Patient Centric Solutions from IBM

Transcription

1 Patient Centric Solutions from IBM Tony Bosselait World Wide Software Group Healthcare Executive Chief Technology Officer And George Eisenberger Chief Architect Distinguished Engineer

2 Traditional Clinical Work Flow Design Preventive Medicine Chronic Disease Monitoring Medication Refills Acute Care Test Results PROVIDER Healthcare Support Team Case Manager Behavioral Health Medical Assistants Nursing Source: Southcentral Foundation, Anchorage AK

3 Patient Centered Parallel Clinical Work Flow Design Medication Refills Chronic Disease Monitoring Test Results Acute Care Preventive Medicine Point of Care Testing Acute Mental Health Complaint Chronic Disease Compliance Barriers Healthcare Support Team Case Manager Provider PROVIDER Medical Assistants Behavioral Health Source: Southcentral Foundation, Anchorage AK

4 Patient Portals engaging citizens Patients Employees Physicians Enterprise Portal Framework Common Infrastructure Copyright IBM Corporation 2009

5 Portal value expected by citizens and patients: Patients are increasingly demanding greater access to information as they attempt manage care in real time: Percentage surveyed who: Want to receive personalized medical information online 80% Want electronic medical alerts 84% Want online charts for monitoring chronic conditions Want their lab tests to be available online 69% 83% 0% 20% 40% 60% 80% 100% Increasing need for Commercial Grade Tooling to support these growing requirements

6 Duke Medicine s Patient Portal Story Solution Needed IBM Engaged Solution Delivered Duke Benefits Duke Medicine needed a way to attract new revenue (referrals) and reduce expenses while improving communication and strengthening linkages with patients. Prior to the portal, Duke Medicine s call center experienced a seasonal increase of 5,000 calls (requests for copies of bills) per month for the winter months leading up to tax season. This impacted their ability to handle procedure scheduling. Duke Medicine wanted their patients and administrators to have a streamlined way to access (and act upon) billing information Duke Medicine sought a scalable, secure, flexible portal platform that could grow organically, starting with billing/account management and able to accommodate additional scheduling and clinical services later IBM Corporation

7 The Duke Wheel of Fortune = requirements: Duke Portal 2009 IBM Corporation

8 IBM Delivered the Duke Medicine Portal Solution Needed IBM Engaged Solution Delivered Duke Benefits Duke engaged IBM to co-develop and deploy the patient portal in August 2006, signed contract in October, delivered in January, Phase 1: of the project was completed in 14 weeks Bill presentment, bill collection, appointment request, view scheduled appointments, update demographics Phase 2 (June 2007): update appointments, view basic clinical results lab, rad,, allergies, proxy accounts Phase 3 (Feb. 2008): expanded clinicals, ability to schedule primary care appointments directly, Now Duke developed Phase 4 (2009): adding annotations, ability to chat with CSR, ancillary clinical system integration (images), workflow. Express Check-in 2009 IBM Corporation

9 Duke HealthView Patient Portal access statistics: Page 9

10 ROI for the Project is Measurable approx 18 mos. Solution Needed IBM Engaged Solution Delivered Duke Benefits >100,000 patient accounts thru February 2009 > 500,000 lab / radiology results viewed by patients to date 100,000 in January ,000 s sent in January notifying patients about 50,000 new results 150,000 results annotated by physicians to date 30,000 in January 165,000 addresses provided by patients to date. These patients receive appointment reminders and an invitation to join the portal 90,000 appointment confirmations 30,000 appointment reminders were ed in January On-line self-scheduling for appointments live throughout primary care Advance Registration live in a dozen clinics 2009 IBM Corporation

11 Average No Show rates reduced > 10% Page 11

12 Demonstration of Duke Portal: Slide # Carefx & IBM Corporation

13 IBM Healthcare IBM Corporation

15 IBM Healthcare EXPRESS CHECKIN IBM Corporation

19 Resources typically allocated for a Patient Portal Copyright IBM Corporation 2009

20 Patient-Centered Medical home Patients Employees Physicians Enterprise Portal Framework Common Infrastructure Copyright IBM Corporation 2009

21 The Patient-Centered Medical home is an approach to providing comprehensive primary care for children, youth and adults The Patient-Centered Primary Care Collaborative (PCPCC) Principles include: Every patient has a personal physician Care is provided by a Physician-directed team that collectively cares for the patient Personal physician is responsible for providing all patients needs, or arranging and coordinating services to be provided by others Care which is coordinated and/or integrated across all aspects of healthcare Quality and safety are hallmarks Compassionate, patient centered care Evidence-based medicine and clinical decision supports Participation in continuous quality improvement and voluntary performance measurement Patients actively participate in decision-making and provide feedback Information technology is utilized to support care delivery Practices participate in a voluntary recognition process Enhanced Access (expanded hours, open scheduling and alternative communication models) Payment which appropriately recognizes the added value of PCMH (FFS, Care Management Fee and P4P) 21 IBM Confidential

22 The new healthcare model will require new information and services for providers in the delivery marketplace New Healthcare Model Collaborative Health Organization Customers Advocacy Marketplace Delivery Marketplace Transaction Marketplace The Patient is at the center of the new healthcare transformation. Patient Center Primary Care is the new care delivery model. The CHO is the sustainable business model that enables of virtualized care delivery model of the future 22 IBM Confidential

23 The Medical Home MSO provides the care giver needs end to end Retail Payer MSO PCP Hospitals Specialists Employers State Programs This data is shared with the virtual care team that is formed by Health Advisory Services marketplace. 23 IBM Confidential

24 What is a Patient-Centered Medical Home? Personal Relationship With a Physician and Care Team Proactive Focus on Health, Care Intervention and Chronic Disease Management Technology, Services & Applications to Support the New Collaborative Care Model This approach will prove to be different because it: Provides for the physician practices to lead the transformation with their patients and care team Integrates best practices, patient information, and options for care at the point of care Establishes metrics and measurements that make sense for the type of care required Results in a collaborative model resulting in more effective and efficient patient care Allows for information transparency across the collaborative community Provides a High Tech environment that enables a High Touch Model of Care Provides a payment and incentive system to support increased quality care Empowers the consumer with information, tools and access to a care team so they actively engage in their own healthcare choices and programs 24 IBM Confidential

25 What are the stakeholder s needs? Physicians Care Team Members Health Plans Employers Consumers I want my Healthcare to be To value me for what I do Founded on a strong patient clinician relationship Focused on the total health of the individual Affordable so I can offer coverage to my employees To be in control, and result in the best outcome To give me a better life balance To reduce practice overhead Actively engaged in helping people be healthy and well Allowing me to access important health records no matter what place of care created them Able to help individuals make healthy choices, more and more often To be driven by evidence based medicine and robust information about all relevant aspects of an individuals live Easy to understand, with less hassle Cost effective Easy to understand, with less hassle Information to be in one place, like banking online Accessible 24x7, for advice, planning, scheduling and To be affordable To free me from administrative hassles To improve my access to information about my patients To let me do what I do best, practice medicine Coordinated with others responsible for providing patient care and support Affordable to employers and individuals now, as well as in the future Higher quality Focused on me and my family Provide me information I need about me and my kids when I need it Give me access to someone who knows me, and can answer my questions and coach me through my decisions 25 IBM Confidential

26 What results are to be expected from implementing a Patient-Centered Medical Home? Costs of Care Costs of Administration ER Visits PMPY Redundant Tests Unnecessary Treatment Hospital Stays PMPY Hospital Readmits PMPY Catastrophic Events Patient Outcomes Patient Loyalty Patient Satisfaction Patient Engagement Chronic Disease Management Patient Centered Focus Patient Compliance Collaboration Among Care Givers Payments for Wellness & Prevention Availability of Relevant Information 26 IBM Confidential

27 The technology components IBM provides directly and with our partners provides a flexible scalable standards based approach to a comprehensive solution User Access Layer User Portals Public Health Researchers Payer State Case Worker Clinical Admin Dx, Rx Physicians & Specialists Patients Clinical Decision Support & Health Analytics Personalized Care Diagnosis & Treatment Quality Measures & Patient Safety Evidence Generation & Health Analytics Portal Access Layer Health Information Warehouse Data Integration Layer Disease Dashboards & Work Flow Patient Portal & Monitoring Data Acquisition & Integration Public Data Sources Pharma, Labs, Diagnostics, Claims, Other Health Info Patient Identity Mgmt Health Information Repository Electronic Medical Records 27 IBM Confidential

28 Patient-centered collaborative care: Physician screen example 28 IBM Confidential

29 Patient-centered collaborative care: Disease dashboard 29 IBM Confidential

30 Base and Value Add capabilities for doctors Primary Centric Medical Home Credentialing Social Networks Information Technology PMS Industry Data Model EMR Patient Portal Additional Portals Physician Content Management Incentive Management Base Capabilities Remote Monitoring Portal Record Retention Value Add Capabilities Accounting Help Desk IT/B&C Training Contacts Data Warehouse Patient Analytics Compliance Practice Analytics Doctors Medical Images Disease Analytics Data Payer Portal Collaboration Peer Reviews CRO Clinical Trials ACH Transfer Lockbox Wellness Programs 30 IBM Confidential

31 While other approaches have addressed some PCMH factors, none has addressed them all FACTOR PCMH Managed Care Pay for Performance Disease Management Wagner Model Purpose and Focus Facilitate strong partnership between doctor and patient Ideally: cost, quality Actually: control utilization Meet operational goals with financial incentives Meet specific mgmt targets for chronic disease Org. framework for chronic care mgmt and practice improvement Patient-Centric/ Personal Physician Yes No No Maybe, but often led by actors independent of primary care Yes, for chronic illness Physician-directed Medical Team Yes No No No Yes Whole Person Orientation (KIDS) Yes No No No Yes Care is Coordinated and/or Integrated Yes No incentive for coordination No incentive for coordination Maybe Yes Emphasis on Quality and Safety Yes, EBM and best practices; improved outcomes rewarded No, reduced utilization rewarded Indirectly; process targets rather than outcome targets Yes, for particular diseases Yes, for chronic illnesses Enhanced Access Yes No, reduced access No Maybe No Appropriate Reimbursement Yes Potential conflict in motivation No, still volume-driven Partially, if EBM used No Source: IBM 31 IBM Confidential

32 IBM HSP Solution Ambulatory EMRS Labs Client Adapter Layer XDS Adapter PIX/PDQ Adapter HL7 Adapter Custom Adapters Hospital EMRs Domain Logic Layer Resource Adapter Subject-ID Management Proofing, arbitration, lookup Provider-ID Management Proofing, credentials, lookup Data Storage, Query & Retrieval Registration Services and Management Data Transformation Services Format, terminology, de/re-ident Access Consent Management and Enforcement Data Management Layer Registry CDA Repository Audit Repository Terminology Server Access-Consent Policy Server EMPI InterCommunity Service Bus Nationwide Health Information Network The MSO s are connected through IBM s National Health Information Network (HSP). As the capability of the HSP grows over time, most information sources will migrate to a connection to the HSP. This, in turn, will simplify the processing at the MSO points. 32 IBM Confidential

33 Managing Assets for Patient Care Patients Employees Physicians Enterprise Portal Framework Common Infrastructure Copyright IBM Corporation 2009

34 Asset Convergence, Availability, Calibration Healthcare organisations are experiencing the convergence of Physical and IT assets This convergence blurs the line between Physical and IT assets Requires a system to manage both in a single solution. 34 Copyright IBM Corporation 2009

35 Maximo Asset Management Healthcare solutions Addresses business challenges of Operations and IT Consolidates point solutions for Asset and Service Management into a logical suite of applications Addresses business challenges of: - Healthcare organizations - Hospitals - Medical Device or Diagnostics Equipment Manufacturers Provides asset and service management support for: - Asset owners/operators - 3 rd Party Maintenaince Service Providers - Facilities management Includes enhanced Workflow - Event Driven - Context-based - Escalation Manager Consolidates point solutions for Hopital equipment, facilities, calibration tools and asset management ITIL - based KPI, Reporting and Analysis Tools SOA technology framework compliant 35 Copyright IBM Corporation 2009

36 Systems Integration Enterprise Management Customer Relationship Management Business Intelligence & KPIs Regulatory Reporting (A) ERP /Financial Management Human Resource Management Operational Systems Performance monitoring Diagnostic integration (LIMS, etc) Dispatching & scheduling Document & Process management Graphical Information 36 Copyright IBM Corporation 2009

37 Maximo Calibration Manager Focus and commitment for a strong Calibration solution: - Calibrate Instruments, MT&E, Standards - User-defined Calibration Data Sheets - Fully 21 CFR Part 11 compliant - Calibration Job plans & Job Plan Revision Control - Calibration Intervals - Calibration Work Orders - Traceability and Reverse Traceability - Loop Calibrations - Calibration History Calibration as option of Maximo, or part of the Industry Solution Maximo for Life Sciences Mobile Calibration Manager - With Maximo Mobile Work Manager - Mobile extension of Maximo Asset Management Fully Integrated with the Maximo suite Growing number of Clients: - from various industries: Utilities, Nuclear, Chemical & Petrol, Automotive, Aerospace & Defense and Life Sciences & Healthcare: (85+in total worldwide) Special Interest Group Maximo Calibration - User driven, cross industry 37 Copyright IBM Corporation 2009

38 Maximo Asset Management Mobile Maximo Mobile for Work Management Maximo Mobile for Inventory Management Maximo Mobile Calibration Manager Developed on Maximo s standards-based architecture (XML, Java) Built as an option to Maximo Asset Management making it easy for organizations to centrally manage and extend their Maximo applications to remote workforces. Benefits: increase quality data, lower labor cost 38 Copyright IBM Corporation 2009

39 Thank you Copyright IBM Corporation 2009