The Path To The Internet of

Everything

Albert Chan, MD

CMIO, Palo Alto Medical Foundation

Stuart James

COO, Sutter Health Information Services

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Sutter Health System

Serving more than 100 Northern CA communities with:

• 5,000 physicians

• 26 acute care hospitals

• Approximately 48,000 employees

• Home health and hospice services

• Outpatient surgery and specialty care centers

• Medical research and medical education/training

• 24 fundraising organizations

Sutter Health

5 Medical

Foundations

26 Acute

Care

Hospitals

Our Mission and Vision

Living Our Mission

• One of the largest Medi-Cal providers in CA

• One of the largest Medicaid providers in the country

• Commitment of quality and patient safety

– One of only three healthcare organizations in the

U.S.to win the 2013 Baldrige Award

– Recognized for work to combat sepsis and improve

obstetric care

• Launch of Sutter Health Plus

• Investment in next generation patient engagement tools

(e.g. MD Live, My Health Online)

Strategy…

We are focused on:

• Quality & cost of care for our populations

• New alliances, technologies and care models to advance

our transformational work

• Development of tools, technology and personalized

practices to create an unmatched customer experience

One Sutter

One team, living the We

Plus You partnership

promise to provide an

exceptional,

compassionate

experience to

everyone we touch.

Accomplishments

• 2009: Ranked as California’s top health system in heath care

quality by The Lewin Group

• 2012: Leadership Gold Award for MyLifeStages.org by

eHealthcare Strategy & Trends magazine

• 2013: Top 20 health care systems for quality in the U.S. by

• Truven Health Analytics

• 2013: Epic Physician of the Year, David Butler, MD

• 2013 and 2014: Top Rated Physician Groups by Consumer

Reports

– Palo Alto Medical Foundation

– Sutter Gould Medical Foundation

• 2014: Epic Physician of the Year, Albert Chan, MD

Changing

Competitors

• Consolidation and

expansion

• New providers

• New types of services

Accelerating Pace

of Innovation

• New care models

• Evidence-based medicine

• Better data and analytics

• New technology (social, mobile, virtual)

Changing Patient

Population

• Expanded access

• Different coverage

• More individual responsibility

• New priorities and expectations for care

experience

Changing Payer &

Employer Environment

• Reimbursement pressures

• More risk shifting

• New payer-provider partnerships

• Employer direct contracting

Keeping Pace with New Customers, New

Competitors and New Expectations

Focus on the market, and enhance our presence

Focus on the future – innovation and growth

Focus on continued operational excellence

Focus on the holistic patient experience

Four Major Themes

Foundational

Functions HR OGC IS S3 Finance

OneSutter

Emerges:

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Sutter EHR Highlights • Largest single instance Epic

implementation of software

• 23 hospitals live on Sutter

EHR

• Over 55,000 users

• Over 8,000 providers

• Over 3 million active patients

Module

Year Implemented

Number of Users

Ambulatory EHR 1999

My Chart 2001 Over 1 million users – My Health Online

Inpatient EHR 2009 - roll out through 2015

Referring Physician Portal 2011 Over 7000 users, 1400 providers

Sutter Community Connect

2011 Over 1800 users, 400 providers

• Over 10 million patient records

• Over 1 million logins to My Health Online

• 4.3 million data accesses per second

• 5,559,788 inpatient medical orders

• 10,442,953 outpatient medical orders

• 38,533,266 total patient interactions

13

Summer

2013

Ian on top of

Mt Lassen

One Week

Later

Ian suffers a

cardiac

arrest

Two Weeks

Later

Ian on the

first day of

school

Dad’s Epiphany

Intranet of Things

Philips IntelliVue Monitor

Integration

Wireless Alaris Pumps – Integration

Draeger Ventilator – Integration (OR live;

ICU and ED in progress)

Continuous Renal Replacement

Therapy (CRRT) – Non-Integration

eICU Integration

What About Outside Sutter?

• We don’t capture all patients’ data

– Other hospitals

– Clinics

– Retail

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Health Information Exchange Impact

2011 – 2014

Interoperability

Great! Now what about everything else?

• Non “Care Delivery” Settings

• Smart Devices/Home Monitors

– Fitbits/Tracking Devices

– Watches

– Scales

– Phones

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Internet Of Everything?

• IOE = Internet of Everything

• IOT = Internet of Things

• IORT = Internet of RELEVANT Things

– Information provided in context

• Place of need

• Time of need

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Does Every Technology Have a Purpose?

How does this relate to our health?

Dr. Albert Chan

CMIO, Palo Alto Medical Foundation

Medical Director, My Health Online, Sutter Health

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Before we get to that, what do we

expect as consumers?

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24

Apple II Plus

Purchased in 1979 for ~USD$2,000

6502 Chip with 8-bit architecture

16 Kilobytes (103) RAM

Floppy Disk Drive (Disk II), 140 kb / disk

iPhone 6+

Purchased in 2014 for USD299

A8 chip with 64-bit architecture

M8 motion coprocessor

16 Gigabytes (109 ) RAM

1080p HD video recording

My First

Computer

My Latest Computer

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How does this relate to our health?

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“Healthcare =

May Be @ Inflection Point

- Mary Meeker”

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My Health Online

91.40%

% Messages Answered Within 1 Business Day

>80% PAMF

• >1,000,000 patients

• 25 million lab results released

• 4 million secure patient messages

• 1 million appointments made online

62.8%

% Enrollment – Sutter Health

• Triggered by knowledge of the patient

• Automated email reminder that the

patient has an order to complete

• Patient can head straight to the lab

The-Patient-To-Consumer-Revolution, Oliver Wyman, October 2014

The Patient Friendly Note

• Office visit notes serve multiple purposes:

– Communication between clinicians

– Documentation of care for payment

– Communication to patients?

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Sutter Health

MPOWER – Breakthrough Consumer Digital Engagement

Y O U R H E A L T H

Context

Matters

How Works

Plan

Track

PROPRIETARY & CONFIDENTIAL

Create

personalized

shared care plan

Track progress

through ecosystem

of apps and

devices

Driving outcomes through active personal engagement.

The “Me” in Mpower

“Your program has

positively impacted my

life in ways that you

can't measure.”

“The Mpower program

certainly allows me to

be more effective as a

provider.”

“Using the feedback,

I increased my exercise

and lost 10lbs within 6

weeks. I feel so much

better!”

INDIVIDUAL

ENGAGEMENT

DRIVING SUSTAINED

OUTCOMES

MANAGING

POPULATIONS

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Your itinerary for today

-9:00 Dr. Shafaie

-10:00 MRI Shoulder

-11:00 Dr. Frank Chen

-12:00 Nutritionist

Would you like me to guide

you to Dr. Shafaie’s office? . . .

Don’t forget to get your 10,000

steps in today.

Kelly prepared your healthy

eating plan. Send it to your

local grocery store? Or order a

healthy meal tonight?

What I hope for from

Internet of Everything

• Analyze the data that is ALREADY around us … that we

don’t pay attention to in a meaningful way today

• Understand all of the factors that influence my health

and well-being

• Make it easier for me to do the right thing

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