From the Frontier: Case Studies of Current and Future Disruptive

Innovations February 29, 2016

Madan Dharmar, MBBS, PhD Assistant Research Professor, Center for Health and Technology

University of California Davis

Conflict of Interest

Madan Dharmar, MBBS, PhD

Has no real or apparent conflicts of interest to report.

Agenda

• Learning Objectives

• Technology Enabled Healthcare – Overview

• Innovative Model of Care – Telehealth

• Innovative Model of Care – Patient Generated

Health Data

• Future of Healthcare

• Questions/Wrap up

Learning Objectives

• Take a closer look at disruptive clinical

innovation and explore how the delivery system

is likely to change.

• Understand how to capture value from

emerging IT innovations.

• Discuss key IT-related implications and

approaches to deal with more patient data.

• Dive into factors that make for a successful, or

at least documented promising, patient

experience.

Challenges in Current Healthcare

• Increasing demand for healthcare

• Shortages in traditional healthcare

• Increasing healthcare cost

• Increasing awareness among consumers

• Reactive model of care

Science and Invention magazine cover (1925) – Technology enabled healthcare

Pathway of Disruptive Innovation…..

Treat Individuals Treat in Institutions

Use Technology to Support Current

Process

Focus on “Professional Caregivers” P

ast

to P

resen

t

Treat Groups and Population

Treat in the Home and Community

Technology creating new authorities on Health

Involve People, Family, Friends and Others in Care

Tran

sit

ion

to

Fu

ture

Disruptive Innovation in Healthcare – First Use Case

• Advancing Technology

– Video conferencing

– Decreasing cost of technology

• Regionalization of Care

– Timely care

– Shortage of providers

– Higher quality of care

– Lower healthcare cost

• Patient Centered Care

– Reduce distance barriers/increasing access

– Higher patient satisfaction/experience

Activity Snapshot

• Approx. 40,000 consultations across 44 counties to over 100 sites (does not include

Radiology or Pathology)

• Over 1,800 participants trained through Telehealth Education Program from 800+ organizations

• Over 4,800 distance education events

• Over 1,600 grand round sessions

• Nearly 130 publications (journal articles, book chapters, letters to the editor, abstracts, limited submission pieces)

Funded by: Telehealth Network Grant Program - Office for the Advancement of

Telehealth (OAT) in the Federal Office of Rural Health Policy (FORHP)

Disruptive Innovation in Healthcare– Second Use Case • Advancing Technology (Pew)

– 64% of U.S. adults have smartphones

– Sensor based Internet of Things

• Empowered People (Pew)

– Seven in ten U.S. adults track a health indicator

– 64% of U.S. adults with two or more chronic conditions track a health indicator

– Almost half say they have changed their overall approach to health

• Empowered Providers

– Team based care

– Data and advanced analytics

Improving Health in Diabetes Program: Changing the Conversation

Funded by: Improving Healthcare Systems – Patient Centered Outcomes Research

Institute (PCORI)

Drivers and Barriers for Patient Generated Health Data

DATA MEANING

ST

EP

S

You have trouble meeting your activity

goals on Mondays and Tuesdays. What

happens on those days? What changes

might you make?

Activity levels seem to be linked to your

sleep quality at night.

Certain night time meals and alcohol

intake appear to impact sleep quality and

mood

Your blood pressure has improved due to

changes you have made to your diet and

activity in the past 3 months!

Patient Generated Health Data Flow

Improving Health in Diabetes Program: • Data Quality • Managed Authentication • Data Stored within Epic • Data Analytics within Epic • Meaningful integration within providers workflow • Patient visualization of data

Collaborative PGHD Goals

• Physical Activity

Steps

Active calories burned

Active minutes (workout)

• Sleep

Sleep length

• Nutrition

Calories

Intake: fat, carbohydrates, cholesterol, sugar, sodium, fiber, protein

Electronic Health Record View: PGHD

Are we on the right track?

“I feel like if someone took the time then [say] ‘Oh, this is what you’re doing during the day. Here’s where you need to improve.’ That would be wonderful.”

“Well, I think it would be a great idea for my doctor and anybody tied to my care to be able to have that information just for the simple fact of okay, this is what you’re doing, you know, maybe we need to adjust your medications.”

“If I could see a pattern, maybe it’s not exercising or maybe it is stress or maybe I was, you know, on medication, that would -- the logical side of me would respond to that. Those are facts.”

Benefits Realized from Technology enabled Health IT

Future is brighter….

http://www.himss.org/ValueSuite

• New authorities of Health

• Workforce change – Colloborative

• Health data analytics

• Patient Centered Care

Questions

Madan Dharmar, MBBS, PhD

Assistant Research Professor, Center for Health and Technology

University of California Davis

mdharmar@ucdavis.edu