wiring healthcare: ehealth & innovation trends : presentation for bulgaria

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1 Wiring Healthcare eHealth for Bulgaria Eugene Borukhovich Chief Executive Officer

Post on 18-Oct-2014

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I was asked by the US Commerce department to attend and present at a roundtable that took place in Sofia, Bulgaria on February 27th. This roundtable included people from president's office, National Healthcare Fund, Patient Groups and key vendors. Bulgaria had many efforts to kickstart eHealth. This was an overview of US legislation and lessons learned as well as a look forward into healthcare innovation trendds

TRANSCRIPT

Page 1: Wiring Healthcare: eHealth & Innovation Trends : Presentation for Bulgaria

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Wiring HealthcareeHealth for Bulgaria

Eugene BorukhovichChief Executive Officer

Page 2: Wiring Healthcare: eHealth & Innovation Trends : Presentation for Bulgaria

Agenda

•What is eHealth?

•Wiring Healthcare: A bit of history

•Wiring Healthcare: Lessons Learned (so far)

•Health Innovation Trends

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What is eHealth?

• Lack of clear and precise definition

• Set of disparate concepts, including health, technology and communication

•Meaning varies with context in which the term is used

•Meant to enhance the quality, improve access to health care services at lower costs and strengthen healthcare systems as a whole

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#digitizing

#connecting

#collaborating

#improving#empowering

#personalizing

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Source: An Overview of eHealth Initiatives -Strategies and Lessons from Around the World by GE Healthcare IT (2011)

Wired Healthcare

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Source: An Overview of eHealth Initiatives -Strategies and Lessons from Around the World by GE Healthcare IT (2011)

eHealth ecosystem

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Wiring Healthcare: US government initiatives

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Meaningful Use: Three stage implementation

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Source: www.ehealthdc.org 

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Meaningful Use: Impact

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Source: “Physician Adoption of Electronic Health Record Technology to Meet Meaningful Use Objectives: 2009-2012,” Health and Human Services Dept. Office of the National Coordinator for Health Information Technology,

• As of 2012, half or more of physicians adopted EHR technology capable of meeting twelveMeaningful Use Stage 1 Core objectives

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Open Health Data: United StatesHealth Data Initiative (HDI)

Launched in 2010 by the Institute of Medicine (IOM) and the U.S. Department of Health and Human Services (HHS)

HDI is a public-private collaboration that encourages innovators and entrepreneurs to utilize HHS data to help improve health and health care

A growing inventory of public health data resources easily available and accessible at a central location: HealthData.gov

Includes clinical care provider quality information, nationwide health service provider directories, databases of the latest medical and scientific knowledge, consumer product data, community health performance information, government spending data and much more

In addition to publishing and promoting the availability of health data, HDI is preparing the data for use by developers while protecting privacy and confidentiality

HDI is seeking to identify, encourage and accelerate the meaningful uses of the published data by organizing forums, public competitions or hackathons

Policy Developments Support OpennessThe Affordable Care Act, signed by President Obama in 2010, authorized HHS to release

new data sources

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Beacon Community Cooperative Agreement Program

•$250 million over three years to 17 selected communities that make progress in Beacon Pursuits linking Health IT, Improvement, and Innovation

• In 2012, three Beacon communities - Crescent City (New Orleans), Southeast Michigan and Greater Cincinnati – launched an innovative mobile health application for individuals at risk of developing Type 2 diabetes

•"txt4health" campaigns aim to support patients with:• Assessing their diabetes risk levels

• Engaging in and managing their health

• Accessing resources on wellness and diabetes care

• Part of a broad effort to leverage mobile health technology to empower self-management of chronic disease

•In cooperation with American Diabetes Association, the Centers for Disease Control and Prevention, the Office of the National Coordinator for Health IT and Voxiva (a mobile technology company)

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Health IT: Progress mixed and savings elusive

•RAND Corporation estimated in 2005 that rapid adoption of Health IT could save the U.S. more than $81 billion/year

• According to a 2013 RAND Corporation study, despite wide investments the cost-saving promise of Health IT has not been reached

•According to the same study, empirical data on the Health IT’s impact on health care efficiency and safety are mixed, and annual health care expenditures in the U.S. have grown by $800 billion

• The study attributes poor HIT performance to:• Sluggish adoption of Health IT systems• Systems that are neither interoperable nor easy to use• Failure of health care providers and institutions to reengineer

care processes to reap the full benefits of health IT 11

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Health IT: Lessons Learned

• Health IT adoption is critical but not adequate alone to improve healthcare

• Need for a broad-based use of EHRs and robust health information exchange (HIE)• Ensuring EHRs integration and interoperability identified as a key to maximizing their benefits

• Need for coordination and monitoring of the regional connectivity across providers

• Implementation of safety and privacy framework

• Building the necessary infrastructure is a first step, yet there are many social, economic, and cultural barriers to overcome• Workflow changes need effort and determination to succeed

• Incentives measures can encourage Health IT adoption among providers

• Timely implementation and achievement of full benefits require training and education

• Need for engagement, collaboration and clear communication across all levels

•Health IT is an investment in health and health care • Need for commitment to transparency

• Quality metrics have shown to be challenging to meet, yet should not be discouraged

• Emphasis on accuracy of measuring and monitoring of outcomes 12

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Recommendations

•Do not make this initiative a health IT project

•Engage all stakeholders form the beginning, including patients!

•Focus on foundational components

•Focus on driving standard for information exchange (ex. HL7)

•Ensure security, integration and interoperability of the systems

•Encourage national and international cooperation

•Track, compensate and communicate efforts

•Health IT adoption is not a race it’s a marathon

•Start with OPEN first

•Do not forget that change can be hard, educate! 13

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Health Innovation TrendseHealth for Bulgaria

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Health Innovation Trends

•Social discovery

•Self-diagnosis

•Telemedicine

•Personalized medicine

•Quantified Self

•Remote health monitoring

•Data analytics and clinical decision support (CDS)

•Appscriptions

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Health Innovation Trends

•Social discovery - to facilitate social learning, self-management and improved decision making

• Online platforms such as CureTogether and PatientsLikeMe allow people to compare their symptoms with each other and share advice about treatments and medical providers

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Health Innovation Trends

•Self-diagnosis - to enable self-tracking and engagement of patients in their health

• iTriage help people to evaluate their symptoms, learn about possible causes and seek appropriate and close-by care

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Health Innovation Trends

•Telemedicine - to extend the reach and accessibility of health care

• American Well Online Care enables patients to conduct real-time video visits with their care providers

• Hello Health provides the EHR Patient Management platform for primary care professionals that allow them simplify their businesses and increase patients’ engagement and convenience

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Health Innovation Trends

•Personalized medicine – to transform and improve disease prevention and treatment

• 23AndMe – provides genetic testing for over 100 traits and diseases as well as DNA ancestry

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Health Innovation Trends

•Quantified self – to enable self-tracking and incorporate healthy habits into life

• Fitbit offers wide range of sensors and devices to motivate users to stay active, live better and reach their healthy goals

• Basis is a wirst-based health tracker and online personal dashboard that enable users to capture heart rate patterns, motion, perspiration and skin temperature to improve their sleep, diet and exercise

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Health Innovation Trends

•Remote health monitoring – to enable self-tracking and disease management

• iBGStar is a blood glucose meter that connects to the Apple devices allowing patients to view and analyze “real time” information

• Approved by FDA, AliveCor's Heart Monitor allows patients and care providers to record, display, store, and transfer single-channel ECG rhythms

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Health Innovation Trends

•Data analytics and clinical decision support (CDS) - harnesses real-time medical data to generate fact-based diagnostic and therapeutic decisions

• “ Outcomes-based reimbursement is the future of the heath industry. To improve patient outcomes, proactively identify chronic and high-risk patients in this new environment, and effectively manage their financial performance, healthcare organizations must be able to provide analytics at the point of service and rely on historical and longitudinal data to manage patient populations.“ Health Research Institute: PwC, February, 2012

• Archimedes IndiGO is a Clinical decision support system that offers individualized guidelines and outcomes

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Health Innovation Trends: mHealth

•Appscriptions – to enable self-management, improve compliance and allow remote monitoring

• Digital ‘medicines’ prescribed as part of a course of treatment• Happtique is a mobile app store for healthcare professionals that offers an

electronic prescription app mRx which enables providers to prescribe, track and remind use of apps assigned to their patients

• Approved by FDA, Proteus Digital Health offers an ingestible medicine compliance tracking sensor

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Eugene BorukhovichChief Executive Officer

@HealthEugenehttp://[email protected]

Questions?