Weitere ähnliche Inhalte Ähnlich wie The New Healthcare Model - Collaboration is Key (20) Kürzlich hochgeladen (20) The New Healthcare Model - Collaboration is Key2. ACO’s, Care Collaboration, EHR -the role
of Collaborative Video Solutions
Dr. Deborah A. Jeffries, Director US Healthcare
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3. History:
Collaborative Video for Healthcare
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Multi Million dollar PACS
Early Telemed Adopters
T1 lines
Expensive Equipment
Spotty coverage
Quality sketchy
License & Reimbursement issues
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Move to IP and WEB based
Browser based PACS 500K
Expansion of grant based telemedicine
Chronic DZ monitoring pilots
Economy tanks
Baby Boomer Age
Doc shortage
Stimulus PKG
Affordable Care Act
2 Billion to CHC
Billions from ONC
7.2 Billion for Broadband
EHR
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• PCMH
• CMS Telemedicine
Codes Expanded
• Grant funding for
collaboration
• 11.5 Billion CHC
• Accountable Care
Peer to Peer
Mobility
Cloud
2-10 billion Innovation
Prevention Wellness
ACO
RE-Admits
EHR Roll out
Care Coordination
Payer/Provider
future
1990s
Large Room Based Sys
2000s
2009-2010
CMA 100k licenses 1st month
2011
2012 2013
HD, RMX, DMA
POCN, Intelligent Core
Polycom Tablet, CloudAxis
Go to a special room for scheduled video
Video where and when you need it, desk, room, home, on the go
Milestone
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Polycom Open, Standards Based, Scalable, Most Cost Effective, Customer focused
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4. HC Reform
ACO’s (Accountable Care Organization’s)
− Medicare Model, Private Model, New Payment Models
Care Coordination
− Prevention and Wellness, Population management, Decreasing Readmits
EHR:
− Select/Plan/Implement/Support/Maintain
across orgs and geography
All Require Collaboration/Coordination
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5. ACO’s (Accountable Care Organizations)
• Newly formed collaborative business model that
focuses on population management, and new
payment models
• Comprised of Providers, Payers, Public Health,
Health systems, Community members, Long
Term Care, Patients, and families
• Goal is to keep patients healthy and to reduce
cost of care and reward practitioners for best
practices and patient outcomes
• Challenge is to collaborate across businesses,
and geographic locations to optimize resources,
including knowledge, expertise, and the power of
peer to peer, face to face influence.
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6. ACO’s (Accountable Care Organizations)
• Payment Models
• Recent Health Innovation Grants:
− 2012 Billion dollars for innovation: focused on inpatient, and heavy
focus on reducing emergency room visits, and enabling models
similar to Coaching model
− 2013 Billion dollar innovation grant: focused on out patient, new
payment models, and prevention and wellness
− Future 8 billion more? Are you ready? Reach out now, line up your
relationships now
• Some thoughts:
− Payers and providers partnering: predictive analytics and
population management, outreach, transitions of care, care
coordination, telehealth
− Payers offering bonuses for better patient health, and outcomes
− Payers and providers partnering for population management
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7. Care Coordination
• Coordination/collaboration across
− Specialists
− Tumor Boards, Multi-disciplinary teams
− Organizations
− Hospitals, Primary Care Groups, Specialists Groups, Payers, Labs,
Community Centers, Long Term Care, Public Health, Centers of
Excellence
− Communities
− Schools, Community Centers, Churches,
− Populations
− Chronic disease, aging in place
− Care Teams
− Home care, Case Management, Discharge Planning, Hospice
• Benefit: better outcomes, more cost effective utilization of
resources, decreased unnecessary readmits
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8. Care Coordination Goals
• Prevention and Wellness
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Target chronic disease
Patient enablement
Population management and outreach
Avoid unnecessary costs
• Decreasing Readmits
− Care coordination
− Regionalization of resources
− Case managers
− Education and safety programs
− Transitional care
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9. Prevention and Wellness: Community/Patient Education
Populations Management
Disease Management
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Diabetes
CHF
COPD
Mental Health
Nutritional Education
− Childhood Obesity
− BP, HTN
Public Service Updates
− Cardiac and Pulmonary
Education
− Smoking Cessation
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10. Population Outreach
• Are mailers effective?
• Do you change your behavior when someone sends
you something in the mail? Or over email? Or just
because your doctor says so?
• Peer to Peer medical education …
− You want to lose weight, you doctor has told you that proper diet, and
exercise is the best approach… and given you a brochure..
− You meet with your friends for a card game, and several tell you that
they have started walking 5 days a week and feel great, and have lost
10 pounds in the last 5 months,, without a diet change.. One
mentioned getting a puppy and how much fun it is to walk, take to
classes, and how she is getting out of the house more.. Another
mentions that actually now that she is more active with her dog, she
really isn’t eating as much and thinking about food as much…
• Why not the best of both worlds??? A live multipoint video for
those interested in weight loss or smoking cessation with a
healthcare expert supervising the discussion?
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11. Decreasing Readmissions
• Law went into effect Oct 1, 2012
• “About two-thirds of the hospitals serving
Medicare patients, or some 2,200 facilities, will be
hit with penalties averaging around $125,000 per
facility this coming year, according to government
estimates”
(1).
•
©
(1) RICARDO ALONSO-ZALDIVAR | October 1, 2012 04:27 AM EST | Associated Press
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12. Re-Admits, Why are they high?
• An avoidable re-admit could have been prevented
by:
− (1) the provision of quality care in the initial
hospitalization
− (2) adequate discharge planning
− (3) adequate post-discharge follow up
− (4) improved coordination between inpatient and
outpatient health care teams.
(1)
•
©
(1)Norbert I. Goldfield et al. Identifying Potentially Preventable Readmissions, Health Care Financing Review, Fall, 2008.
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13. Re-Admits, Why are they high?
• Medicare Hospital Readmissions: Issues, Policy Options and
PPACA (1) lists:
− An inadequate relay of information by hospital discharge
planners to patients, caregivers, and post-acute care
providers
− Poor patient compliance with care instructions
− Inadequate follow-up care from post-acute and long-term
care providers
− Insufficient reliance on family caregivers
− The deterioration of a patient’s clinical condition
− Medical errors
(1) Medicare Hospital Readmissions: Issues, Policy Options and PPACA Julie Stone, Specialist in Health Care Financing Geoffrey J. Hoffman, Analyst in Health Care Financing September 21, 2010
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14. Collaboration is Key, B-to-B, B-to-C
• Case Management
− Bring everyone to the table
• Discharge Planning
− Live video discussion, written plan + video tips, video recorded
supportive education
• Post Acute Care
− Live video to Case Manager or coach once home
− Follow up with Primary Care over live video
− Tablet accessible educational material on web portal
• Prevention and Wellness Programs
− Live multipoint, interactive peer to peer educational sessions
− Stored version available
− Support patient wellness programs
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15. EHR Electronic Health Record
• Early: The Medicare and Medicaid EHR Incentive Programs
provide incentive payments to eligible professionals, eligible
hospitals and critical access hospitals (CAHs) as they adopt,
implement, upgrade or demonstrate meaningful use of certified
EHR technology. Eligible professionals can receive up to
$44,000 through the Medicare EHR Incentive Program and up
to $63,750 through the Medicaid EHR Incentive Program
• Now: Medicare eligible professionals who do not meet the
requirements for meaningful use by 2015 and in each
subsequent year are subject to payment adjustments to their
Medicare reimbursements that start at 1% per year, up to a
maximum 5% annual adjustment.
• Eligible hospitals and CAHs that do not successfully
demonstrate meaningful use of certified EHR technology will be
subject to Medicare payment adjustments beginning in FY 2015
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16. EHR: Collaboration is Key, B-to-B, B-to-C
• Project Plan and Management
− Bring everyone to the table over video
• Selection
− Live multipoint video for discussion, demo
• Implementation
− Live video hand holding
− Video Recorded FAQ’s and guidance
• Training
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Live multipoint, interactive educational sessions
Streamed video
Stored version available
Consistent, timely, avoid travel, repeatable, easily tracked
• Support and Maintenance
− Video interactive support, introduce changes more easily
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16
17. Healthcare
Collaboration
ONE-TO-ONE
• Case Mgr to Patient
• Peer to peer
• Patient to family
member
• IT to End User
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ONE-TO-MANY
MANY-TO-MANY
• ACO meetings
• Community center to
commuinty center
• Hospital to hospital
group meetings
• Community health
education
• Specialist to
many patients
IT to Many for EHR
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AD-HOC
• Virtual HC teams
• Discharge Planning
• Follow up calls
• Transition support
• IT to End User
18. Making Collaboration Available to Everyone
Diabetes Exercise
All participants
experience a
All have a
secure, high
secure quality
experience
high quality
experience
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18
Content sharing
with just a click
and can be
initiated by
anyone in the
meeting
20. Solution: Collaborative Video for Healthcare
Home
Clinic
Hospital
Video Care
Coordination
Family
Video
Support
One-to-one
Video
Practitioner
Consultation
Multipoint
Video
Video Health
Coaching
Recorded
Video
Education
Patient
Education
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Long Term Care
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21. Collaborative Video for Healthcare
Remote Medical
Specialists
RealPresence CloudAXIS
EHR
IT
PACS
Hospital Center of Excellence
Polycom®
RealPresence™
Platform
Mobile
Telepresence
Rural Treatment Center
Physicians Office
Community Health Center
Desktop
Room based
Practitioner Cart
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21
22. Summary:
• ACO Operation and prevention and wellness programs can be
enabled with collaborative video.
• Collaborative ubiquitous video can support continuum of care, case
management, and discharge planning to extend care to the patient
as they transition back to long term care or home and reduce Readmits
• EHR can be rolled out with focus on user satisfaction and better
utilizations using collaborative video
• Collaborative video solutions enable continuous patient centered
care, and assist in reducing the cost of healthcare
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22
24. Who? What? When? Why? How?
Who? Team of experienced grant managers
What? Providing grant support to customers and
grant projects
When? Now! Grants pop up every day!
Why?
• Why not?
• Grants can fund major
initiatives that would be
otherwise unaffordable!
How? Contact us to get started!
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25. Spanning the Gamut of Telehealth
Rural Healthcare
Healthcare
Innovations &
Research
Health
Professions
RUS-DLT
Healthcare
Innovation
(HCI)
HRSA - NEPQR MIECHV
Rural Health
Network
Development
PCORI
DOL/ED H-1B
Eliminating
Youth
Disparities in
Career/Connect Perinatal Health
Delta State Rural
Network & Delta
Health
NIH – Health
Disparities
grants
HRSA –
Advanced
Nursing
Education
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Home Health &
Health Outreach
School Based
Health Centers
27. Grant dollars often follow reform trends….
• HCI focuses on healthcare transformation –
• Keeping patients well
• Reducing readmissions
• Including the Continuum of Care
• Creating a new payment model with incentives for
wellness/prevention
• Rural Healthcare grants focus on equalizing access to all types of
healthcare resources
• Healthcare patient wellness and prevention education
• Access to specialty and sub-specialty care
• Delivery of behavioral health services
• Health Professions grants focus on the need for a skilled workforce
• Providing HC professions training to all areas (rural, suburban
and urban) all socio-economic groups and all ethnicities
• Address the lack of qualified HC workers, and focus on
collaborative opportunities that take a “grow your own” workforce
approach (H-1B YCC, H-1B and TAACCCT)
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28. It’s not about the grant, or the
technology….
It’s all about the application!
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•
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Identify your specifics need
Quantify your needs
Design a Project to address those needs
Articulate general benefits
Project specific outcomes
Most importantly… find a grant that’s the right fit
for you!
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Polycom, Inc. All rights reserved.