Post on 06-Mar-2018
Saint Luke’s eHealth Outreach: Establishing eHealth as a core competency in your program
January 26, 2017
Stephen Kropp, MSSystem Director, eHealth and Outreach
Saint Luke’s Health System
eHealth & Outreach:
Saint Luke’s eHealth/Outreach History
Ahead of, in, or behindthe eHealth wave?
Dementia ScreensAnderson Co. Hosp
eCardiologySLH to WMH
ePsychiatryto area EDs
SLHS eGovernance
SLHS eHealth/Outreach
200620011998 2010 20162007
eICU®5th in USA
Saint Luke’s24/7
2012
eSpecialty
eHospitalists
2005
Home eHealth
SLH = Saint Luke’s Hospital (Plaza); SLHS = Saint Luke’s Health System; WMH = SLHS Wright Memorial Hospital, Trenton Missouri
eHealth as a Core Competency
Core Competency
• A concept in management theory introduced by Prahalad, Kriviak and Hamel
• "A harmonized combination of multiple skills that distinguish a firm in the marketplace” ―Prahalad CK and Hamel G. Harvard Business Review.
Characteristics
• Provides potential access to a wide variety of markets
• Makes significant contribution to perceived customer benefits of the end product
• Difficult to imitate by competitors
Align With Organization’s Mission/Vision/Values
• eHealth concepts should synergize and support your organization’s strategic plan.
• eHealth benefits should directly impact key points within the strategic plan.
• eHealth projects must be communicated clearly and must resonate with executive leaders responsible for innovation and business development.
Source: Prahalad CK and Hamel G. The core competence of the organization. Harvard Business Review. 1990;68:79–91.
eHealth/Outreach—Why Now?Changing Health Care Landscape—Payment Models
Fee-for-Service
Volume –based
Traditional, acute care paradigm
Based on illness
Value-Based
Quality
Safety
Patient satisfaction
Reduced cost
Population Health Management
Global payment
Wellness/
prevention
Medical home
Managing chronic disease
Goals – Touch More Patients – Improve Care – Improve Efficiency
SLHS eHealth Driving Principles
5
Market
Expansion
Operational
Efficiency
Competitive
Differentiation
Defensive Strategy
How large is the
opportunity?
Are the program
benefits equal to or
greater than the cost
to produce them?
What distinguishes our
programs from competitors?
Do we need to react to
competing eHealth programs?
In 2010, Saint Luke’s eGovernance Council defined 4 goals to evaluate and guide investment decisions.
Transition From Cost Avoidance to Revenue Generation…
How will your organization’s current and future state be impacted by how you define your health care model today?
“More than just cost avoidance, eHealth has arrived as a revenue source for both NFP and for profit health systems/providers.”
-SLHS eHealth 2015.
NFP = not for profit.
Buckminster Fuller –Knowledge Doubling Curve
(Source: Critical Path)
• He describes the curve as beginning in year AD 1. At this point in time, all human knowledge was represented in something he called a “knowledge unit” which took a 198,000 years to amass.
• By 1500, human knowledge had doubled to 2 units
• In 1750, with the introduction of the printing press, it doubled to four units
• By 1900 (around 150 years), human knowledge had doubled again
• In 1950, knowledge doubled again to 16 units
• At the time Critical Path was published (1982), Fuller estimated that human knowledge was doubling every 18 months
• Now, it is estimated that human knowledge is doubling every 12 to 13 months
• IBM predicts that human knowledge could soon double every 12 hours.
Percentage of Large Employers Offering Telemedicine Benefits
2015
48% 74%
2016
Sources: National Business Group on Health, survey of 140 large employers; Beck M. How telemedicine is transforming health care. Wall Street Journal. June 26, 2016.
Kansas Hospitals1 - Community Memorial, Marysville
2 -- Nemaha Valley Community,
Seneca
3 – Sabetha Community, Sabetha
4 – Hiawatha Community, Hiawatha
5 – Horton Community, Horton
6 – Community Healthcare, Onega
7 – Wamego City Hospital, Wamego
8 – Holton Community, Holton
9 - Atchison Hospital, Atchison
10 – FW Huston Medical Center,
Winchester
11 – St Francis Health Center,
Topeka
12 – Stormont-Vail Healthcare,
Topeka
13 - Lawrence Memorial, Lawrence
14 – Newman Regional Health,
Emporia
15 – Ransom Memorial, Ottawa
16 – Miami County Medical, Paola
17 – Coffey County, Burlington
18 – Anderson County, Garnett
19 – Allen County, Iola
20 – Mercy Hospital Fort Scott
21 – Neosho Memorial Regional
Medical Center
22 – Girard Medical Center, Girard
23 - Via Christi Hospital, Pittsburg
Missouri Hospitals24 – Community Hospital, Fairfax
25 – St Francis Hospital, Maryville
26 – Northwest Medical Center, Albany
27 – Harrison County Community,
Bethany
28 – Wright Memorial, Trenton
29 – Sullivan County Memorial, Milan
30 – Heartland Reg Med Center, St.
Joseph
31 – Cameron Reg. Med Center,
Cameron
32 – Hedrick Medical Center, Chillicothe
33 – Gen John J Pershing Mem,
Brookfield
34 – Ray County Memorial, Richmond
35 – Carroll County Memorial, Carrollton
36 – Lafayette Reg. Health Ctr, Lexington
37 – I-70 Community, Sweet Springs
38 – Fitzgibbon Hospital, Marshall
39 – Belton Regional Med Center, Belton
40 - Cass Reg Medical Center,
Harrisonville
41 – Western MO Med Ctr, Warrensburg
42 – Bothwell Reg Health Center, Sedalia
43 – Cooper County Memorial, Boonville
44 – Bates County Memorial, Butler
45 – Golden Valley Mem Healthcare,
Clinton
46 – Ellett Memorial, Appleton City
47 – Sac Osage Hospital, Osceola
48 – Nevada Regional Medical Center
49 – Cedar County Mem, El Dorado
Springs
50 – Barton County Memorial, Lamar
51 - Citizens Memorial Hospital, Boliver
SLHS Regional Facility
Allen
Anderson
Andrew
Atchison
Atchison
Barton
Bates Benton
Bourbon
Brown
Buchanan Caldwell
Carroll
Cass
Cedar
Chariton
Clay
Clinton
Coffey
Cooper
Crawford
Daviess
DeKalb
Doniphan
Douglas
Franklin
Gentry
Grundy
Harrison
Henry
Hickory
Holt
Howard
Jackson
Jackson
Jefferson
Johnson
Johnson
Lafayette
Linn
Linn
Livingston
Lyon
Marshall
Mercer
Miami
Moniteau
Morgan
Nemaha
Neosho
Nodaway
Osage
Pettis
Platte
Polk
Pottawatomie Ray
Saline
Shawnee
St Clair
Sullivan
Vernon
Wabaunsee
Woodson
Worth
4
5
3
21
9
87
1213
1
4
1516
1
7
19 20
21
22
23
2425
26
27
29
30
31
33
34
35
3637
38
39
40
41 42
43
44
45
46
47
4849
50
51
6
10
11
18
28
32
Wyandotte
Leavenworth
SLHS SSA Regional Hospital Markets
Telemedicine Rapid Expansion: “More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.” Wall Street Journal, June 26, 2016
2015, 2016 (2017 Planning): Statewide Telemedicine Legislative Summit in Jefferson City –Summit for Health Care Providers, Insurers, Telemedicine Industry and Missouri Legislators
eHealth—Why Now?
Source: Beck M. How telemedicine is transforming health care. Wall Street Journal. June 26, 2016.
eHealth Works!WSJ: How can technology and digital patient data be used to improve outcomes in whole populations?DR KIZER: “Social media can be used to track infectious-disease outbreaks such as influenza and food-borne illnesses. Online immunization registries and portals can help parents and schools ensure children are appropriately vaccinated. Electronic health records can be especially useful for identifying patients who need close monitoring or extra effort to avoid emergency visits and hospitalizations. Linking electronic health records with other virtual-care technologies is being used to support new models of care like community paramedicine [emergency medical transportation], in which paramedics provide home health checks or other basic services.” Wall Street Journal, June 26, 2016
eHealth—Why Now?
Source: Beck M. How telemedicine is transforming health care. Wall Street Journal. June 26, 2016.
eHealth (TeleHealth) Opportunities
Prebirth/Healthy
Outpatient
Inpatient
End-of-Life Care
Death
eHealtheHealth
Intervention
SLHS
eHealth
Services
Iowa
Wayne Co Philips eCare
Iowa
Grinnell Philips eCareHays
HMCPhilips eCare
Pittsburg
Via ChristiPhilips eCare
Manhattan
MercyPhilips eCare
Family
GuidancePolycom
NCMHTandberg
Polycom
Warrensburg
WMMCInTouch
Patient HomesCardiocom
Clinton
GVMHPolycom
I-70
HospTandberg
Saint Lukes
Wright Memorial
Hospital
Saint
Lukes
Hedrick
Medical
Center
Saint
Lukes
Cushing
Hospital
eHome Health
ePsychiatry
ePharmacy
ePsychiatry
Non-System eICU
ePsychiatry
eHome Health
eICU
eHospitalists
eNeurology
eCardiology
ePulmonary
eEndocrine
eNephrology
eOncology
eID
eRehab
eWound
eHepatology
eNICU
ePharmacy
Saint
Lukes
East
Hospital
Saint Lukes
North Hospital
Smithville
CrittentonSaint Lukes
South Hospital
Saint Lukes
Hospital –
Plaza
Anderson
Community
Hospital
Saint Lukes
North Hospital
Barry Road
eHealth Outreach for Critical Access Hospitals: A Saint Luke’s Core Competency
2
• eSpecialty inpatient and outpatient services provided through WiFi InTouch RP-Lite cloud-based service
• eSpecialists available only during normal duty hours M-F
• eHospitalists available 24/7/365
• eSpecialist supplement patient care from local physicians
• eHealth embraced by patients, local physicians and hospital administrators
• eSpecialty and eHospitalist goals:
– Patient care via evidence-based protocols
– Decrease unnecessary patient transportation to metro
– Help increase hospital’s acuity level (and staff’s comfort level)
– Help increase inpatient census in local hospitals
The Hedrick Experience: Problem
2
500
550
600
650
700
750
800
850
2011 2012 2013
Admissions
Transfers
Source: Saint Luke’s Health System and Hedrick Medical Center—General Accounting.
The Hedrick Experience: Solution
600.00
650.00
700.00
750.00
800.00
850.00
900.00
950.00
1,000.00
2011 2012 2013 2014 2015
Total IP Admissions ( Med Surg, Swing,ICU/PCU)
Total Transfers
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
7.00%
8.00%
9.00%
10.00%
7000
7500
8000
8500
9000
9500
2011 2012 2013 2014 2015
ER Visits
% of ER Transfers to ER Visits
Source: Saint Luke’s Health System and Hedrick Medical Center—General Accounting.
eHealth as a Core Competency
Core Competency
• A concept in management theory introduced by Prahalad, Kriviak and Hamel
• "A harmonized combination of multiple skills that distinguish a firm in the marketplace”
Characteristics
• Provides potential access to a wide variety of markets
• Makes significant contribution to perceived customer benefits of the end product
• Difficult to imitate by competitors
Align With Organization’s Mission/Vision/Values
• eHealth concepts should synergize and support your organization’s strategic plan.
• eHealth benefits should directly impact key points within the strategic plan.
• eHealth projects must be communicated clearly and must resonate with executive leaders responsible for innovation and business development.
eHealth as a Saint Luke’s Core Competency
Core Competency - Saint Lukes embraces eHealth as a Core Competency
Characteristics
• eHealth Provides medical care/access in Saint Luke’s Kansas City & Regional facilities
• eHealth contributes to customer benefits (see below)
• Saint Luke’s eHealth Services have yet to be imitated in the Kansas City Region
Align With Organization’s Mission/Vision/Values
• eHealth supports Saint Luke’s strategic plan for patient Access and Service
• eHealth directly impacts Saint Luke’s strategic patient-centered concepts & vision:
– Patient Benefit: Augments local care, facilitates family/community support and allows aging in place
– Hospital benefit: Improved efficiency, reduced cost and decreases complications & length of stays
– Physician benefit: Improves access, efficiency, job satisfaction and quality of life for physicians
• Saint Luke’s eGovernance Council sets expectations and reports to System BOD.
As a core competency within the Saint Luke’s Health System, the
real patient impact is summed up in this brief video.
• https://www.saintlukeshealthsystem.org/about/news/videos-and-podcasts/hedrick-medical-center-ehealth-success-story
• https://youtu.be/wUKBGFvppTk