience

• Hunter Gather

• Agrgeaian

• Industrial

• Computer

• Augmented

Pay attention, remember, develop and use patterns – “deep learning” with intution

CognitvityPhysicallyPerceitvely

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Accessibility

• Embedded Provider Search

• Automated Out of Pocket Price Estimates

• Integrated Digital Scheduling Systems

• Vitural Visits

• Hospital Way Finding

• Workflow Automation

• Customer Driven Data

• Cost Accounting for Affordability

• Real‐Time Feedback Systems

• Integrated Patient Portals

• Simplifed Billing

• Loyality Programs to promote “Stickiness”

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BC /BS Patient ratings 80% “very good or excellent”

• About 90% of healthcare executives surveyed report that their organizations have begun developing or already implemented a telemedicine program (Foley 2014 Telemedicine Survey Executive Summary)

• The number of telemedicine patients will increase from 350,000 in 2013 to 7 million in 2018 (Cisco Customer Experience Report)

• In 2015, 29 states already required health insurers to pay for telemedicine services and another 26 bills were pending in Congress (How Telemedicine Became Mainstream)

• About 22% of employers with 1,000 or more employees offer telemedicine services and another 37% planned to by the end of 2015 (Foley Telemedicine Survey Executive Summary)

• Telemedicine makes up nearly one‐fourth of the health IT market that was valued at $15.6 billion in 2014 and is expected to increase to approximately $20 billion by 2019 (HIS Press Release)

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Is Remote Patient Monitoring A Miracle Therapy?

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Key Factors that Drive eVisist

• Assessiblity

• Location of services (Drive Time)

• Take My Insruance

“In the near future, we are going to have a sensory swarm, a great deal, a great variety of all kinds of heterogeneous sensors that are going to interface the cyber world, the computing world, with the physical world,” according to Alberto Sangiovanni‐Vincentelli, an electronic design automation expert at the University of California at Berkeley.

IoT

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CVS to Deploy Epic EHR Across Its Chronic Care Management Programs. Community member CVS is moving to Epic for their care management programs. “By transitioning to the Epic EHR,” says Trip Hofer, president of CVS subsidiary Accordant, “we can further coordinate care across health care disciplines and settings, which promotes more effective and informed health care decision making.” (Source: Healthcare IT News)

Riding Out the Storm

• Living in Two Worlds – Cost and Value

• Miseray Loves company? = ACOs et

• Tech Trends

• Emerging Tech

We are still very early into the transition. Some tech may help…consumerism but how much in post acute care? Innovation, perhaps a great deal

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Emerging Realities

• The Cloud and the Fog

• The Era of Augmentation

• Healthcare Reponse

ECRI Institute lists its “2017 Top 10 Patient Safety Concerns for Healthcare Organizations” that includes:1.Information management in EHRs 2.Unrecognized patient deterioration 3.Implementation and use of clinical decision support 4.Test result reporting and follow-up 5.Antimicrobial stewardship 6.Patient identification 7.Opioid administration and monitoring in acute care 8.Behavioral health issues in non-behavioral-health settings 9.Management of new oral anticoagulants 10.Inadequate organization systems or processes to improve safety and quality

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Inevitability of Change

• Technology Changing Examples

• The “human” “get it curve”, NOT!

• The gap

Technology Change will compound the social challenges stressing health care….Humans have trouble grasping the gap

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The future is all ready here, it just is unevenly distributed –William Gibson

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winds of changecahsah.org/asp/conferencehandouts/2017/m1400.pdf · · 2017-04-20winds of change...

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