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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...
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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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
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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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
Mirror, Mirror: Rankings of Health System Performance
Source: The Commonwealth Fund, Mirror, Mirror On the Wall, 2014 Update
mHealth
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“What are data needs from the
Commonwealth Fund Perspective?”
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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
Access to Care
8
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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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.
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*
11
Source: 2014 Commonwealth Fund International Health Policy Survey of Older Adults
in Eleven Countries.
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.
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Care Coordination and Transitions
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.
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.
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
16
Source: 2015 Commonwealth Fund International Health Policy Survey of Primary Care Physicians
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Management of Chronic Conditions and Self-Management Support
Patient Engagement in Chronic Care Management, Among Adults Age 65 or Older, 2014
18
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
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.
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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Patient-Centered Care
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.
Health Promotion
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.
Patient Reported Outcomes
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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
