powerpoint ja euhwf presentation
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Game Changers in Social Policy
Patients becoming People: Integrating the social
perspective into health policyEdinburgh, Friday 27 May 2016
Magda Rosenmoller
IESE Business School
EIP AHA B3 AA3 Integrated Care
EIT Health Core Partner
Excellent Integrated Care for Rare Diseases
Promoting learning | Developing guidance | Sharing ideas
Project INTEGRATEBenchmarking Integrated Care for Better Management of Chronic and Age-related conditions in Europe
Promoting learning | Developing guidance | Sharing ideas
Project Integrate - Strategic Objectives
Gain in-depth knowledge: how integrated care can be developed and delivered successfully.
Identify fostering and hindering factors of integrated care.
Generate specific knowledge: process design and delivery models, patient involvement, professional skills mix/ ICT, financial flows and regulatory issues.
Examine management and leadership strategies used to realise integrated care.
Formulate policy recommendations for fostering integrated care at regional/ national /EU levels.
Promoting learning | Developing guidance | Sharing ideas
Project Integrate Overview
Promoting learning | Developing guidance | Sharing ideas
Triple AIM as shared Goal of Health (Integrated) Care
IHI - Triple Aim Initiative launched in 2007Source: Institute of Health Care Improvement - www.ihi.org
Promoting learning | Developing guidance | Sharing ideas
Framework for Analysis Integration of Theoretical and Practical Knowledge
Vertical vs. Horizontal
Degrees of integration – Segregation
– Linkage
– Coordination
– Full Integration
Levels of integration– System
– Organisational
– Functional
– Professional
– Clinical
– Normative
Conceptual framework for integrated care based on the integrative functions of primary care (source: Valetijn et. al., 2013)
Promoting learning | Developing guidance | Sharing ideas
Policy Recommendations - comprehensive
Triple Aim as starting point
Vision & context
Policy Models – Medical, Public Health, Social Determinants
Entry Points
– Childhood Adverse Events
– Life Course Approach – Health Literacy
– Educational and professional reforms
– Collaborative Entities and Teams
– Regulatory Frameworks for Improved Population Health
Promoting learning | Developing guidance | Sharing ideas
Practical Managerial Recommendations
Stakeholder Involvement (& institutional support)
Transparency / Information
Different approaches: top-down vs. bottom-up
Managerial capacity building
Process Redesign
Leadership
HOF Framework
Business Processes • Purchasing
• Reimbursement
• Marketing and Comm.
• Knowledge Mgt
• Information Mgt
• Control and Finances
• Budgeting
• Innovation
Results &
Value
Creation
• Patients
• Personnel
• Payers
• Society
• Financial
• Quality
Resources
& Capabilities
• Personnel
• Facilities
• Financial
• IT
• Partnerships
• Other
Risks &
Opportunities
Clinical Processes • Monitoring/Preventing
• Diagnosing
• Medication
• Intervening/Treatment
• Recovering/Rehabilitating
• Ageing
• End of life
Processes
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HOFHospital of the Future
Source: The Hospital of the Future. IESE CRHIM, 2015
Hospital of the FutureA New Role for Leading Hospitals in Europe Jaume Ribera / Gabriel Antoja / Magda Rosenmöller / Pablo Borrás
14 Key Messages for Leading Hospitals
1 Context 2 Smaller more Complex 3 New Scope of Services 4 Dual Orientation
5 Knowledge Driven Redesign Services 6 Open Distributed 7 Reference for Innovation 8 Research and Education
9 Risk Sharing All STH 10 Professionals as Leaders 11 Integrated Care / Processes 12 Connected Hospitals
13 New Professionals Roles 14 Patient Centred Innovation
Excellence of Care Framework
TECHNOLOGY EXCELLENCE
PATIENT EXPERIENCE
OPERATIONAL EXCELLENCE
Excellence of Care Framework
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TECHNOLOGY EXCELLENCE
PATIENT EXPERIENCE
OPERATIONAL EXCELLENCE
Green Architecture Boston Children Hospital
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“The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
Sandra L. Fenwick, President and CEO, Boston Children Hospital
Design: MikYoung Kim, www.myk-d.com
New Technologies : Five Devices, Physicians need to know about
1. ECG - Smartphone / credit card-size version
2. Blood Glucose measuring / behavioral impact (device arm / abdomen)
3. I Rhythm (adhesive patch – 2 weeks of heart rhythm)
4. Monitor IC Unit patient on an Ipad
5. Ultrasound Stethoscope (validated)
15Source: Eric Topol, The Creative Destruction of Medicine, Basic Books 2013
16Source Marty Kohn, IBM, Future Med, San Diego, Nov. 2013
New Access to Knowledge
Excellence of Care Framework
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TECHNOLOGY EXCELLENCE
PATIENT EXPERIENCE
OPERATIONAL EXCELLENCE
Atul Gawande: How to Heal Medicine
18Atul Gawande – How to Heal Medicine.
Source: Ted Talk, 2012, www.ted.com
FOUR Habits of High Value Health Care Organisations
• Specification and Planning
– Patient flow (admissions, discharge), core clinical decisions – explicit criteria
– Criteria-based decision making
– treatment algorithms, severity and risk scores, criteria for initiating call to a rapid-response team or triggering the commitment of a future resource, patient shared decision making
• Infrastructure Design
– Microsystem, subgroups / Clinical Guidelines (pathways) / capacity of HHRR
– Mutually reinforcing management Systems
• Management and Oversight
– From obligation to management based in results.
– Annual target setting
• Self –Study – knowledge management rapid-cycle experimentation)., ..
19Bohmer, R (2011)
The Four Habits of High-Value Health Care OrganizationsN engl j med 365; 22 Dec, 2011
Process Redesign throughDesign Thinking
Leading Clinicians vs. Clinicians Leading• Clinical Microsystems
– Effective care teams and good management of local operations
• Leadership Tasks
– create conditions that enable / encourage others to achieve a shared goal
through collective action
• Four Principle Tasks
1. Strategy / Objective - shared y need – collective action (teams)
2. Implementation – manage clinical micro systems• EBM vs. Patient centred
• Clinical vs. Human needs
• Clinical Precision vs. Compassion
3. Results – monitoring system performance
Quality / Costs
4. Improve Performance
financial pressure – new technology
Bohmer, R (2013)
Leading Clinicians vs. Clinicians Leading
N engl j med 368; April, 2013
Excellence of Care Framework
TECHNOLOGY EXCELLENCE
PATIENT EXPERIENCE
OPERATIONAL EXCELLENCE
Values and Cultures at Veterans Affairs
Fuente: Gaudet, T. (2011). Consumer-Centric Health Models for Change '11Seattle University, 12-13 Oct, Health Innoventions.
CTCA: Patient Centred Care24
Fuente: CTCA – Cancer Treatment Centers of Americawww.cancercenter.com
Leadership – by Patients
Fuente: Multiple Myeloma Research Foundation www.mmrf.org
EIT Health is supported by the EIT, a body of the European Union
EIT Health:a powerful alliance forhealthy living and active ageing
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Our mission
EIT Health promotes entrepreneurship and innovates in
healthy living and active ageing, with the aim to improve quality of life and healthcare across Europe.
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A strong partnership across Europe6 Co-location centres
8 InnoStars regions
International HQ
• International Headquarter in Munich
• 6 Co-Location Centres (CLCs):
o UK-Ireland (London)
o Scandinavia (Stockholm)
o Belgium-Netherlands (Rotterdam)
o Germany (Mannheim/Heidelberg)
o France (Paris)
o Spain (Barcelona)
• 8 InnoStars regions in 6 countries: o Croatia
o Hungary
o Poland
o Portugal
o Slovenia
o Wales
www.eithealth.eu
B3 Action Group on Integrated Care AA3 Workforce
Good practices related to WorkforceDevelopment, Education and Trainingoffer replicable training programmes,and show how a skilled healthworkforce can answer to thechallenges.
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European synergies for health