OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin...

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Harvard Global Health Institute Boston, Massachusetts Robin Osborn Vice President and Director International Health Policy and Practice Innovations The Commonwealth Fund OECD Expert Consultation: Mobile Technology-Based Services for Global Health and Wellness- Opportunities and Challenges 1

Transcript of OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin...

Page 1: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Harvard Global Health Institute

Boston, Massachusetts

Robin Osborn

Vice President and Director

International Health Policy and Practice Innovations

The Commonwealth Fund

OECD Expert Consultation: Mobile Technology-Based Services for Global

Health and Wellness- Opportunities and Challenges

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Page 2: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Commonwealth Fund International Health Policy Surveys 2

• Since 1998, the Commonwealth Fund has conducted an annual

international health policy survey of patients, doctors, and the general

population on their health care experiences and views

• The survey includes 11 countries:

• Australia, Canada, France, Germany, Netherlands, New Zealand,

Norway, Sweden, Switzerland, United Kingdom, and United States

• Core funding is provided by The Commonwealth Fund with co-funding

provided by 14 country partners

• Combined sample size – eg 20,000 adults in 2013 survey

• The survey is designed by The Commonwealth Fund in collaboration

with country partners

• Findings are published annually in Health Affairs and attract major

media attention

Page 3: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

What is the Value of the Commonwealth Fund International Surveys?

• Benchmark country performance

• Comparability– same instrument, same sampling design and methods,

same time frame

• Questions are policy relevant and timely

• Focus is on experiences and objective measures

• Enable policymakers to track policies and reforms

• Findings reflect differences in country health care systems and policies

• Performance differences show what is possible

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Page 4: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Questionnaire Categories 4

• Overall Views

• Access

• Doctor-Patient Relationship

• Prevention & Health Promotion

• Coordination and

Communication

• Information Technology in

Practice

• Patient Safety

• Primary Care

• Quality Improvement in Practice

• Chronic Illness

• Emergency Room

• Hospital

• Medications

• Complexity of System

• Health Care Coverage

• Demographics

Page 5: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Mirror, Mirror: Rankings of Health System Performance

Source: The Commonwealth Fund, Mirror, Mirror On the Wall, 2014 Update

Page 6: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

mHealth

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“What are data needs from the

Commonwealth Fund Perspective?”

Page 7: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

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Basic Needs

• Access to Care

• Care Coordination and Transitions

• Management of Chronic Conditions and Self-Management Support

• Patient-Centered Care

• Health Promotion

Page 8: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Access to Care

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Page 9: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Percent could get same- or next-day

appointment

83 83 81 76

71 69 65

57 54 53

45

0

20

40

60

80

100

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries

6 6 7 8 9 10 12 19

25 26 31

Percent waited 6 days or more

for appointment

Access to Doctor or Nurse When Sick or Needed Care, Among Adults Age 65 or Older, 2014

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Page 10: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

10 Access to After-Hours Care, Among Adults Age 65 or Older, 2014

23 29 31 31 34 34

38

45 46

59 63

0

25

50

75

100

NETH UK FR NZ SWIZ NOR GER US AUS CAN SWE

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries.

Percent who said it was somewhat or very difficult to get after-hours care

without going to the emergency department*

* Base: Needed after-hours care.

Page 11: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Waited Less Than Four Weeks for Specialist Appointment, Among Adults Age 65 or Older, 2014

86 82

71

64 62 61 60 60

50 46 46

0

20

40

60

80

100

US SWIZ NETH AUS NZ GER FR UK SWE CAN NOR

* Base: Saw/Needed to see a specialist in the past two years.

Percent*

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Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults

in Eleven Countries.

Page 12: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

12 Primary Care Practice Provides Patient with Option to Email About Medical Question or Concern, 2015

80

61 57 57

54 53 50

38 32 30

15

0

25

50

75

100

SWIZ SWE NET US FR NZ GER UK NOR AUS CAN

Percent

Source: 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

Page 13: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

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Care Coordination and Transitions

Page 14: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

14 Experienced a Coordination Problem in the Past Two Years, Among Adults Age 65 or Older, 2014

8

20

24 25 27 27

33 37

40

45

0

10

20

30

40

50

FR NZ AUS NETH UK SWE CAN US NOR GER

* Test results/records not available at appointment or duplicate tests ordered; received conflicting information from different

doctors; and/or specialist lacked medical history or regular doctor was not informed about specialist care.

Percent with at least one chronic condition*

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries.

Page 15: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

15 Gaps in Hospital Discharge Planning*, Among Adults Age 65 or Older, 2014

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries.

When you left the hospital: AUS CAN FR GER NETH NZ** NOR SWE SWIZ UK US

You did NOT receive written

information on what to do when you

returned home and what symptoms to

watch for

21 25 26 29 25 10 47 44 41 22 10

The hospital did NOT make

arrangements or make sure you had

follow-up care with a doctor or other

health care professional

15 20 24 29 28 5 25 31 17 14 11

Someone did NOT discuss with you

the purpose of taking each of your

medications

23 25 36 32 24 26 45 40 23 22 19

You did NOT know who to contact if

you had a question about your

condition or treatment

10 11 17 17 14 7 28 17 9 17 5

Any of the above gaps in hospital

discharge 41 44 54 56 59 32 70 67 56 38 28

Base: Hospitalized in past 2 years.

** Note: NZ sample size is 94.

Page 16: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

France, 42%

Netherlands, 59%

UK, [VALUE]

Norway,[VALUE]

Netherlands, 3% Sweden, 4%

France, [VALUE] Australia,[VALUE]

US, 17%

US, 26%

US, 42%

US, 63%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Percent

Communication and Coordination: Primary Care Doctor Reports That He/She ……

Always receives timely and relevant information from

Specialist

Always is notified when patient is discharged from Hospital AND

Seen in ER

Frequently coordinates with Social Services/

Community Providers

Routinely advised by Home Care Provider of relevant change

in patient’s condition/status

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Source: 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Page 17: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

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Management of Chronic Conditions and Self-Management Support

Page 18: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Patient Engagement in Chronic Care Management, Among Adults Age 65 or Older, 2014

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Had a treatment plan for their condition

they could carry out in their daily life

83 80

76 73

64 62

53 47

41 41

30

Percent who have a chronic condition and:

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries.

68 67 62

58 57

50 50 48 47 41

30

0

20

40

60

80

100

A health care professional discussed their

main goals

Page 19: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Support for Self-Management Between Doctor Visits,

Among Adults Age 65 or Older

47

30 28 24 24 23

17 16 15 14 9

0

20

40

60

80

100

Contacts them to check in They can contact to ask questions or

get advice

84 83

75 75 71

67 65

58 55 53

43

Percent who have a chronic condition and had a health care professional that between

doctor visits:

19

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults

in Eleven Countries.

Page 20: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Base: Excludes doctors who report that they "never“ see these patients. Source: 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

Multiple Chronic

Conditions Dementia Palliative

Care

Long-Term Home Care

Services

Social Services in

the Community

Severe Mental Health

Problems

Substance Use-Related

Issues

AUS 85%

CAN 70%

FR 45%

GER 88%

NETH 88%

NZ 81%

NOR 86%

SWE 66%

SWIZ 80%

UK 79%

US 76%

Doctors’ Views of Practice Preparedness to Manage Patients with

Complex Needs- 50% or More Saying “Well-Prepared”

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Page 21: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Patient-Centered Care

Page 22: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

22 Regular Doctor Always/Often Encourages Them to Ask Questions, Among Adults Age 65 or Older, 2014

88 82 81 80 80 79

72 70

55

43 40

0

10

20

30

40

50

60

70

80

90

100

FR GER US AUS NZ UK CAN SWIZ NETH SWE NOR

Percent

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries.

Page 23: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Health Promotion

Page 24: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Reported That a Health Professional Counseled Them About Diet, Exercise, and Stress in the Past Two Years,

Among Adults Age 65 or Older

24

76

70

64 63 62 61 57

52 50 45

41

29 31 31

21 25

18 22

15 13 9

12

0

10

20

30

40

50

60

70

80

US GER AUS CAN UK FR NZ SWIZ NOR SWE NETH

Healthy diet or exercise

Things that can cause stress

Percent reporting a health care professional talked to them about:

Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults in Eleven Countries.

Page 25: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

Patient Reported Outcomes

Page 26: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

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Page 27: OECD Expert Consultation: Mobile Technology-Based Services for Global Health … - Robin Osborn.pdf · 2016. 12. 15. · Source: 2015 Commonwealth Fund International Health Policy

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Take Away Messages

• mHealth is a tremendous opportunity

• Unique opportunity to capture the views and experiences of patients

• Window of opportunity to define the measures that capture impact

• Comparability is the holy grail

• “What are data needs from the Commonwealth Fund Perspective?”

– Data to benchmark and track health system performance

– Data that reflects what is important to the Patient