Refer Well and Mount Sinai Health Ventures - Health 2.0 10th Annual Fall Conference

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Streamlining the referral process
for dramatic results.
February 27, 20161
Provider Symposium – Health 2.0 Conference
Presented Sept 25, 2016
Anatomy of a Pilot

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Brent Stackhouse
Mount Sinai Ventures
Vytas Kisielius
ReferWell
Panelists

3. Mount Sinai Health System Overview
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• Mount Sinai Health System
• 7 Hospitals in New York City with 3,500 beds and 135 operating rooms
• More than 150 ambulatory locations, 33 Departments
• Top ranked Icahn School of Medicine trains over 2,000 students and fellows
• Research program is leading recipient of NIH funding
• 36,000 staff, 6,500 nurses, 6,200 physicians, and 2,000 residents and fellows
• More than Over 3.26m patient visits in 2015
• Mount Sinai Innovation Partners leading tech transfer and commercialization initiatives
• Mount Sinai Ventures
• Mission to invest in strategic opportunities that improve population health management
• $9m deployed with a $31m return in 6 years

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5.  Tracking patient flow and care coordination is difficult
 Referral workflows are not consistent
 Care teams do not have necessary information to make the best recommendation
 Sooner scheduled, more likely to go
 Network management is key in risk-based reimbursement arrangements
As a result:
 Patients seek care inappropriately, or not at all
 System loses patients to competitors
 Receiving provider does not have necessary information
 Patient hit with out of network cost based on referring provider recommendation
Referral Management Challenges
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Patient
45-65%
of referrals are not fulfilled,
costing providers
66%
of the time PCPs don’t
learn results of referral
55%
of the time Specialists
get no data or reason
for visit
Payer
Provider

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ReferWell
Balances
Complementary
Needs
Patient Payer
Provider
 Simplify referral process and network conformance
 Improve care coordination
 Increase referral visit capture
 Improve health outcomes
 Reduce unreimbursed costs
 Improve compliance, satisfaction
 Increase referrals to high
quality/low cost provider
 Reduce Out-of-Network visits
 Decrease inappropriate or
unnecessary treatments

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The Right Doctor, Right Away - Better Patient Compliance - Easy Data Sharing
Appointment at point of care
Specialist who takes my insurance
50-92% increase in patient visits
EMR agnostic
Cloud-based

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PILOT RESULTS
• Start:August 2014
• End: November 2014
• Scope: 100 users, 50 locations
• Targeted referrals: 5K
• Build integration to Epic & IDX
• Start: November 2014 (soft launch)
January 2015 (full launch)
• End: June 2015
• Scope: 125 users, 50+ locations
• Referrals supported: 24K
• Integration to Epic: complete
• Integration to scheduling pending
(new interface underway at Sinai)
PILOT PROPOSAL

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Successful Pilot
Tips
Recommendations for
Vendors
• Preparation: Choose Wisely
– Project champion is the keystone
– Keep ROI for partner in mind
– Ask a lot of questions
• Contracting: Execute Quickly
– Legal moves slow, politics change fast
– Include post-pilot considerations
• Implementation: Thoroughly Plan
– Metrics match everyone’s ROI
• Communicate, Communicate…
– Internal and External PR
• Design with Post-Pilot in mind

11. Questions to Ask Pilot Organization
• How do you maximize adoption of a solution?
• Who are the key stakeholders? (Financial/Clinical/etc)
• What is the process for disseminating information across key stakeholders?
• How does each stakeholder define success?
• What is the procurement process and budget cycle?
• What metrics are used for evaluation?
• Who else has piloted at the organization? What were the lessons learned?
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Vytas Kisielius
(302) 897-8768
vytas@referwell.com
Brent Stackhouse
(917) 608-1268
brent.stackhouse@mountsinai.org
For more information