CommunicationCollaboration

EducationRapid Cycle Improvement

Willingness to adopt the paradigm shift

Healthcare UnboundPhysician Value

• Simplified workflow• Reduced Liability• Improved Pt.

Compliance• Higher Clinical

Outcomes• Proven Cost Benefit• Ability to ‘once again’

practice medicine

Payer Value• Ability to expand

population across State Lines

• Capacity to create products that attract physicians and patients

• A new paradigm where they are seen as team collaborator in population health improvement

• Accurately weighted clinical outcome, member, physician satisfaction and cost efficiency metrics

Patient Value• Better quality of life• Decrease cost out of

pocket• Actual rewards for

careful self management

• Supportive community and employer

• New community of friends with similar conditions

• Ability to understand the quality of our products

Data

and

Info

rmat

ion

Healthcare UnboundPerhaps an opportunity to Engage and Motivate Patients

Hi Jeff, Here is some great educational material (click here): Your employer has awarded you many self care credits and has allocated six hours per month for health improvement activities and won’t fire you: AND PLEASE FORGET ALL OF THE FORMS WE HAVE BEEN SENDING.

A pa

tient

(me)

and

my

tool

s co

mm

unic

ate

thro

ugh

my

I-Pho

ne to

the

Web

usi

ng a

sing

le P

HR

inte

rfaceWhat I want!

Secure message

Healthcare Unbound

Hi there! Will you please follow us down this rabbit hole?

Coronary Artery Stent2007

Help me!I can’t breathe!My chest hurts!

Well, you have great insurance, lets take you to the lab and fix

that nasty blood vessel

Here, Read this and you will be all set

Coronary Artery Stent2007

Help me!I can’t breathe!My chest hurts!

Well, you have great insurance, lets take you to the lab and fix

that nasty blood vessel

Here, Read this and you will be all set

Coronary Artery Stent2015

Help me!I can’t breathe!My chest hurts!

Well, I don’t even need to

check to see if you have a source of

payment; lets get going!

Here, Read this and then go to lifestyle

retraining

Medical Home Coordinates The Best Care

A personal ‘real time’ example of what is available to Jeff Harris in

March 2011

Selecting providers

Activating Patients

My PHR

How I connected my system• Located physician with knowledge of health data

interchange and motivation to heal• Located surgeons who would treat me as equal• Located tools online that worked and were

interoperable• Created my own accounts {HealthVault, Connected

to

• Connected to CVS, SPINN secure Communication and LabCorp

• Keep redundant record at Duke

Duke Health View

Dukes Vital Sign Communicationand Film Education

Example of one-way communication at Duke

Not Good

Duke’s p-HR home page

Decision Support

Details of record source

Who ordered drug

Med

icat

ion

Rec

onci

liatio

n

Where did record come from

Is this patient staying with medical home or Dr. Shopping

Family History

Prov

ider

s and

Con

tact

s

Mon

itori

ng

Now data tools for smart phones

My Droid Diabetes Meal and Insulin Managers

Self maintenance personal note

What Scenarios are Patients Face

Apparently Healthy •Educate on reform•Educate on Medical Home

Episodic Care •Participate in care coordination•Educate on provider selection and best practices

Chronic Care •Participate in interdisciplinary coordination•Learning self mastery

Diabetic Gangrene Prior To Amputation

Diabetic with healthy feetGood Self Management

• My feet forever please

What is the difference between an engaged patient and one without influence to engage