Healthcare in the Age of the Consumer

University HospitalsMedicine Quality SummitNovember 22, 2014

Thomas F. Zenty IIIChief Executive Officer

Agenda

• How we got here

• Importance of social media

• Increasing demands on physicians

• Opportunity in a consumer directed market

• Dialogue

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Healthcare Spending

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Enrollment in High-Deductible Plans has Tripled since 2009

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Growth in High Deductible Health Plans

Total Enrollment in High2014 Data by State Deductible Health Plans1. Illinois 1,055,0002. Texas 1,043,0003. Ohio 803,0004. Pennsylvania 692,0005. Michigan 691,000

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Consumer Paradigm:

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“Doctor, the patient will see you now”

Change Imperatives

• Increased competition• Increased cost-sharing• Consumerism and retail

markets• Public and private

exchanges• Social media and UH’s

reputation• Medicare growth

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Change Imperatives

•Give me choice and control•Keep it simple and personalized•Make it convenient, accessible and available•High quality is assumed

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Change Imperatives

• Support sustainable growth

• Improve efficiency and consistency

• Increase affordability• Leverage technology

investments to improve speed to market and member experience

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New Entrants Into Healthcare

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Importance of Social Media

• Global penetration of cellular coverage is 92% as of 2013; – 25% of US smartphones have healthcare apps

• 70% trust medical information shared by others on social media

• 40% likely to share information about their health on social media

• 50% use social media for health care decisions

• More than 50% of health care reporters look to social media for information and medical experts

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2005 – Pope Benedict Inauguration

2013 – Pope Francis Inauguration

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Importance of Social Media

Consumers feel social media was built by

consumers and trust the medium more than others

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ZocDoc – One example

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Increased Transparency – Univ. of Utah

• Internal website shows all patient comments – both negative and positive – when patients search for a doctor

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UH Access Department

• Central scheduling and physician referral services handle ~ 900,000 calls / year– 50% of calls lead to scheduled appointments– 30% of calls related to what it will cost the

patient• Copay, deductible, facility fee, etc. • Physician A vs Physician B• Facility A vs Facility B

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UH Access Department

• New system (Clear Quote) predicts what patients out of pocket costs will be – Expected go live Q1 2015– Takes into account physician behavior

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UH Access Department

Community standard is same day appointment

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Emergence of Virtual Health

• Virtual doctor-patient video consultations to grow 65% by 2018

• Expected revenue from video consultations:– 2013 - $100 Million– 2018 - $13.7 Billion

• Mayo Clinic goal - serve 200 million people

• Kaiser of Northern California predicts by 2016 they will have more virtual visits than in-person visits

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Emergence of Big Data

• As an industry we are now beginning to use data to anticipate what consumers want and expect

• Big data leads to:– New research and treatments based on clinical intelligence– Identification of best practices– Reduction in inconsistencies among providers– Predictive models to forecast patient behavior and provide

preventive care– Better patient experience by targeting what patients want

and when they want it– Cost savings from more efficient use of information

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Early Results of ReformHigher Quality Can Coincide with Lower Cost

National results since 2010:– Early elective deliveries down by two-thirds

– Ventilator-associated pneumonia down by > than half

– Pressure ulcers down by 26%

– Patient falls down by 15%

– Medicare 30-day readmissions down by 8%

– Prevented 560,000 hospital-acquired conditions

– Saved 15,000 lives

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Early Results of ReformHigher Quality Can Coincide with Lower Cost

UH results since 2010:– Early elective deliveries down by 72%

– Ventilator-associated pneumonia down by 50%

– Pressure ulcers down by 49%

– Patient falls down by 52%

– Medicare 30-day readmissions down by 19%

– Prevented 149 hospital-acquired conditions

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Increasing Demands on Physicians

• Improve quality

• Manage costs

• Coordinate care

• Improve productivity

• Shift from volume to value

• Respond to regulatory change

• Adopt culture of shared authority

• Engage patient as partner

• EMR

• Social media interactions with patients

• Stay current

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The Challenge of Change for Physicians

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From Challenge to Opportunity in Consumer Directed Healthcare

• Investing in / improving EMR

• How long people are willing to wait

• How do patients want to communicate

• Use of apps

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Taxi/Car

Booking a Flight

Online

Booking

a Flight

via Phone

Opening

a Bank

Account

Opening

a Credit

Card

Online

Shipping

Accessing

a Doctor

MIN

UT

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OU

RS

D

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S

WE

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S

MO

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What Will You Wait For?

Patients Prefer Near-Term Appointments

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How Do Patients Want to Communicate

• 62% want to communicate via email with physician

• 65% want appointment reminders via email

• 25% want to schedule appointments online

• 76% are willing to go online to view test results

• 10% want interactions solely through an app on their phone

Health systems who don’t adapt will continue to struggle to build a strong consumer experience

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Clinical Integration

• Higher quality

• Continuity of care

• Bi-directional information flow

• More efficient processes

• Cost reduction for all stakeholders

• Positioned for lower risk management

• Customer facing

• “Doctor, the patient will see you now”

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Primary Care Institute

Four main goals:

1. Help physicians deliver excellent outcomes and patient experience

2. Increase physician engagement and satisfaction with UH

3. Encourage innovation in developing new care models

4. Improve value

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Primary Care Institute Deliverables

• Discover new models of patient management and clinical care

• Improve communication

• Adopt care models that enhance experience and outcomes

• Foster growth in care services that MDs want to deliver

• Create opportunities for MDs to partner with community

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What PCP’s Can do to Help

• Be open to learning, discovery and innovation

• Participate and share insights

• Trust that future incentives will lead to better health outcomes

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