Soccnx III - Using Social for social good - the case for Social Business in Healthcare

© 2012 IBM Corporation© 2011 IBM Corporation

Social Business for Patient Care Coordination

02/20/2012

© 2012 IBM Corporation

Healthcare is a Social Business. Are you ready?

• Social is everywhere. Patients and providers are living in a socially networked world. Healthcare is a social business. Are you ready?

• Social businesses leverage collaboration capabilities to connect people and break down traditional boundaries. They activate networks of people that apply relevant content and expertise to improve and accelerate how work gets done.

• This is a demonstration of social business capabilities applied to healthcare for improved patient outcomes and efficiency of care delivery. You will see examples of connecting providers across acute and ambulatory care settings in new ways via social business technologies and open standards.

• Featured technologies are IBM Connections social business software for healthcare and InfoSphere MDM (formerly Initiate).


GOVERNMENTS

Provide leadership and political willpower, remove obstacles, encourage

innovation and guide countries to sustainable healthcare delivery.

DOCTORS, NURSES AND OTHER CAREGIVERSCollaborate through partnership with individuals, payers/health plans and other stakeholders, to promote and deliver personalized, evidence-based healthcare.

CARE DELIVERY ORGANIZATIONS

Expand focus on episodic, acute care to more proactive chronic disease management for illness prediction and prevention.

PAYERS AND HEALTH PLANS

Promote individual wellness and derive higher value from the healthcare system by assisting care delivery organizations and clinicians in delivering higher-value care.

PHARMACEUTICALS AND DEVICE MANUFACTURERS

Collaborate with care delivery organizations, clinicians and individuals

to create products that improve outcomes at lower costs.

COMMUNITIES

Make realistic, rational decisions regarding lifestyle, acceptable

behaviors, healthcare rights and wellness.

Source: “Healthcare 2015 Series,” IBM Global Business Services and IBM Institute for Business Value

In a smarter healthcare system, patients receive collaborative, coordinated services and care.


Turning Smarter Healthcare into reality requires a new approach – Social Business – leveraging people networks to provide interconnected, intelligent and instrumented healthcare.


Social healthcare organizations share common characteristics—they are highly collaborative and networked.

Connect people, information and systems across all types of boundaries

Enable people networks to form and dissipate as needed

Deliver the right content and expertise to the right people

Improve and accelerate how things get done

Share the data generated by these networks inside and outside the organization to make better treatment decisions.


Care Coordination

Patient Information

Identification and Intervention of patient-specific gaps in care

Analyzing and monitoring a patient’s use of pharmaceuticals and diagnostic devices

Development and implementation of care plans with support for the patient, family and care team

Coordination andcommunication among providers

Coordination at the time of transition from one care setting to another

Care Coordination

6

Information flow

Work flow

Social Business enables provider and patient communication across systems for better care coordination


Why Social Business for Care Coordination?

• However, there are many challenges to care coordination today, e.g.

• Systems of record not timely or accurate• Handoffs cross organizational

boundaries• Systems not integrated

• Shorten LoS in hospital • Avoid non-reimbursable expenses, reduce

risk for hospital acquired conditions, improve patient workflow / capacity

• Realize faster & better transition, avoid readmissions - increase bonuses, eliminate penalties

Public & private payors are introducing new reimbursement models to incent care coordination

AHRQ REPORTS HOSPITALS SPENT $3O.8 BILLION ON 4.4 MILLION UNNECESSARY READMISSIONS IN 2006

Discharge communication provided to post-hospitalization care providers.Ample literature identifies the frequent delays between the time of patient discharge and written communications regarding the hospitalization reaching the principle care providers. Often, the discharge summary fails to arrive before follow-up visits and is surprisingly inadequate or incomplete for the needs of these providers.(Kripalani, LeFevre et al. 2007)

Is the care plan being followed? Is it effective? Is the patient taking their meds? As prescribed? Did they schedule / keep their GP appt? What was result?What are their vitals? How is the patient feeling?

• Providers could easily connect and collaborate on patient care coordination across organizations

• Important patient events could be quickly surfaced to key providers

• You could easily connect to your patients online

What if?

Result


PoC Scenario

• The patient is Laurie Thompson, suffering Congestive Heart Failure (CHF).• Starting point is Laurie’s admission to the hospital. • Scenario explores the roles involved, collaboration required, and use of social business

technologies to coordinate Laurie’s care as she transitions across care settings


Primary Actors and Care Settings

Patient Centered Medical Home

Patricia CarlsonCare Manager

Philip CartierPCP

Hospital

Henry RigginsRN

Hannah DouglasHospitalist

Skilled Nursing Facility

Sarah NichollsReceiving RN

Steve NorquistAttending Physician

Laurie ThompsonPatient

Specialist

Caroline DooganCardiologist

The challenge:

Effectively coordinate Laurie’s care to achieve a quality outcome.

All while using different systems that may or may not be integrated….


A Collaboration Platform for the Care Team

Accurate identification of patients and providers through master data

management

Route, transform, monitor HL7 and IHE messages between systems. Surface key

milestones to collaboration platforms

Extensible collaboration platform allows providers x-enterprise to find and communicate with each other


Workflow

• Care Manager (Patricia) logs in

• Patricia creates community for patient (Laurie)

• Patricia finds and invites care team members

• Together they work on care plan for Laurie• Share files - discharge summary, care plan

draft• Forum - Q&A, clarifications

• Care plan is communicated to care team• Notifications (news feed, mobile devices)

• System of record notifications to care team (patient discharged)

• Laurie is successfully transferred from hospital to Skilled Nursing Facility


Setting up the Community


Care Team Relationships – IBM Initiate

• Manages patient and provider profiles, relationships, userids• Easy to find and invite to a community


Collaborating on the Care Plan


Notifications, and Form Factors


Surface Key Patient Events from Core Systems to the Care Teamwith Activity Streams


How well are we doing? Analyzing impact of connecting providers with social business technology

• Patient outcomes (30-day hospital re-admission rate) mapped to measurable online collaboration and communication among providers

• with IBM CoreMetrics Web Analytics

Usage by role and type of interaction

Correlate engagement across 30 days with outcomes

Community access mapped to outcomes

Patient satisfaction

Usage by time period


W3C Social Business Community Group – Join us!

• W3C Social Business Community Group – join - http://www.w3.org/community/socbizcg/

• W3C Social Business JAM Report - http://www.w3.org/2011/socialbusiness-jam/report.html

http://www.w3.org/community/socbizcg/

http://www.w3.org/2011/socialbusiness-jam/report.html


Next Steps: Assess Your Organization: Take the IBM Collaboration Assessment Build a Roadmap: Schedule a Social Business Agenda Workshop

Get More Information:• Whitepaper: The Social Business, Advent of a New Age• Whitepaper: Forrester Study: Total Economic Impact of IBM Social Collaboration • Video: Business Value of Social Software

Get Plugged In:• Register with the IBM Reinventing Relationships Social Media Aggregator• Follow us on Twitter: SocBizAgenda

Note: Click on the links above for more information.

Start your social business transformation with IBM Today…

http://www-01.ibm.com/software/lotus/collaboration/assessment/

http://www.ibm.com/smarterplanet/global/files/us__en_us__socialbusiness__epw14008usen.pdf

http://bit.ly/cmTXTW

http://bit.ly/cmTXTW

http://bit.ly/e3yphd

https://www-304.ibm.com/social/aggregator/socialbusiness

http://twitter.com/

http://twitter.com/


Contacts

Joseph Preston – [email protected]

Francois Commagnac – [email protected]

Deanna Nole – [email protected]

Jacob Eisinger – [email protected]

Rich Rogers – [email protected]

mailto:[email protected]





Soccnx III - Using Social for social good - the case for Social Business in Healthcare

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