the nuts and bolts of virtual care and digital health · virtual care and digital health best...
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Greater Kansas City HIMSS September 2018
The Nuts and Bolts of Virtual Care and Digital Health
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Why Virtual Care and Digital Health?
• Have you defined virtual care and digital health?
• Do you have system/enterprise strategies that align with virtual care and digital health ?
• How are objectives and key results (OKRs) for virtual care and digital health program(s) being tracked?
• Have you established clinical champion(s)?
• What IT and digital health infrastructure resources do you currently use/need to support virtual care services?
• Do you have a system/enterprise patient experience or access strategy?
Poll Responses at PollEv.com/mattsmith788 or Text MATTSMITH788 to 22333
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Virtual Care impact across thecontinuum
• spans the entire continuum of care, involve patients, providers, facilities, ancillary services – and competitors.
• impacts patient behaviors, provider workflows, clinical processes, disease outcomes – and health system finances – in numerous and unexpected ways.
Virtual Care and Digital Health Strategy Design
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Virtual Care and Digital Health Best Practices and Lesson Learned
Profitable, scalable, and sustainable virtual care programs share a set of foundational building blocks in common
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What are program governance essentials?
Centralized Governance is a key component to scalable and sustainable Virtual Care Program staffed with clinical, operational, and financial expertise
Virtual Care Planning Office
Director of Virtual Care and Executive Clinical Champion
Virtual Care Operations Center
Service Line IIIService Line IIService Line I Service Line IV Service Line VIService Line V
Executive Steering Committee
CMO, CNO, CMIO and CIO
Virtual Care Steering Committee
Clinical Site IIIClinical Site IIClinical Site I Clinical Site IV Clinical Site VIClinical Site V
Regulatory and Policy Compliance
Clinical ServicesInformationTechnology
Performance Management and
Finance
Business Development
Represents today’s common parallel project approach as opposed to a centralized program
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Clinical, operational, technical and data requirements
■ Individual Patients & Health Plan Contracts
■ Employers■ Correctional Systems
Ambulatory care Hospital acute care Community and Post-acute care
Virtual Care Consultation Record System (e.g., ViTel Net) (Standard Data Capture, Work flows & Clinical Protocols, Help Desk Support)with Video Teleconferencing Platform (e.g., Vidyo or Cisco, enterprise scale options)
Patient Engagement Platform – Personal Health Record (supporting Meaningful Use Stage 2 requirements)(e.g., Epic MyChart or Get Real Health Instant PHR)
Enterprise Data Warehouse (For Business Intelligence and Quality Reporting for Continuous Process Improvement)
Internal Medical Specialist Network Home Health Group
Electronic Medical Record System Epic Electronic Medical Record System
Virtual eVisit PlatformOnline Providers/eVisits Records/Reimbursement
Home Health Monitoring System with Call Center
Current technology gap Partially deployed technology Implemented technology
Administrative, virtual-consult Scheduling & Performance Management Platform (Technical Help Desk, Automated Consult Triage)
Referral
Self-referral
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Direct admit
Ed admit
Discharge
Home care
Medical Consultants
ProviderVirtual CareInformation and CollaborationTechnology
PatientEngagementAccess Tools
Business Intelligence
Clinical technologies and services for pilot
Virtual care and digital health target operating model
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
We have identified the following components that need to be quantified in order to calculate expected Return on Investment:
•Market shift earned via telemedicine
•Adjustments to GBR-base because of new services enabled by virtual care and digital health
•Rewards earned through HSCRC policies
Incremental Revenue
•Reduction in utilization costs
•Reduction in penalties assessed in HSCRC policies
•Reduction in travel / transport costs
• Shared Savings from CCIP / HCIP
Cost Savings
•Direct clinical professional services
•New virtual care administrative costs
•New digital health technology costsIncremental Costs
𝑹𝑶𝑰 =𝑰𝒏𝒄𝒓𝒆𝒎𝒆𝒏𝒕𝒂𝒍 𝑹𝒆𝒗𝒆𝒏𝒖𝒆 + 𝑪𝒐𝒔𝒕 𝑺𝒂𝒗𝒊𝒏𝒈𝒔 − 𝑰𝒏𝒄𝒓𝒆𝒎𝒆𝒏𝒕𝒂𝒍 𝑪𝒐𝒔𝒕𝒔
𝑰𝒏𝒄𝒓𝒆𝒎𝒆𝒏𝒕𝒂𝒍 𝑪𝒐𝒔𝒕𝒔
Financial analysis: Measuring the value of virtual care and digital health programs
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Robust performance measurement capabilities and tools are needed to monitor program ROI and facilitate ongoing program management
How do I develop KPI’s and OKR’s to align with my goals?
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Designing an enterprise standard workflow architecture is key to adaptability and scalability of virtual care and digital health programs
Enterprise workflow design
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Developing an enterprise virtual care program requires a high level of documentation and process mapping for successful implementation at scale.
Operational readiness tools
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
The future of patient access
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Access | Google Alliance
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Hey google, I’m having
painful urination, and I
want to see my doctor
as soon as possible.No problem, let me
see when Dr. Dane
is available.
Nancy is having painful urination symptoms, and she needs to see a doctor. Dr. Dane has availability
a week from today, would
you like me to schedule that?
No, I need to see someone sooner.
What are my options?
No problem, there are other Primary Care providers in
your network available in 2 days, OR you could go to
an urgent care center.
What is the closest and shortest wait for an
urgent care appointment?
Midvale Urgent Care, is 5 miles from
your house, and the wait time is 25
minutes.
The other option for you would be a
telemedicine appointment, I can
connect you immediately.
That’s great, lets do that. Ok, let me connect you.
Patient Assistance Demo/Use Case
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Uses NLP , deep learning and predictive modeling to understand customer interactions and behavior to reduce call volumes, increase customer satisfaction, and reduce operating costs.
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Contact Center Analytics | Google Alliance
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Access | Google Alliance
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Physician sponsorship
Robust change management
Templates, rules and appointment types
Consumer-centric workflows
A scalable technology platform
Sustained staff engagement
Performance management and accountability
Access | Success Factors
© 2018 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. All rights reserved.
Thank you!
Matthew Jansen, [email protected]
Tony Nunn, RN, BSN, [email protected] University of Kansas Health System