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