transforming health through innovation and digital - deloitte · croke park, 14th february 2017...
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Croke Park, 14th February 2017
Transforming Health through Innovation and Digital Dr. Robert Williams, MD Life Sciences & Healthcare, Deloitte Consulting
What are the outcomes that we want to improve?
What some folks have said about making better decisions . . .
‘I never guess. It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.’ -Sir Arthur Conan Doyle
‘Facts do not cease to exist because they are ignored.’ -Aldous Huxley
‘If you don’t know how to ask the right question, you will discover nothing.’ -W. Edward Deming
Delivering safe and effective care
First,
Do no harm.
Do things well.
Do the right things
well.Provide optimal care and
service to patients,
families, and care givers..
Safety
EffectivenessStandard
order sets
Evidence-based
practice
Culturally
appropriate
Protocols
Length of
stay
Demand
matching
Avoid overuse
Avoid misuse
Avoid under-
use
Timeliness
Measurement &
feedback
Pharmacy &
therapeutics
Hospital-acquired
infection
prevention
VTE prophylaxis
Medication
reconciliation
Pressure sore
avoidance
Medication error
reduction
Mortality
reduction
Elimination of
wrong surgery
Fall prevention
Financial Stability
CitizenSatisfaction
Patient experience
1
1
2
3
2
3
Acute Care Primary Care Population Health
Selected examples of what can be achieved
• Safety, effectiveness and efficiency
• Medication management: prescribing, dispensing, administering
• Patient-centred, effectiveness, timeliness
• Prevention
• Chronic disease management: medical and behavioural
• Big bucket opportunities: analytics: financial and clinical
• Individuals at higher risk: stratification and targeted interventions
• Effective, efficient, equitable, patient-centred, timely
• Chronic disease management: care coordination
• Social determinants of health
http://www.edenmedicalcenter.org/yourstay/medication.html http://www.libdems.org.uk/investing-2-5bn-in-providing-patient-care-closer-to-home http://health.gov.ie/publications-research/statistics/statistics-by-topic/demographics/
What other folks have said about making better decisions . . .
‘Data! Data! Data! I can’t make bricks without clay!’ -Sir Arthur Conan Doyle
‘Errors using inadequate data are much less than those using no data at all.’ -Charles Babbage
‘A point of view can be a dangerous luxury when substituted for insight and understanding.’ -Marshall McLuhan
In-home sensors monitor activity levels for people with functional impairment in order to identify potential problems and adverse events earlier
Remote monitoring options for extending Care Management
Motion or “Activities of Daily Living”
Monitoring of vital signs to assess status of a particular illness in members with high disease burden
Interactive Voice
Response [IVR]
Telephonic and/or web-based health survey questions to elicit self-reported symptoms & biometric readings
Biometric Video Visit
Two way audio-video communication in order to interact with sickest members as an adjunct to home visits
Personal Emergency Response
[PERS]In-home emergency response system for people who live alone or with limited caregiver support
Passive monitoring Active monitoring
Monitoring activities of daily living:
Health sense’s eNeighbor System
• 11 sensors and a home/away pendant installed in member home
• eNeighbor analyzes sensor data using algorithms to detect abnormalities in member home
• Alerts generate recommended interventions
Call pendant
Contact sensor
Motion sensor
Bed sensor
Toilet sensor
I’m okay sensor
What other folks have said about making better decisions . . .
‘The value of an idea lies in the using of it.’ -Thomas A. Edison
‘If you can’t explain it simply, you don’t understand it well enough.’ -Albert Einstein
‘An idea not coupled with action will never get any bigger than the brain cell it occupied.’ -Arnold Glasow
Other future technologies, but core first
• Research• Omics• Personalised /
Precision Medicine• Advance care
management • Apps
Population Health
The broader opportunity for integrated care . . .
•Big bucket opportunities: analytics: financial and clinical•Individuals at higher risk: stratification and targeted interventions•Effective, efficient, equitable, patient-centred, timely•Chronic disease management: care coordination – INTEGRATED CARE•Social determinants of health
http://health.gov.ie/publications-research/statistics/statistics-by-topic/demographics/
In Sum, digital alone is insufficient . . . it’s not about the shiny objects
There are hosts of failures to learn from, as well as successes.
It should be clinically and operationally led, enabled by technology.
Change and engagement: doctors, social care, other clinicians and citizens are paramount
Focus on core components of electronic medical and social records in all settings and integrate them.
Then based on data, use core analytics and in the future more advanced analytics.
Acute Care
Primary Care
Population Health
‘Once we know something, we find it hard to imagine what it was like not to know it.’ - Chip & Dan Heath, Authors of Switch
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