Download pdf - Would You Like a Visit With That Healthcare?

3/21/14

1

ì

Daniel Z. Sands, MD, MPH @DrDannySands Society for Par=cipatory Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA

© Copyright 2014 D. Z. Sands, All Rights Reserved -‐ @DrDannySands

Would You Like A Visit With That Health Care?: Changing Our Thinking About Health Care Delivery

Commercial Disclosures

ì  Best Doctors, Inc. – consultant

ì  Kinergy Health, Inc. – consultant

ì  SeniorLink, Inc. – consultant

ì  PostWire, Inc. – consultant (2013)


I will not be discussing products or services of any of these companies in my presenta8on.

3/21/14

2



The Consumerization of Health and the Virtualization of Care

Diagnose and Treat

Prevent and

Maintain

Physical Resources

Virtual Resources

Drivers: •  Burden of chronic illness •  Ageing popula=on •  Resource maldistribu=on •  Cost-‐containment •  Consumer demand

Health Treatment

Hospital

Home

Anywhere

Built on ideas from Michael Gill

$$$$$

$

3/21/14

3


Care Delivery Costly in Traditional Settings

Yet There is Relentless Demand for Services


3/21/14

4


A Perfect Storm


And Our Systems Are Optimized for Managing Acute Care

3/21/14

5


So We Must Focus More on Chronic Disease Prevention and Treatment


Also Have Maldistribution of Resources

~40% Fewer Clinicians Outside

Major Ci=es

3/21/14

6


Therefore, We Must Adopt New Care Models

More care op=ons for pa=ents § Bring care to pa=ent rather than pa=ent to care § Care and services when and where is needed § Pervasive care availability: formal to informal se^ngs à be_er service, sa=sfac=on, outcomes, value


… Eventually Providing Care Anywhere

3/21/14

7

Online Population Rising…


…And Health Info Seeking Popular


3/21/14

8

Online Health Habits of US Adults

Sources: www.pewinternet.org; PwC HRI Social Media Consumer

Survey, 2012

ì  80% of online adults have looked for health info ì  Rising over =me ì  Each day, more people search for health informa=on than see a physician! ì  More than half act on the informa=on

ì  1/3 have read about others’ health experiences

ì  1/4 have tracked their health informa=on online

ì  1/3 use social media for health



Patient-‐Generated Health Information

3/21/14

9

Many Patients Want To Be Engaged

Involvement in

Care

Communica=on

Convenience Informa=on


hBps://www.paEentsite.org

Bringing It All Together: Patient Portals


3/21/14

10

Services: § Prescrip=on refills § Appointment requests § Referrals § View bill

EducaEon: § Search § Info prescrip=ons § Pa=ent selected links § Predefined collec=ons


Mail: § Secure § Automated rou=ng § Task assignment

Records: § Secure § All system records § Upcoming appointments § Meds, Problems, Results … and Notes § Personal records

Feedback from Dave, a 56 yo M consultant

This is too cool. It's almost SILLY that things can be this easy. I am having a very good patient/customer experience so far. (Seriously.)


3/21/14

11


Ideally, What Is Patient Care?


Health Care Is a Collaboration …

3/21/14

12


… But Collaboration ≠ In Person


… But Collaboration ≠ In Person

Source: natr/Community Telco

3/21/14

13



Many Tools Can Be Used for Collaboration, From Simple…

3/21/14

14


… To Sophisticated

Source: Philips, American Well, Cisco, InTouch


E-‐messaging Is Just the Start

3/21/14

15

Attributes of Collaboration Channels

Technology Synchronous? InformaEon Density

Telephone þ ««

E-‐messaging o «

Text messaging/IM o/ þ «

Remote monitoring þ «

Telemedicine þ (usually) «««

Advanced Telemedicine þ ««««

Office visit þ «««««


Attributes of Personnel

PaEent Self-‐care

Counselor/ Educator

Clinical Nurse

NP/PA Physician

§ Different personnel can provide care § Each has a_ributes § Each should prac=ce at “top of his/her license” § Can add others to this list, even perhaps, Watson…


3/21/14

16

Optimizing Channel and Personnel

PaEent Self-‐care

Counselor/ Educator

Clinical Nurse

NP/PA Physician

Telephone

E-‐messaging

Text messaging/IM

Remote monitoring

Telemedicine

Advanced Telemedicine

Face-‐to-‐face visit


Because of the Web, Patients Can Connect to Information and Each Other (and to Care)


3/21/14

17

We Have The Tools We Need


Self-‐Care, Transparency, and Pa=ent-‐Provider Collabora=on Can Save Healthcare

Conclusions

ì  Good pa=ent care is a collabora=on

ì  Technology can facilitate remote collabora=on

ì  The drive to offer telehealth services comes from: ì  Need to manage chronic disease effec=vely ì  The over-‐extended health care system ì  Pa=ent demand for convenience

ì  We must op=mize technologies and personnel for each encounter to both meet our customer’s needs and to scale our health care systems


3/21/14

18


Questions?

Questions and e-‐mail address

[email protected] hBp://www.DrDannySands.com

@DrDannySands © Copyright 2014 D. Z. Sands, All Rights Reserved -‐ @DrDannySands