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Summit on the Patient Care Experience * Cleveland 2014
Virtual Patient Experiences:The Dominant OpportunityIn a Transforming Market
By
A. Ray Pentecost IIIDrPH, FAIA, FACHA, LEED AP
President, International Academy for Design & Health
Summit on the Patient Care Experience * Cleveland 2014
Major USHealthcare System Percentage Percentage
Inpatient encounters .36% ?
Outpatient encounters 99.64% ?
Virtual patient encounters ?
TOTAL ENCOUNTERS 100% 100%
Where are patients experiencing us?
Summit on the Patient Care Experience * Cleveland 2014
Priority:Health
Price:Unaffordable
People:Empowered
Process:Technology
VirtualPatient
Experience:The What?
Forces shaping the virtual patient experience
Summit on the Patient Care Experience * Cleveland 2014
Priority:Health
Forces shaping the virtual patient experience
Summit on the Patient Care Experience * Cleveland 2014
Select Provisions on public health/ prevention:
• Title IV: B: Increasing Access to Clinical Preventive Services
• Title IV: C: Creating Healthier Communities
• Title IV: D: Support for Prevention and Public Health Innovation
• Creation of the National Prevention, Health Promotion and Public Health Council
The Patient Protection and Affordable Care Act
Gwendolyn Robers Majette, JD, LLM, PPACA and Public Health: Creating a Framework to Focus on Prevention and Wellness and Improve the Public’s Health, Journal of Law, Medicine and Ethics, Fall, 2011, p 366‐379.
Summit on the Patient Care Experience * Cleveland 2014
Framework for National Prevention Strategy
1. “Create, sustain, and recognize communities that support prevention and wellness;
2. “Connect prevention‐focused health care and community efforts to increase preventive services;
3. “Empower and educate individuals to make healthy choices;
4. “Eliminate disparities in traditionally underserved populations to improve the quality of life for all Americans.”
Gwendolyn Robers Majette, JD, LLM, PPACA and Public Health: Creating a Framework to Focus on Prevention and Wellness and Improve the Public’s Health, Journal of Law, Medicine and Ethics, Fall, 2011, p 366‐379.
Summit on the Patient Care Experience * Cleveland 2014
National Prevention Strategy ‐ Priorities
1. Tobacco‐free living
2. Preventing alcohol and other drug abuse
3. Healthy living
4. Active living
5. Injury free living
6. Mental and emotional well‐being
7. Sexual health
Gwendolyn Robers Majette, JD, LLM, PPACA and Public Health: Creating a Framework to Focus on Prevention and Wellness and Improve the Public’s Health, Journal of Law, Medicine and Ethics, Fall, 2011, p 366‐379.
Summit on the Patient Care Experience * Cleveland 2014
Source: Breslow L., Health measurement in the third era of health, American Journal of Public Health , 2006:96:17‐19.
Greater emphasis on health vs. medicine
YouAreHere
Summit on the Patient Care Experience * Cleveland 2014
Priority:Health
Price:Unaffordable
Forces shaping the virtual patient experience
Summit on the Patient Care Experience * Cleveland 2014
Daily Medical Expenditures in the U.S.:
1. Heart Disease $501,000,0002. Cancer $430,000,0003. Digestive Disorders $337,000,000 4. Obesity $320,000,0005. Diabetes $273,000,000RAND corp./ US NIH 2000 (From the work of Mark Haynes, DC, Norfolk, VA, 2011.)
And DEMENTIA: $1,000,000,000Ruth Bettelheim, America can’t afford to neglect dementia care, USA Today, March 16, 2011
Traditional care is costly
In these 90 minutes the U.S. expenditure will
be around: $178,812,500
Summit on the Patient Care Experience * Cleveland 2014
United States perspectives
Chronic diseases are expensive: d
• Today total impact: $1.3 trillion/ year
$1.1 trillion: lost productivity
$277 billion: CD treatments
• 2023 total impact:
42% increase in CD over today’s rates
$4.2 trillion: lost productivity and treatmentsd An Unhealthy America: The Economic Burden of Chronic Disease – Charting a New Course to Save Lives and Increase Productivity and Economic Growth, October 2007.
Summit on the Patient Care Experience * Cleveland 2014
Alarming fall in reimbursements
May 9, 2013, 2:46pm EDT
Health-care providers to see big impact from reimbursement cuts
“In the latest [Premier] survey, 48 percent of the respondents anticipate that reimbursement cuts will have the greatest impact on their business during the year ahead.”
“ . . . Medicare reimbursements already fall short of what it costs to provide care. On average, inpatient reimbursements fall 5.8 percent shy of actual costs, while outpatient procedures fall 10 percent short . . .”
2013, A. R. Pentecost and Peter L. Bardwell, How Ten Forces are continuing to change Healthcare Design
Summit on the Patient Care Experience * Cleveland 2014
Select Provisions on Accountable Care Organizations:
• Title II, Subtitle I, Section 2706Pediatric ACO Demonstration Project
• Title III, Subtitle A, Part III, Section 3022Medicare shared savings program
The Patient Protection and Affordable Care Act
Emma Dolan, Accountable Care Organization Provisions in the Patient Protection and Affordable Care Act, Integrated Healthcare Association.
Summit on the Patient Care Experience * Cleveland 2014
Creativity in Patient Care Financing
1. Accountable Care Organizationsa) 50% + of US population lives in health service areas
with ACOsb) 28% of patients in US live in areas with 2 or more
ACOsc) 14% of US population with ACO organizations d) Opportunity to compete in healthcare on value
2. Growing interest in capitation vs. bundlinga) Potential for better management of paymentsb) Fuels migration to reduced use of medical care
Athena Healthcare., http://www.athenahealth.com/ citing work of Oliver Wyman at http://www.oliverwyman.com/content/dam/oliver‐wyman/global/en/files/archive/2012/ACO_press_release(2).pdf
Summit on the Patient Care Experience * Cleveland 2014
Priority:Health
Price:Unaffordable
Process:Technology
Forces shaping the virtual patient experience
Summit on the Patient Care Experience * Cleveland 2014
Importance of personal health technologies
Tor Constantino, IMS Institute for Healthcare Informatics, 2014.
Market Penetration:
43,000 health‐related apps in iTunes store
50% + healthcare apps downloaded less than 500 times
5 apps = 15% of all healthcare downloads
Focus: Wellness, Diet, Exercise