LIVE WEBCAST | FeaturingAugust 21, 2012

C3N Supported by NIH NIDDK R01DK085719

AHRQ R01HS020024 AHRQ U18HS016957

Welcome!• We will pause for questions after

the C3N Project overview, and at

the conclusion of our feature

presentation we will host more

time for Q&A; but you can also

direct questions and comments

anytime using the chat function

• After the presentation, a short

survey will appear – thanks for your

feedback + participation!

• First, a few technology pointers…

Peter Margolis, MD, PhD

Michael Seid, PhD

Mute/ Un-Mute Your Line

Raising Your Hand

4

Raise your hand Lower your hand

Writing Comments & Asking Questions

CLICK HERE TO OPEN BOX.

TYPE YOUR QUESTION HERE!

6

take the conversation to twitter

#C3N@C3NProject@Ginger_io

An Introduction of the C3N Projectwith Dr. Peter Margolis

What if….?

• …we could create a vastly better chronic care system

by harnessing inherent motivation and collective

intelligence of patients and clinicians?

• … this system allowed patients and physicians to

share information, collaborate to solve problems, use

their collective creativity and expertise to act in ways

that improve health?

.5 x .5 = .25

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What is the C3N?

• Self-reinforcing network

• “Lab” and “proving ground”

• A social, technical and scientific platform to support a learning health system

Learning Health Systems

• Patients and providers work together to choose care

based on best evidence

• Drive discovery as natural outgrowth of patient care

• Ensure innovation, quality, safety and value

• All in real-time

Institute of Medicine

Design

Observation

Synthesis

Screen

Test Adapt, Implement & Spread

Prototype testing

Pilottesting

Concept design

Generate new ideas Test new ideas Spread new ideas

C3N Design Process

Creating Conditions for a C3N

1. Align motivation around common vision

2. Make it easy to contribute

– design, system engineering and technology

3. Enable better communication

4. Reduce “transactional” costs

Percent of Patients in Remission

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Jul-2007 N

=338

Aug-2

007 N

=396

Sep-2

007 N

=428

Oct-

20

07 N

=4

79

Nov-2

007 N

=508

Dec-2

007 N

=531

Jan-2

008 N

=570

Fe

b-2

008 N

=607

Mar-

2008 N

=643

Ap

r-2

00

8 N

=6

54

May-2

008 N

=667

Jun-2

008 N

=671

Jul-2008 N

=686

Aug-2

008 N

=731

Sep-2

008 N

=754

Oct-

20

08 N

=8

01

Nov-2

008 N

=832

Dec-2

008 N

=901

Jan-2

009 N

=973

Fe

b-2

009 N

=995

Mar-

2009 N

=1021

Apr-

2009 N

=1070

May-2

009 N

=1112

Jun-2

009 N

=1194

Jul-2009 N

=1240

Aug-2

009 N

=1277

Sep-2

009 N

=1314

Oct-

2009 N

=1344

Nov-2

009 N

=1366

Dec-2

009 N

=1400

Jan-2

010 N

=1421

Fe

b-2

010 N

=1410

Mar-

2010 N

=1440

Apr-

2010 N

=1455

May-2

010 N

=1461

Jun-2

010 N

=1471

Jul-2010 N

=1489

Aug-2

010 N

=1518

Sep-2

010 N

=1547

Oct-

2010 N

=1576

Nov-2

010 N

=1985

Dec-2

010 N

=2032

Jan-2

011 N

=2043

Fe

b-2

011 N

=2065

Mar-

2011 N

=2124

Apr-

2011 N

=2191

May-2

011 N

=2206

Jun-2

011 N

=2272

Jul-2011 N

=2301

Aug-2

011 N

=2335

Pe

rce

nt

of

Pat

ien

ts

Month

Percent of IBD Patients in Remission (PGA)

Why Crohn’s as a Prototype?

• Number of patients small

• Few incentives for industry to invest in research

• No center has enough patients

• Teenagers especially likely to use Internet

communications

Reducing Transactional Costs Example: Data Collection

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“Enhanced” Registry

• Research using distributed registry of 10,000 patients

• Automated Pre-visit Prompts

• Automated Physician Pre-Visit Planning

Infliximab and Thiopurine Treatment by Site

0%

10%

20%

30%

40%

50%

60%

70%

Sites

Perc

en

tag

e o

f C

D P

ati

en

ts

Infliximab Thiopurine

“Enhanced” Registry - Research

QUESTIONS?