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© Polycom, Inc. All rights reserved.
ACO’s, Care Collaboration, EHR -the role of Collaborative Video Solutions
Dr. Deborah A. Jeffries, Director US Healthcare
© Polycom, Inc. All rights reserved. 3
future
1990s 2000s 2009-2010 2011 2012 2013
Milestone
• Multi Million dollar PACS• Early Telemed Adopters• T1 lines• Expensive Equipment• Spotty coverage• Quality sketchy• License & Reimbursement issues
• 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
• Peer to Peer• Mobility• Cloud• 2-10 billion Innovation• Prevention Wellness• ACO• RE-Admits• EHR Roll out• Care Coordination• Payer/Provider
• PCMH• CMS Telemedicine
Codes Expanded• Grant funding for
collaboration• 11.5 Billion CHC• Accountable Care
Polycom Open, Standards Based, Scalable, Most Cost Effective, Customer focused
Polycom Tablet, CloudAxis
HD, RMX, DMA
CMA 100k licenses 1st month
History: Collaborative Video for Healthcare
Large Room Based Sys
POCN, Intelligent Core
Go to a special room for scheduled video
Video where and when you need it, desk, room, home, on the go
© Polycom, Inc. All rights reserved. 4
� 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
HC Reform
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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.
© Polycom, Inc. All rights reserved. 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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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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Care Coordination Goals• Prevention and Wellness
− 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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Populations Management
� Disease Management− Diabetes
− CHF
− COPD
− Mental Health
� Nutritional Education− Childhood Obesity
− BP, HTN
� Public Service Updates− Cardiac and Pulmonary
Education
− Smoking Cessation
Prevention and Wellness: Community/Patient Education
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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?
© Polycom, Inc. All rights reserved. 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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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.
© Polycom, Inc. All rights reserved. 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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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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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
© Polycom, Inc. All rights reserved. 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− 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
© Polycom, Inc. All rights reserved. 17
HealthcareCollaboration
ONE-TO-ONE ONE-TO-MANY MANY-TO-MANY AD-HOC
• Case Mgr to Patient• Peer to peer• Patient to family member
• IT to End User
• Community health education
• Specialist to many patients
IT to Many for EHR
• ACO meetings• Community center to commuinty center
• Hospital to hospitalgroup meetings
• Virtual HC teams• Discharge Planning• Follow up calls• Transition support• IT to End User
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Making Collaboration Available to Everyone
Content sharing with just a click and can be initiated by anyone in the meeting
All participants experience a secure, high quality experience
All have a secure high quality experience
Diabetes Exercise
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Requirements
ACO’s, Care Coordination, EHR
All require collaboration across physical boundaries
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Solution: Collaborative Video for Healthcare
Home Hospital Clinic Long Term Care
PatientMultipoint
Video
Education
One-to-one Video
Practitioner Consultation
Video Care Coordination
Family Video
Support
Video Health
Coaching
Recorded Video
Education
© Polycom, Inc. All rights reserved. 21
Polycom® RealPresence™
Platform
Community Health Center
Remote Medical Specialists
Physicians Office
PACS EHR
ITHospital Center of Excellence
Rural Treatment Center
Mobile
Desktop Room based
Telepresence
Collaborative Video for Healthcare
Practitioner Cart
RealPresence CloudAXIS
© Polycom, Inc. All rights reserved. 22
• 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 Re-admits
• 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
Summary:
© Polycom, Inc. All rights reserved.
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!
© Polycom, Inc. All rights reserved.
Spanning the Gamut of Telehealth
Rural Healthcare Healthcare Innovations & Research
Health Professions
Home Health & Health Outreach
RUS-DLT Healthcare Innovation (HCI)
HRSA - NEPQR MIECHV
Rural Health Network Development
PCORI DOL/ED H-1B Youth Career/Connect
Eliminating Disparities in Perinatal Health
Delta State Rural Network & Delta Health
NIH – Health Disparities grants
HRSA – Advanced Nursing Education
School Based Health Centers
© Polycom, Inc. All rights reserved.
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)
© Polycom, Inc. All rights reserved.
It’s not about the grant, or the technology….
It’s all about the application! • 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!