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Promoting the Spread of Health Care Innovations

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Promoting the Spread of Health Care Innovations

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AHRQ’s Health Care Innovations Exchange held a Web event on Promoting the Spread of Health Care Innovations on April 9, 2013. For more information, visit https://innovations.ahrq.gov/events/2013/04/promoting-spread-health-care-innovations.

AHRQ’s Health Care Innovations Exchange held a Web event on Promoting the Spread of Health Care Innovations on April 9, 2013. For more information, visit https://innovations.ahrq.gov/events/2013/04/promoting-spread-health-care-innovations.

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Promoting the Spread of Health Care Innovations

  1. 1. Promoting the Spread of Health CarePromoting the Spread of Health Care InnovationsInnovations Web SeminarWeb Seminar April 9, 2013April 9, 2013 Follow this event on TwitterFollow this event on Twitter Hashtag: #AHRQIXHashtag: #AHRQIX
  2. 2. Using the Webcast ConsoleUsing the Webcast Console and Submitting Questionsand Submitting Questions 2 Click the Q&A widget to get the Q&A box to appear To submit a question, type question here and hit submit.
  3. 3. Accessing PresentationsAccessing Presentations  Download slidesDownload slides from consolefrom console – Click on theClick on the “Download“Download Slides” widgetSlides” widget for a PDFfor a PDF versionversion 3
  4. 4. What is the Health CareWhat is the Health Care Innovations Exchange?Innovations Exchange?  Publicly accessible, searchable database of health policyPublicly accessible, searchable database of health policy and service delivery innovationsand service delivery innovations  Searchable QualityToolsSearchable QualityTools  Successes and attemptsSuccesses and attempts  Innovators’ stories and lessons learnedInnovators’ stories and lessons learned  Expert commentariesExpert commentaries  Learning and networking opportunitiesLearning and networking opportunities  New content posted to the Web site every two weeksNew content posted to the Web site every two weeks Sign up atSign up at http://www.innovations.ahrq.gov under “Stayunder “Stay Connected”Connected” 4
  5. 5. Innovations ExchangeInnovations Exchange Web Event SeriesWeb Event Series Archived Event MaterialsArchived Event Materials Available within two weeks under Events & PodcastsAvailable within two weeks under Events & Podcasts at http://www.innovations.ahrq.govat http://www.innovations.ahrq.gov Next EventsNext Events Thursday, April 25, 2013 1-2 pm ETThursday, April 25, 2013 1-2 pm ET Payment Models that Support Medical Home andPayment Models that Support Medical Home and Accountable Care Organization Principles: Maryland’sAccountable Care Organization Principles: Maryland’s ExperienceExperience Thursday, May 9, 2013 1-2 pm ETThursday, May 9, 2013 1-2 pm ET A Close Look at Care Coordination: West Virginia’sA Close Look at Care Coordination: West Virginia’s ExperienceExperience 5
  6. 6. Today’s Event ModeratorToday’s Event Moderator Ronie Nieva, PhDRonie Nieva, PhD Vice President, Westat and Editor-in-Chief of theVice President, Westat and Editor-in-Chief of the AHRQ Health Care Innovations ExchangeAHRQ Health Care Innovations Exchange 6
  7. 7. Essentia HealthEssentia Health Linda Wick, RN, CNPLinda Wick, RN, CNP 7 Manager, Heart Failure ProgramManager, Heart Failure Program
  8. 8. RespondentRespondent Janell Moerer, MBAJanell Moerer, MBA Group Vice President, Strategy andGroup Vice President, Strategy and Business Development, Centura HealthBusiness Development, Centura Health
  9. 9. Essentia HealthEssentia Health Heart Failure ProgramHeart Failure Program  First visit 5-7 days after discharge  Cardiology oversight – once per year  Patients managed in clinic: 4-7 office visits the first year  Registered nurses do case management: use protocols, manage home telescale data, follow up on lab/test data, and triage phone calls
  10. 10. Program ComponentsProgram Components  CoachingCoaching  EducationEducation  SupportSupport  Consistency of care providerConsistency of care provider  Immediate feedback on health choicesImmediate feedback on health choices  Prescheduled follow-up appointmentsPrescheduled follow-up appointments  Relationship building with patient/familyRelationship building with patient/family  Multidisciplinary team approach to careMultidisciplinary team approach to care  Engaged/passionate staffEngaged/passionate staff
  11. 11. TripleTriple Aim  OutcomesOutcomes – Use of guideline directed medications/devices – Total yearly admissions/30 day readmissions  Patient SatisfactionPatient Satisfaction  Reduced Cost of CareReduced Cost of Care – Total yearly admissions/30 day readmissions – Reduce duplication of testing – Using the right provider at the right time for the right diagnosis
  12. 12. SHOW ME THE MONEY!SHOW ME THE MONEY!
  13. 13. Readmission RatesReadmission Rates Note: 6 month rates for heart failure patients N=294-229 FY2005-2010
  14. 14. Essentia Health St. Mary’s Hospital Readmissions 0 10 20 30 40 2010 2011 2012 Nat'l Avg All Cause HF
  15. 15. “Times They are a Changing”  Essentia Health is an Accountable Care Organization  CMS Bundled Payments for Care Improvement Initiative  Primary care is using health care home model: stable Heart Failure Program patients discharged to primary care physician
  16. 16. Challenges:Challenges: Administrative Buy-InAdministrative Buy-In  Ongoing challenge of administrative buy-in  Dialog changed once organization became an Accountable Care Organization: risk/benefit  Demonstrate how model fits Triple Aim  Markets within the organization have different priorities  NCQA accreditation process fits model
  17. 17. Challenges: Provider Buy-InChallenges: Provider Buy-In  Progress with physician and provider buy in: show data on outcomes  Culture changing from physician- centered to patient-centered  Culture changing from individual provider-based to team-based care  Other chronic disease programs changing to Heart Failure Model within Essentia
  18. 18. Challenges: WorkforceChallenges: Workforce  Sustaining workforce with potential nursing shortage  Clear staffing roles  Inclusion/exclusion criteria for patients  Using Telehealth technology
  19. 19. Scale Up and SpreadScale Up and Spread  Added Telehealth video visits to remoteAdded Telehealth video visits to remote sitessites  Added program staff to neighborhoodAdded program staff to neighborhood clinicsclinics  Developed interface with primary careDeveloped interface with primary care case managers: shared care plancase managers: shared care plan  Integrated home scale data intoIntegrated home scale data into electronic medical records with optionselectronic medical records with options for coverage from other sitesfor coverage from other sites
  20. 20. Closing ThoughtsClosing Thoughts If everything seems under control, you’re not going fast enough – –Mario Andretti
  21. 21. RespondentRespondent Janell Moerer, MBAJanell Moerer, MBA Group Vice President, Strategy andGroup Vice President, Strategy and Business Development, Centura HealthBusiness Development, Centura Health
  22. 22. Comments and ConsiderationsComments and Considerations  Continuity of leadership and passion forContinuity of leadership and passion for the service has assisted growth andthe service has assisted growth and adoptionadoption  Data beginning to reflect intendedData beginning to reflect intended impact to new value equationimpact to new value equation
  23. 23. Impact of Changing EnvironmentImpact of Changing Environment  Transformation and disruption of the normTransformation and disruption of the norm has accelerated adoption and scalehas accelerated adoption and scale  Fee-for-service payment toFee-for-service payment to bundle/Accountable Care Organizationbundle/Accountable Care Organization  Change in value equation: outcomes/costChange in value equation: outcomes/cost
  24. 24. Shift to Team-Based CareShift to Team-Based Care  Emphasis on team-based care: patient-Emphasis on team-based care: patient- centered medical homes/health homescentered medical homes/health homes  Heart Failure Program and team areHeart Failure Program and team are more “part of” the delivery vs. “separatemore “part of” the delivery vs. “separate from” due to emphasis on team-basedfrom” due to emphasis on team-based care.care.
  25. 25. Overarching QuestionsOverarching Questions  Where does this program need to resideWhere does this program need to reside in the short term, mid-term, and long-in the short term, mid-term, and long- term?term?  Who should “own” it? Accountability?Who should “own” it? Accountability?  How are the physician championsHow are the physician champions engaged in development and adoptionengaged in development and adoption with peers?with peers?  How will guardrails for compliance withinHow will guardrails for compliance within the delivery system be addressed?the delivery system be addressed?
  26. 26. Key ConsiderationsKey Considerations How will the challenges and opportunitiesHow will the challenges and opportunities change due to the transformation ofchange due to the transformation of payment and care delivery?payment and care delivery? Administrative buy-inAdministrative buy-in Physician adoptionPhysician adoption Delivery system needs and compositionDelivery system needs and composition Data gathering to data aggregation andData gathering to data aggregation and segmentationsegmentation New competitorsNew competitors
  27. 27. Key ConsiderationsKey Considerations How and what will the Heart Failure ProgramHow and what will the Heart Failure Program need for innovation and to accelerateneed for innovation and to accelerate adoption with sustainable value?adoption with sustainable value? Community partnerships i.e. parish nursing,Community partnerships i.e. parish nursing, community emergency medical servicescommunity emergency medical services Telehealth to clothing with monitoring devices;Telehealth to clothing with monitoring devices; iHeart FailureiHeart Failure Technology partnershipsTechnology partnerships Retail competitors and opportunitiesRetail competitors and opportunities Patient/consumer experience and literacyPatient/consumer experience and literacy
  28. 28. Transformation to ValueTransformation to Value SHOW ME THE MONEY!
  29. 29. Questions?Questions? Click me to get Q&A boxClick me to get Q&A box to appearto appear
  30. 30. The Innovations ExchangeThe Innovations Exchange  Visit our Web site:Visit our Web site: http://www.innovations.ahrq.gov/ andhttp://www.innovations.ahrq.gov/ and Scale Up and Spread VideosScale Up and Spread Videos  Follow us on Twitter:Follow us on Twitter: #AHRQIX#AHRQIX  Send us email:Send us email: info@innovations.ahrq.govinfo@innovations.ahrq.gov 30

Hinweis der Redaktion

  • Alt Text: Image of attendee console with an arrow pointing to the box to type in questions and another arrow pointing to the Q&A widget.
  • Alt Text: Image of attendee console with arrow pointing to the Download Slides widget.
  • Alt Text: Image of Ronie Nieva
  • Alt Text: Image of Linda Wick
  • Alt Text: image of Janell Moerer
  • Alt Text: Bubble with words: “Show me the money” inside.
  • Alt Text: Image of a bar graph showing hospital readmission rates. The national average for all years (2005-2010) was 40; the rate for heart failure patients in 2005 was 6.6 , in 2006 was 2.8, 2007 was 3.1, 2008 was 3.5, 2009 was 2.9, and 2010 was 4.8; the rate for health failure patients in 2005 was 18.1, in 2006 was 20, 2007 was 18, 2008 was 11, 2009 was 10.9, and 2010 was 10.9.
  • Alt Text: Image of bar graphing showing Essentia Health St Mary’s Hospital readmission rates. In 2010 the national average was 25, all cause readmission at St. Mary’s was 30, and 5 for the heart failure program. In 2011 the national average was 25, all cause readmission at St. Mary’s was 15, and 5 for the heart failure program. In 2012 the national average was 25, all cause readmission at St. Mary’s was 21, and 7 for the heart failure program.
  • Alt Text: image of Janell Moerer
  • Alt Text: Bubble with words “show me the money” inside. Money is crossed out and replaced with value.
  • Alt Text: Image of attendee console with an arrow point to the Q&A widget.

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