This document discusses how data exchange is essential to support new technologies and healthcare innovation. It provides an overview of Montefiore Medical Center's strategies for incorporating innovation, including establishing an organizational governance model and multi-disciplinary innovation process. Barriers to data exchange are also examined, and examples of new patient monitoring technologies are presented to illustrate how real-time data can be used to personalize care delivery and support value-based healthcare models.

1. How Data Exchange Is Essential In
Support of New Technologies &
Healthcare Innovation
Mony Weschler, B.A., M.A., FHIMSS, CPHIMS
Senior Director Applications Strategy and
Innovation
Albert Einstein College of Medicine
Montefiore Medical Center
Bronx, NY USA

2. Conflict of Interest Disclosures
Mony Weschler
General Electric Healthcare IT
Executive Committee
AFC Industries - Consultant
Terarecon - Consultant
SenseHealth – Consultant

3. Excellence in care requires access to
population clinical and wellness data…
All of it!
Learning Objectives:
- Discuss IT governance components that
positioned Montefiore to achieve
extensive community outreach efforts
- Review strategies for incorporating
innovation and new technologies into
existing processes.
- Identify the data exchange challenges

10. Fee For Service Payment System not a Preferred
Option in Environments
with Large Government Payer Base
Bronx:
1.4 M Residents
725 K
Medicaid
70 K
Duals
Current Bronx Total Health Care Spend = $12 B
80% of Medical Expense paid by Medicare and Medicaid

11. Source 2012
Population
2012 Est.
Revenue
2015
Population
2015 Est.
Revenue
Risk Contracts 140,000 $850 m 170,000 $1.04 b
Shared Risk 78,000 $490 m 165,000 $1.02 b
Medicaid health
Home (Care
Coordination)
10,000 $10 m 10,000 $18 m
Total 228,000 $1.35 b 345,000 $2.08 b
Risk Arrangements Now Account
for Half of Montefiore’s Revenue

14. Governance Models
Top Leadership buy-in and support
Must be part of the organizations strategic plan
Its not an IT governance model
It’s a multi disciplinary organizational model
Its not a typical vendor selection and ROI process
One needs to include innovation and Startups
Select a solution and implement across the enterprise
Enable one solution for everyone; provider & population
Culture
Must be ready to change the culture

15. A PROCESS FOR EVALUATING AND ADOPTING
INNOVATION IN THE CLINICAL SETTING IS CRUCIAL
IN THE DEVELOPMENT OF TELE-HEALTH AND
REMOTE MONITORING
PURPOSE: The disruption of healthcare as
we know it has begun. Achieving success is a
challenge for both innovator and institution.
Developing and implementing a strategy and
process for managing innovations is critical.

16. Health
System
Culture for
Innovation
Keen
Understanding
of Institutions
Needs
Resources are
Allocated for
Innovation
Must be “In
Line” with
Organization’s
Strategic Plan
Ability to
Identify New
Emerging
Technologies
Highest Level of
Support from
Executive
Leadership
Failing is an
Important
Component of
the Process
The Innovation Culture

17. Knowledge of Clinical
& Operational
Challenges
Ability to Foster an
Innovative
Environment
Internal & External
Innovations Funnel
Technical, Financial &
Multidisciplinary
Review & Selection
IRB, Pilots, VC and
Equity
Implementation and
Operational Turnover
The Innovation Cycle

18. Patient Monitoring

19. Patient Monitoring: Unfortunately
Its True

20. Mobility, Then & Now

21. Wearable Sensors Redefined
Prescribing Fitness
Bio-Sensor
Less invasive

22. Still Dreaming Of Star Trek’s Tricorder

23. First Steps
AliveCor : Mobile ECG’s
Founder: Dr. Dave Albert
Available Today
Alvio: gamification of spirometry

24. A Real Tricorder
• Crowd funded on Indiegogo
• 8,500 contributors in one month
• Goal: $100K
• Raised: $1.6 Million
• Year: 2013

25. Tele-Health Plus Vitals
Undergoing Clinical Trials
• Heart
• Lungs
• Ears
• Skin
• Throat
• Eyes
• Temp

26. MEMS & Sensors
http://www.memsindustrygroup.org

27. Implantable Sensors:
MEMS Micro-Electromechanical
Systems
Telemonitoring of Human Physiological Data
Blood Pressure / Hypertension
Heart Rate / ECG
Respiration
Pulse Oximeter
Medication Level
Glucose
Stress
Sleep
BMI
Position / Gait
Air quality
Epilepsy / Seizures

28. • Born 2002
• 8 Years to Develop
• 1 epidemiologist
• 16 programmers
• $40 Million
• Licensed for commercialization to Streamline Health
Predictive Analytics on the Longitudinal Patient Record

29. 700 Clinicians Trained and have access to CLG.
Helping Them with ACO and PCMH Challenges

30. Barriers To Data Exchange?
Culture – Resistance to change; This is not how we do things
Change the culture or change the people
Competition: Payers & Providers
Not a Patient, Not a Customer…a Person
Standards
Simple and Well Defined
Structure
More Structured Elements
Data Mapping
Self Describing Data Elements
Big Data Plus; overwhelming
Cognitive computing will provide actionable data
Reimbursement
Not consistent, state variable
Resources
Will Need a Workforce to Get It Done

31. • The Healthcare model is changing and it
is enabled by data
• Disruptive Technology is good enough for
new paradigms of continues monitoring.
• Real time data can be used to trend and
calibrate dosages and personalize
medications
• Access to complete and longitudinal
healthcare data is the key to the success
of population and community health
A New Level of Improved Data Exchange Spearheaded
by Wedi is required to Support Innovation & New Tech
That Can Enable the Shift To Value Based Healthcare

32. The Future
IoT
Internet
Of
Things

33. Thank You!
Questions ?
Mony Weschler, B.A., M.A., FHIMSS, CPHIMS EMTP
Chief Senior & Director Applications Strategy and Innovation,
Montefiore Information Technology, Montefiore Health Systems
Office: 914-457-6058
Twitter: @Monywempt
Email: mweschle@montefiore.org