background & context - hfma region 9...caymanian businessman gene thompson, dr. devi...
TRANSCRIPT
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Healthcare Transformation: It’s Easy When It’s From The Heart
HFMA Region 9 ConferenceNovember 2015Dale [email protected]
Background & Context
• Health City Cayman IslandsHealth City Cayman Islands
• Tertiary care, medical tourism facility on Grand Cayman Island
• Collaboration between the the Cayman Islands government, Caymanian businessman Gene Thompson, Dr. Devi Shetty/Narayana Health of India, and Ascension Health of the US
• I was the CIO for the Cayman Islands health system ‐ a natural ACO ‐f 2009 2012 h H l h Ci i dfrom 2009‐2012 when Health City was conceived
• Health Catalyst, my current company, filmed a documentary about Health City in the summer of 2014 because we want Health City to succeed and expand its influence in the world
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cHealth Catalyst Snapshot
Founded 2008
Patients Hospitals
50M 300+Clinics
3000+
Integrated Delivery Systems
Founded 2008
Employees 400+
HQ Salt Lake City, UT
Accountable Care Organizations Children’s Hospitals
Community Hospitals
Academic Medical Centers
Health Catalyst Product Lines
• Financial Decision Supportpp
• Operations & Performance Management
• Clinical Decision Support
• Population Health & Accountable Care
• Patient Relationship & Care Management
• Comparative Analytics For Excellence (CAFÉ)p y ( )
• Research Informatics
• Precision Medicine
• Health Catalyst Analytics Platform – a Enterprise Data Warehouse
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Health City Cayman Islands (HCCI)Overview
Cayman Islands• 50,000 permanent residents• 1.1M visitors per year• Corporate & personal tax‐free since 1700s• Low crime, high standard of living
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Why Cayman?
‘Close to Home Far From Expected’Close to Home, Far From Expected
• English Speaking
• Safe for visitors
• Well established service industry
• First World Infrastructure
• Mature Airlift Framework (Direct service from 14 major US cities)
• One hour from Miami
• US Dollars Accepted
• Family Destination
• High Standard of Living
• Multicultural Country – 128 different races and nationalities
“Hands that serve are holier than lips that pray.”
Mother Theresa
Dr. Devi Shetty, founder of HCCI, was Mother Theresa’s cardiologist.
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Health City Origins
Health City Cayman Islands was founded byHealth City Cayman Islands was founded by renowned cardiac surgeon and award‐winning medical pioneer, Dr. Devi Shetty, Chairman of Narayana Health. As one of the world’s largest and most economical healthcare service providers, Narayana Health operates 32 hospitals in India, celebrates some of the best surgical outcomes in the world, and provides these services at costs unheard of in US American healthcare.
‘A solution is not a solution unless it is affordable’ – Dr. Devi Shetty
A U.S. Patient Says...
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Health City Specialties
• Adult & Pediatric CardiologyAdult & Pediatric Cardiology• Electrophysiology• Adult & Pediatric Cardiothoracic Surgery• Adult & Pediatric Orthopedics & Sports Medicine• Neuro & Spine Surgery• Pediatric Endocrinology• Pulmonology & Sleep Lab• GI & Bariatric Surgery• Medical Oncology *• Executive Health Checks• Artificial Heart‐ LVAD
* Near term plans for Health City include a Comprehensive Cancer Center including Radiation and Surgical Oncology
Bundled Pricing Includes:
C l i Consumables Consultations
Pre and post‐operative
investigations
(lab, X‐Ray, MRI, CT scan)
Admission charges
Physician's surgical fees
Consumables
Room and food charges
Medications
Post‐operative physiotherapy
Transportation to and from the h i l i d
Physician s surgical fees
Operating rooms fees
Anesthesia fees
Implant cost
hospital as required
All physician visits up to 2 weeks post‐treatment
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Concierge Service
• Patient Care Relations Team (PCR)Patient Care Relations Team (PCR)
• Concierge, patient navigator service for assistance from initial contact through rehabilitation
• The PCR Team acts as the 1st & last contact for the patient as well as a constant for the patient & loved ones through their care at HCCI
• Available 24x7 to handle any issues or problems that may arise
Concierge Service
The PCR Team coordinate:
• the physician consults
• appointments
• travel & transportation
• accommodations
• admission
• discharge
• follow‐ups
• rehab
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Sampling of Contracts
Royal Caribbean Cruise lines M d R t t
Upward trend: direct contracts with employers
• Royal Caribbean Cruise lines
• Aetna International
• AXA Assistance USA, Inc..
• Best Doctors
• Med Retreat
• National HealthCare
Solutions Ltd (NHSI)
• Quality Health Management
LLC• Cigna Global Health
• Companion Global Healthcare
• Edison Health
• United Health International
Inc.
• Rubicon Group
A Few Factoids
• Opened June 2014, exactly one year after groundbreaking
• JC International certified 11 months later
• 104 beds, 5 ORs, 17 ICU beds, 107K sq ft
• versus a comp of 230K sq ft in US
• 169 employees, 23 physicians
• Environmentally sustainable design; 70‐80% of waste stream is recycled
• 2 facility engineers
• $430K per bed construction cost (2x is not unusual in the US)… Category 5 hurricane protection
• Everything is bundled, single line item billing
• 2.5 FTES in the billing department
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The Billing Department– No Coders
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A Few Factoids, continued…
• In first year of operation, an 18% drop in operating expensesIn first year of operation, an 18% drop in operating expenses
• Close their books everyday at 3 pm
• “We want to know how much charity care we can provide to our
patients in the hospital, today.”
• Proprietary, self‐developed Hospital Management Information
System with 19 integrated modules and support for iPads and
iPhones
• A private “App Store” to encourage internal software innovation
• Bar codes are used extensively to gather data and track workflow,
patients, physicians, assets, medications, specimens, et al
A Few Factoids, continued…
• All clinical care is protocol and checklist driven everything• All clinical care is protocol and checklist driven...everything
• All non‐emergent surgeries are reviewed by a committee for medical necessity
• No hospital privileges
• “We are not in the real estate rental business.”
• All physicians are employed
• At age 46 the oldest surgeon has already performed over 8 000• At age 46, the oldest surgeon has already performed over 8,000 surgeries
• In first year– 10,000 patients treated; 800 inpatients; 600 surgeries
• HAI and avoidable readmissions were essentially non‐existent
• Zero bed sores
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A Few Factoids, continued…
• Tort reform in the Cayman Islands + JCI certification• Tort reform in the Cayman Islands + JCI certification• Dropped malpractice insurance rates by 90%
• Their surgeons, nurses, and other staff are compensated at
competitive rates to the US• Their cost savings comes from supply chain, 30% lower administrative overhead,
efficient building design, nursing ratios and “top of license” practice, fewer HAIs
and adverse events… not salaries
• 10‐year plan• 10‐year plan• Expand to 2,000 beds
• 1,500 assisted living units
• 2 hotels
• Medical and nursing school
• Staff residential units
“Nothing we do is rocket science. It’s just common sense.”
Gene Thompson
Executive Director, Health City Cayman Islands
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Documentary Video
• 30 minutes• Funded and produced by Health Catalyst
From the Heart - Healthcare Transformation From India To The Cayman Islands