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Steve Hester, MD, MBA Senior SVP, Chief Medical Officer
Norton Healthcare
Effective Care Delivery Across the Continuum
2013 Total encounters 2,214,079
Per Day Statistics:• Average Daily Census…………………………………….…….875• Admissions………………………………………………………….168• Surgeries (IP & OP)………………………………………………134• Outpatient visits (excluding ER)…………………………1,080• ER visits……………………………………………………………….570• Freestanding Diagnostic visits………………………………..69• Practice visits (primary care & specialists)…………4,045• Total encounters per day…………………………………..6,066
Norton Healthcare
Norton Medical Group
Norton Medical Group Profile 2013Total Visits 1,465,657 Primary Care, ICC, and Pediatrics 674,334 Specialist Visits 791,323Total Locations 128Total Visits per day 4,015Total Primary Care Visits per day 1,847Total Specialist Visits per day 2,168Total ICC Visits 161,805
Healthcare – A System in Chaos
• The health care system is under duress
• Irresistible drivers of change include:– Medical progress – Aging population– Global economy
• Challenges for providers and patients:
– Too many people involved, too much to do, no one with all the information, no one with full accountability
– Result: Chaos gaps in quality and safety, inefficiency
Specialty Physician
Home ICC
Diagnostic Center
Skilled Nursing; LTAC;
Rehab
Patient HomeHome Health
Hospital - ER services, OP services, IP stays
Value in the Future = Patient Care Continuum
Care Team Center Wellness
Center
Changing Care Delivery
• Hospital Practices: Improved management of complex patients
– Complex Care Management
– Multidisciplinary Plans of Care through electronic health record
– Increased emphasis to social barriers
• Physician Practices: Patient-centered care
– Patient Centered Medical Home (PCMH)
– Practice redesign
– Payor collaboration
– Wellness – increased screening & lifestyle coaching
Why now?Physician Centered Care Patient Centered Care
Physician
Patient
Nurse
PharmacistSocial Worker
Physical Therapist
Patient
Physician
Pharmacist
Physican TherapistNurse
Social Worker
Required Support for Patient Success
Overcoming health system barriers
Education where knowledge deficits exist
Communication between patient, care provider, and the community
The Future Patient Experience
• Patient Navigation: Result of Fragmented Healthcare• Patients will truly be in control of their care. • Never have to traverse the complicated health system
alone.• Be informed of the care they are provided and be better
able to make knowledgeable decisions.
Navigation Results
• Cancer patient rates as an example:– The screening rate improved 10.8 - 17.1%– Adherence to diagnostic services after an
abnormality was detected improved 21 - 29.2%.
This information provided by: a patient navigation intervention. Cancer. 2007;109(2 suppl):359-367.
Next Steps in Patient Navigation
Commitment from all stakeholders for sustainability
Standardization of the methodology and certification process
Defined standards and metrics for billing
Norton Healthcare’s Patient Navigator Program
NHC Patient Navigators
Discuss Medications
Schedule Follow-ups
Go over discharge instructions
Provide additional information
Answers all questions
Assists the patient in overcoming barriers
Questions?