8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
1/41
2014 The Advisory Board Company advisory.com
1
Do we REALLYwantPatient
Centered Care?When Putting the Patient FIRST, Makes the Provider LAST
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
2/41
2014 The Advisory Board Company advisory.com
3
Are we willing(and ready) to
AbateOur Profits?
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
3/41
2012TH
EADVISORYBOARD
COMPANY-260
86A
We Love Technologywith a PRICE
Innovations to Come Will Take Very Different Form
Source: Hotz RL, Printing Evolves: An Inkjet for Li ving Tissue, Wall Street Journal,
September 18, 2012; Pollack A, Mice as Stan-Ins in the Fight Against Disease, NewYork Times, September 25, 2012; Advisory Board interview and analysis.
Technology in Brief: Mouse Avatar
Researchers are implanting mice "avatars" with a patient's
tumour or part of the patients anatomy
Different treatments are then tested for effectiveness on mouse
In one test, 12 out of 14 test patients successfully shrank theircancerous tumours with fewer side effects using drug tested
first on mouse avatar
Technology in Brief: Bioprinting
Building on 3D printing technologies, researchers in multiplelocations working on ways to print living human tissue
Replacing ink with living cells, scientists printing tailored tissues
suitable for surgery and organ transplant
Simplest experimental prototypes ready for clinical testing in
five years
IMAGECREDIT:AUDREY_
SEL.
IMAGE
CREDIT:MAYBEMEME
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
4/41
2012TH
EADVISORYBOARD
COMPANY-260
86A
What if Better is CHEAPER?
5
Is There Anything Duct Tape Cant Do?
Source: Focht, D.R., Spicer, C., Fairchok, M.P., The Efficacy of Duct Tape vs Cryotherapy in the Treatment
of Verruca Vulgaris,Archives of Pediatrics & Adolescent Medicine 2002; 156 (10):971-974; Cost Helperavailable at http://health.costhelper.com/wart-removal.html; Advisory Board interviews and analysis.1) Cryotherapy: Liquid nitrogen applied by doctor over 3-6 visits
Cost Comparison of Wart Treatments
Study in Brief: Duct Tape
Treatment of the Common Wart
2002 study assessed effectiveness
of duct tape occlusion versus
cryotherapy1for treating common
warts
Results found duct tape at least as
effective a treatment as more
expensive cryotherapyIMAGE
CREDIT:SYIBUS2003.
4
488
Duct tape Cryotherapy
Efficacy Comparison of Wart Treatments
85%
60%
Duct tape Cryotherapy 1
http://health.costhelper.com/wart-removal.htmlhttp://health.costhelper.com/wart-removal.htmlhttp://health.costhelper.com/wart-removal.htmlhttp://health.costhelper.com/wart-removal.html8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
5/41
2012TH
EADVISORYBOARD
COMPANY-260
86A
New Model for Patient Services
6
Innovators Unrestricted by Current Delivery, Payment Models
Iora Health Contracts Directly WithEmployers to Deliver Primary Care
1) Per member per month.
2) 2009; relative to control group created using propensity
matching; gross spending dropped 18%.
Source: Iora Health, available at: www.iorahealth.com;Advisory Board interviews and analysis.
Case in Brief: Iora Health Operating the Dartmouth Health Connect clinic for Dartmouth College in Hanover, New
Hampshire, and the Culinary Extra Clinic for the Culinary Health Fund in Las Vegas, NV
Manage top 10 percent of sickest patients using comprehensive, team-based approach
Achieved 12.3 percent decrease in total spending for patients enrolled in 20092
Iora Health Local Employer GPs, contracted specialists
provide care to employee population
Employer pays fixed PMPM1fee, clinic
reports outcomes at monthly meetings
Iora doctors coordinate care with
hospitalists; hospital provides data back
Weve been worrying about the impact of
our decisions on physicians and hospitals,
but its time to worry about the impact onthe patient. The hospital perspective is not
our problem, its creative destruction.
Rushika Fernandopulle, MDIora Health
Putting the Patient First
http://www.iorahealth.com/http://www.iorahealth.com/http://www.iorahealth.com/8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
6/41
2012TH
EADVISORYBOARD
COMPANY-260
86A
Are we willing(and ready) to
Abate Our Profits?
AbandonOur Comforts?
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
7/412013Th
eAdvisoryBoardCompany27852
Not Just One Service, But Many
8Health Care Advisory Board CONCLUSION
High-Risk
Patients
Rising-Risk Patients
Low-Risk Patients
60-80% of patients;
any minor conditions
are easily managed
15-35% of patients;
may have conditions
not under control
5% of patients;
usually with complex
disease(s), comorbidities
Managing Three Distinct Patient Populations
HIGH SERVICE
and LOW COST
HIGH EFFORT
8
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
8/412012TH
EADVISORYBOARD
COMPANY-260
86A
1440 Minutes Per Day
24 Hours a Day / 365 Days Per Year
On Demand Technical Help
Initial Help FREE of Charge
Online / On Phone / In Store
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
9/412014 The Advisory Board Company advisory.com 28600A
1010
Source: PINGMD, available at: www.PINGMD.com,accessed
October 1, 2013; Health Care Adv isory Board interviews and analysis.
1) Proprietary.
2) Documented exchanges reduce physician liability; patient acknowledges disclaimer describing proper platform use.3) 100% HIPAA compliant secure communication,100% of the time.
Health care technology startup located in New York, NY
Online platform enables efficient care network communications through secure text,
picture, and video messaging; mobile app notifies user when communications are
sent, received and resolved
Platform reports 100% improvement in customer satisfaction
Real-Time Patient Access to
Physician, Care Providers
Patients submit clinical
questions via mobile wizard1
or web application
Photo or video attachments
provide detail on ailment2,3
Physician or care provider
recommends next care step
Case in Brief: PINGMD
Point, Click, and Heal
http://www.pingmd.com/http://www.pingmd.com/http://www.pingmd.com/8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
10/412014 The Advisory Board Company advisory.com 28600A
11
On the Phone, All the Time,
Source: Creswell J, Start-Up Health Insurer Finds Foothold in New York,
The New York Times, March 28, 2014, available at: www.nytimes.com ;Health Care Advisory Board interviews and analysis.
Fastand FREE
Case in Brief:
Prepaid healthcare
offers free televisits,
free generic drugs, and
a limited number of free
PCP visits per year
SCREENSHOT:OSCAR
Average televisit
response time
7 min
Promises response time
of less than one hour
http://www.nytimes.com/http://www.nytimes.com/8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
11/412014 The Advisory Board Company advisory.com 28600A
12
Catering to an Unmet Need
12
Patient Portal Access Increases Engagement with Health System
Source: McCarthy D, et al., Kaiser Permanente: Bridging the Quality Divide with Integrated Practice, Group Accountability, and HealthInformation Technology, The Commonwealth Fund, 2009: 1-28; Kaiser Permanente Careers: Hawaii, available at:
http://www.kaiserpermanentejobs.org/hawaii.aspx,accessed April 30, 2013; Health Care Advisory Board interviews and analysis.
Case in Brief: Kaiser Permanente Hawaii
Branch of Kaiser Permanente based in
Honolulu, Hawaii; cares for 229,000 members
across the state
Piloted Kaisers patient portal in 2005
Region experienced a 26% decrease in
doctor visits in the two years following
portal implementation
8%Despite a 26% drop in doctor visits post-portal
implementation, Kaiser Permanente Hawaii
experienced an 8% increase in total patient contact
2003 2007
Secure messaging
Scheduled telephone visits
Office visit
Distribution of Patient Contacts
at Kaiser Permanente Hawaii
5.215.61
Contacts
per
member
26%
http://www.kaiserpermanentejobs.org/hawaii.aspxhttp://www.kaiserpermanentejobs.org/hawaii.aspxhttp://www.kaiserpermanentejobs.org/hawaii.aspx8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
12/412013TheAdvisoryBoardCompany27505B
Are we willing(and ready) to
Abate Our Profits?
Abandon Our Comforts?
AbdicateOur Positions?
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
13/41
N L R t d?
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
14/412013TheAdvisoryBoardCompany27505B
UnpopularEven When Right
No Longer Respected?
No Longer In Control?
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
15/41
Being Guided by Others
No Longer In Control?
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
16/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
17/41
Are we willing(and ready) to
AbateOur Profits?
AbandonOur Comforts?
AbdicateOur Positions?
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
18/41
Three Unique Roles for Us To Play
1) Servants to Exceed Expectations
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
19/41
Far Beyond Our Work Alone
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
20/41
Treating the (Obvious) Symptoms
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
21/41
Far Beyond Our Work Alone
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
22/41
Treating the (Obvious) Symptoms
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
23/41
Service Happens in the White Space
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
24/41
Addressing Needs Not Activity
Patient Experience Simulations
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
25/41
Patient Experience Simulations
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
26/41
Three Unique Roles for Us To Play
1) Servants to Exceed Expectations
2) Gamers to Encourage Behavior
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
27/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
28/41
Profuse apologies for the realities of life, making
amends for service slips, and trying to placate
frustrated patients
Encouraging patients to face
reality and accept care plans
via honest conversations
Celebrations and token
gestures to boost spirits
and reward compliance
Convincing patients that
hard choices and trade-
offs are the best course
of action for their care
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
29/41
Counterintuitively, passiveacceptance is not what we want. We
need patients to be activated,
motivated, and involved in their care
The very uncertainty and lack ofcontrol that causes grief is also the
necessary ingredient for triggering
action!
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
30/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
31/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
32/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
33/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
34/41
Three Unique Roles for Us To Play
1) Servants to Exceed Expectations
2) Gamers to Encourage Behavior
3) Entrepreneurs to Envision the Future
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
35/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
36/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
37/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
38/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
39/41
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
40/41
Are we willing(and ready) to
AbateOur Profits?
AbandonOur Comforts?
AbdicateOur Positions?
Global CampusTalent Development
8/10/2019 Mike Wagner_Do We Really Want Patient Centered Care
41/41
Are we willing(and ready)to become
1) Servants to ExceedExpectations
2) Gamers to
Encourage
Behavior
3) Entrepreneurs to
Envision the
Global CampusTalent Development
Are we willing(and ready)to
AbateOur Profits?
AbandonOur
Comforts?
AbdicateOur
Positions?