Presentation: Leading the Change In Healthcare Education and Delivery: how to surmount the barriers. Presented by: Dalal Haldeman, Senior Vice President, Marketing and Communications, John Hopkins Medicine What does the triple aim really mean and how do we get there? How can strong brands in healthcare influence outcomes, research and patient wellbeing for a healthier future in America and in the world.

1. Leading the Change In Healthcare
Education and Delivery: how to
surmount the barriers
Presented by: Dalal Haldeman, Ph.D., M.B.A
Senior Vice President, Marketing and Communications
Johns Hopkins Medicine
February 25, 2014

2. Johns Hopkins Medicine
• School of Medicine
• 6 academic & community
hospitals
• 40 community health care
& surgery centers
• Regional primary/specialty
care network
• Home care service
• Managed care plans for
military & employers
• Johns Hopkins Medicine
International Affiliations

3. 3

4. 4

5. The Healthcare Economy:
Challenges & Opportunities with ACA
Challenges:
§ Cuts in federal funding of research and in payments
§ Affordable Care Act expands insurance
coverage to millions more Americans
Opportunities:
§ The triple aim: experience of care, health of population
and cost per capita
§ National focus on reducing costs of care.
• Manage the decrease in provider payments
• Increase efficiencies
• Emphasize preventive measures, population health
• Decrease inpatient stays and readmissions
§ Change in Health Care Waiver in Maryland
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6. The ACA Implications For
Marketers and Communicators
§ There is an influx of new consumers, local and
global
§ The uninsured will be required to purchase a policy
§ Local targeting and health exchanges will
increase
§ Consumption of medical services will increase in
initial phases
§ The need to pay more attention to patients,
empowerment, and to educating the decision
coaches will increase
§ The need to provide CUSTOMIZED HELPFUL,
HONEST and QUICK information and interactions
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will continue to increase

7. Implications for Communication
§
§
§
§
§
Shared decision making tools
Telemedicine
New mobile applications
Content and interactivity
Connections
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8. Strong Brands
Before today, which of the following have you heard of?
(Select all that apply)
McDonald's
90.5%
Google
90.1%
Coca-Cola
89.9%
Apple
88.4%
FBI
86.5%
PepsiCo
86.0%
Johns Hopkins
80.2%
Mayo Clinic
79.1%
Kaiser Permanente
45.7%
None of the above
4.2%
0%
25%
Base: Aided responses of national sample of 22,139 adults
Source: NRC Ticker, fielded during the month of July, 2013.
50%
75%
100%
8

9. Influence On Outcome
Average Survival Score
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10. What is the main reason you prefer Johns
Hopkins
if you needed to travel for specialized care?
Reputation for innovation in medical research
59.1%
City of location
20.7%
Quality of care
17.0%
Ease of appointment and visit facilitation
3.1%
0%
20%
40%
Base: National sample of 5,237 adults preferring Johns Hopkins and answering this question.
Source: NRC Ticker, fielded during the month of June, 2012.
60%
80%
100%
10

11. Which ONE of the following universities has the best
reputation for its medical school?
Johns Hopkins
29.5%
Harvard
9.3%
Stanford
3.7%
University of Pennyslvania
2.0%
Washington University - St. Louis
1.8%
UCSF
1.6%
I don't know
52.1%
0%
Base: Aided responses of national sample of 24,414 adults answering this question
Source: NRC Ticker, fielded during the month of November, 2013
25%
50%
75%
100%
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12. Patient Well Being
Removing the Barriers: Which Clinician
when?
§ Not everyone needs to see an MD. The role of
NPs and RNs could be significantly optimized.
§ Members of a multidisciplinary team must be
willing and able to operate at the top of their
licensure to optimize a care team.
Non-Hopkins conducted research
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13. Which of the following health care professionals
have you seen during the past 3 years? (Select all
that apply.)
Medical Doctor
79.3%
Nurse Practitioner or Physician Assistant
39.5%
None of these
15.3%
0%
Base: Aided responses of national sample of 21,498 adults
Source: NRC Ticker, fielded during the month of August, 2013.
25%
50%
75%
100%
13

14. If your doctor needed to cancel an existing
appointment for a potentially serious health
concern, which would you prefer to do?
Reschedule the appointment with your doctor
for a later date
60.4%
Keep the appointment, but be seen by a
nurse practitioner or physician assistant
instead of your doctor
39.6%
0%
Base: Aided responses of national sample of 21,498 adults
Source: NRC Ticker, fielded during the month of August, 2013.
25%
50%
75%
100%
14

15. Patient Well Being
Removing the Barriers
How do you simultaneously improve patient
health and the quality of health care while
lowering health care costs?
15

16. Removing the Barriers:
Maryland Unique Payment System (Waiver)
A special federal waiver allows the state of
Maryland to set the amounts that patients and
insurers pay hospitals. A new revision, approved
January 10, ties the growth in hospital budgets to
the state economy and rewards hospitals for
keeping people healthy instead of paying them
by the number of patients they admit.
16

17. D Removing the Barriers: Changing
the Payment System
The new system means that hospitals will:
§ increase their efforts to keep patients healthy
after discharge so they don’t need to return to
the hospital;
§ increase efforts to lower the number of patients
who get new illnesses while in the hospital; and
§ provide the most appropriate care at the
lowest cost.
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18. Hospital charges shown to vary widely
Some bill more 'because they can'
“For Mr. Gray's last round of outpatient chemo at Johns
Hopkins on Jan. 10, 2013 -- including medications, IV
therapy, supplies and pharmacy service -- the hospital
charged $2,544.65 and was paid $2,493.06 by the insurer.
Two weeks later, for the same procedure and ancillaries, the
other hospital charged $13,789.75 and the insurer paid
$7,704.40.”
Source: By Steve Twedt / Pittsburgh Post-Gazette
http://www.post-gazette.com/business/2014/02/16/Hospital-charges-shown-to-vary-widely/stories/201402160092
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19. Removing the Barriers:
Fundraising To Improve Research, Outcome, and Patient Well Be
$350 M
Johns Hopkins Medicine
$319
$313
FY 2012
FY 2013
$300 M
$261
$250 M
$200 M
$227
$200
$150 M
$100 M
$50 M
$0 K
FY 2009
FY 2010
FY 2011
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20. Connecting People to People
JHM’s Internet Strategy
“…to connect the people of the world with the
people of Johns Hopkins Medicine”
Research
Teaching
Patient Care
Create opportunities for meaningful interactions and
access to a complex organization –
– providing the right information at the right time.
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– connecting the right people at the right time.

21. Integrate Content & Social Strategies
http://tinyurl.com/lwoqrg2
Goals
– Provide basic information and scientific
perspective
– Increase visitation to key pages
– Promote online chat
– Call to action: request appointment
2/28/2014
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22. Connect with Content:
Integrate Content & Social Strategies
Home Page
Twitter
Facebook
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23. Connect and seek out audiences &
conversations
“Could somebody explain how
this happened?”
“I thank everyone who acted on
our concerns. My sister’s
surgery date is now set…Thank
you!”
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24. Know Channels & Audiences
Facebook: Major Characteristics
• East Coast
• Female
• 18-44 years of age
• Patient Stories, Well-Packaged Research
Content
World-wide Audience
• Strong East Coast
• Major cities across
the country
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25. Know Channels & Audiences
Twitter: Major Characteristics
• East Coast
• Slightly male dominated
• Heavy 35-44 demographic
• Research Content & Institutional Content
World-wide Audience
• Strong East Coast
• Major cities across
the country
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26. Impact on Wellness
Wellness Benefits for Employees
§ Discounts for gym memberships
§ Weight Watchers, Innergy
§ 8 week HeartSmart program
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27. Impact on Wellness
Medicine for the Greater
Good
All internal medicine residents at Bayview must do a project
that promotes health in the community.
Curriculum Goals
§ Train physicians who have a broader
sense of the determinants of health
and of health disparities
§ Promoting the health of patients and
populations
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28. Impact on Wellness
Johns Hopkins Community Health
Partnership (J-CHiP)
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29. Communicating Biomedical Discovery
and Education

30. Communicating Clinical Innovations:
Double arm transplant

31. Communicating Clinical Innovations:
HIV cure

32. Communicating with Physicians
and Nurses globally

33. Technology: The Future
The Good, The Bad, The Ugly
Source: http://www.huffingtonpost.com/2013/12/09/poll-women-technology-complicated-relationship_n_4395935.html
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34. Technology: The Future
The Good, The Bad, The Ugly
Source: http://www.huffingtonpost.com/2013/12/09/poll-women-technology-complicated-relationship_n_4395935.html
34

35. Technology: The Future
The Good, The Bad, The Ugly
Source: http://www.huffingtonpost.com/2013/12/09/poll-women-technology-complicated-relationship_n_4395935.html
35

36. Companies Changing
Healthcare: HealthSpot
•
Private, walk-in medical kiosk
that reinvents a visit to the
doctor
•
Patients can visit a
HealthSpot for a variety of
primary care conditions.
There, they interact with
board-certified healthcare
providers using highdefinition video conferencing
and a suite of connected
medical devices that stream
biomedical information in
real time.
http://www.healthspot.net/
36

37. Companies Changing
Healthcare: MyHealthDIRECT
•
Web-based platform that
connects health plan
members and patients to the
right care, at the right time
and at the right place.
•
Enables health plans,
hospitals, physician groups,
and other participants in
care delivery to search for,
schedule, and confirm
appointments on behalf of
patients.
•
Text and email confirmations
are sent to ensure
appointments are kept.
http://myhealthdirect.com/
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38. Companies Changing
Healthcare: PokitDok
•
Web and mobile health
marketplace where
consumers can request a
quote and purchase a
service directly from health
providers with insurance,
health savings accounts, or
cash.
•
Physicians and other care
providers can set up a virtual
storefront on PokitDok to
market their services.
•
Over 1,000 practices have
signed up to the beta.
https://pokitdok.com/
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39. Factors Affecting Patient Choice
of Health System
Source: http://www.visioncritical.com/blog/3-factors-driving-patient-loyalty-in-healthcare-industry
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40. 40

41. National Patient Survey:
Information Sources Used to
Select a Facility for a Procedure
11%
Doctor/provider
9.0%
Friend/family
Other
80%
Note: Categories are not mutually exclusive; respondents could select multiple categories.
Base: National sample of 13,500 adults.
Source: Center for Studying Health System Change. Research Brief, December 2008.
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42. Our Patients’ Decision Process
New Patient Survey
Questionnaires were mailed to 13,508 out-of-state Hopkins patients new to a specific clinical area.
Results n=3087
October 2010
42

43. Measure: National and International
New Patient Survey
Note: based on those respondents deciding to come to JH mostly on their own.
n=3087
October 2010
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44. If you needed treatment for a serious medical condition,
would you consider traveling more than 100 miles for
treatment?
Yes
74.9%
No
25.1%
0%
25%
Base: Aided responses of national sample of 21,330 adults
Source: NRC Ticker, fielded during the month of May, 2013.
50%
75%
100%
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45. Performance
Out-of-State Consumer Outreach
Pennsylvania
Delaware
CNN Physicians Network Markets
CNN Airport Network and
Southwest Airlines In-Flight Markets
Google Search Ads and JH Health Newsletter Markets
Over 123 Million Impressions

46. Performance
Website Visitors by Region

47. Performance
Performance
JHH Out-of-State Volume Growth
Discharges: Out of State
11k
Outpatient Visits: Out of State
150k
140k
10k
130k
120k
9k
100k
8k
100k

48. A Healthier Future In America And In The World:
Collaborations
1. Trusted brand
• Medicine for the greater good
2. Share the knowledge
• Quality Collaborations via our Armstrong Institute
for quality and safety
• “Best Practice” Collaborations
• Management Services Agreements
• Joint Operating Agreement/Joint Ventures
• Expansion of Network of Care and Mergers
3. Connect
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49. Thank you!
Dalal J. Haldeman, Ph.D., M.B.A.
Senior Vice President, Marketing & Communications
Johns Hopkins Medicine
dhaldeman@jhmi.edu
410-955-0071

50. Link to Pediatrics Urology Video:
Cloacal Exstrophy
•
https://www.hopkinschildrens.org/a-milestone-in-pediatric-urology-cloacal-exstrophy/
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