Saint Luke’s eHealth/Virtual Care Evolving models of Virtual Care Stephen Kropp, MS, System Director of Virtual Health Services
Where there is no vision, the people parish…… Proverbs 29:18 Governance – The way rules, norms, and actions are structured, sustained and regulated and held accountable. (Wikipedia)
Saint Luke’s eHealth— Outreach History SAINT LUKE’S HEALTH SYSTEM 3 CONTENTS CONFIDENTIAL AND SUBJECT TO THE ATTORNEY/CLIENT PRIVILEGE – DO NOT DISTRIBUTE
Changing Health Care Landscape Payment models Fee-for- Population Health Value-Based Service Management Volume – Global Quality based payment Traditional, Wellness/ acute care Safety prevention paradigm Based on Patient Medical illness satisfaction home Managing Reduced cost chronic disease Goals: touch more patients, improve care, improve efficiency SAINT LUKE’S HEALTH SYSTEM 4
SLHS eHealth Driving Principles In 2010, Saint Luke’s eGovernance Council defined four goals to evaluate and guide investment decisions. Market How large is the Expansion opportunity? Are the program Operational benefits equal to or Efficiency greater than the cost to produce them? Competitive What distinguishes our Differentiation programs from competitors? Do we need to react to Defensive Strategy competing eHealth programs? SAINT LUKE’S HEALTH SYSTEM 5
Buckminster Fuller — Knowledge Doubling Curve The curve begins in year AD 1 ; human’s • “knowledge unit” took a 198,000 years to accumulate By 1500 , human knowledge had doubled to • two units Exponential In 1750 , with introduction of the printing • Growth press, it doubled to four units By 1900 , human knowledge had doubled again • In 1950 , knowledge doubled again to 16 units • At the time Critical Path was published in • 1982, human knowledge was doubling every 18 months Linear Growth Now, human knowledge is doubling every • 12 – 13 months IBM predicts human knowledge could soon • Time – Historical double every 12 hours. SAINT LUKE’S HEALTH SYSTEM 6 (Source: Critical Path)
Rural Missouri Hospital Telemedicine Usage and Patient Retention 2017 2017 50% 80% Usage percentage Retention percentage SAINT LUKE’S HEALTH SYSTEM 7
SLHS SSA Regional Hospital Markets Worth Mercer Atchison Nodaway Harrison Missouri Hospitals 24 Gentry Sullivan 25 27 Kansas Hospitals 27 Hospitals 26 Grundy 29 23 Hospitals Holt 28 Andrew Daviess Linn Brown DeKalb Nemaha Livingston 4 Marshall 33 Doniphan 3 30 32 1 2 5 31 Caldwell Buchanan Clinton Atchison Carroll Chariton 6 9 Jackson Platte Ray 35 Pottawatomie 8 10 Clay 34 Saline 7 Leavenworth Howard Shawnee Jefferson 36 38 Wyandotte 37 11 Jackson Lafayette 12 Wabaunsee 13 Johnson Cooper Pettis Douglas Johnson 43 39 41 42 Moniteau Cass Osage 15 Lyon 16 40 Franklin Miami Henry Morgan 1 4 45 Bates Coffey Anderson Benton 44 1 Linn 18 7 46 St Clair 47 Hickory Allen Bourbon Vernon Woodson 19 20 48 49 Polk Cedar 22 51 Neosho Barton Crawford 21 50 SAINT LUKE’S HEALTH SYSTEM 8 SLHS Regional Facility 23
How does eGovernance impact the rise or fall of a strong Telemedicine program? • Listen • Incentive Alignment • Congruent with organizational strategic plan • Homework • Pilot • Develop your 90 day plan • Mission, Vision, Values consistent with organization SAINT LUKE’S HEALTH SYSTEM 9
Due Diligence in the selection of your stakeholders • Don’t always start with the COO lowest hanging fruit. Executive Sponsor • Profiling is PC when identifying key leaders possessing the vision Chief Innovation Officer and energy to innovate. eGovernance Lead • Executive sponsorship coupled with clinical engagement is as IT, Nursing, Mrktg, System Director of Virtual Innovative Outreach, Pharm, important as O2. Virtual Care Health Specialists Post Acute, Operations Enablers Physician sponsors • IT is a necessary member, not a driving force. SAINT LUKE’S HEALTH SYSTEM 10
Establishing a Strong Market Presence Telemedicine Rapid Expansion: “One report claims that, globally, Telemedicine will be a $36.2 billion industry by 2020. Up from $14.3 billion in 2014”. AARP— February/March 2018 Exercise Your Governmental Relations Office regularly: 2015 – 2018: Statewide Telemedicine Legislative Summit in Jefferson City – Summit for Health Care Providers, Insurers, Telemedicine Industry and Missouri Legislators SAINT LUKE’S HEALTH SYSTEM 11 Source: Beck M. How telemedicine is transforming health care. Wall Street Journal. June 26, 2016.
SLHS eHealth Service
CMS is trying to keep pace with the pace of healthcare evolution. Chronic Care Remote Physiologic Monitoring • If finalized, the new codes go live Jan. 1, 2019 • 33% less time • Separate payment for initial set up and training • Clinic staff are allowed to conduct the encounter • SAINT LUKE’S HEALTH SYSTEM 13
Provider engagement and training • Work closely with your system • Technology must be intuitive to transfer program. care givers • Identify regional demand for • Training should not exceed 15 each specialty minutes for the technology • Internal assessment with • Once the providers register and specialties in demand explore the sand-box, create a series of mock patients on-which • Determine provider resources to practice and stretch RVU goals for each requested specialty • Staff from originating site spends time with providers nurse • Virtual Innovative Health Specialist (VIHS) SAINT LUKE’S HEALTH SYSTEM 14
The Hedrick Experience: Problem 850 800 750 700 Admissions 650 Transfers 600 550 500 2011 2012 2013 SAINT LUKE’S HEALTH SYSTEM 15
The Hedrick Experience: Solution 1200 1000 800 Admissions (Med Surg, ICU, & Swing) 600 Transfers 400 200 0 2011 2012 2013 2014 2015 2016 2017 9500 14.0% 12.0% 9000 10.0% 8500 8.0% ER Visists 6.0% 8000 % of ER Transfers to ER Visits 4.0% 7500 2.0% 7000 0.0% 2011 2012 2013 2014 2015 2016 2017 SAINT LUKE’S HEALTH SYSTEM 16
Apache Data – Ratios SAINT LUKE’S HEALTH SYSTEM 17
Apache Data – Ratios (cont.) SAINT LUKE’S HEALTH SYSTEM 18
Apache Data – Ratios (cont.) SAINT LUKE’S HEALTH SYSTEM 19
Apache Data – Mortality with Sepsis SAINT LUKE’S HEALTH SYSTEM 20
Take Saint Luke’s With You Wherever You Go SAINT LUKE’S HEALTH SYSTEM 21
Cost Savings SAINT LUKE’S HEALTH SYSTEM 22
Saint Luke’s 24/7— Targeting Employees SAINT LUKE’S HEALTH SYSTEM 23
ePulse SAINT LUKE’S HEALTH SYSTEM 24
Saint Luke’s 24/7 Brand Awareness SAINT LUKE’S HEALTH SYSTEM 25
Engaging Households on Multiple Fronts SAINT LUKE’S HEALTH SYSTEM 26
Patient Impact • As a core competency within the Saint Luke’s Health System, the real patient impact is summed up in this brief video. https://youtu.be/wUKBGFvppTk SAINT LUKE’S HEALTH SYSTEM 27
Thank you. Questions? Stephen Kropp, M.S. Saint Luke’s Health System skropp@saintlukeskc.com SAINT LUKE’S HEALTH SYSTEM 28 CONTENTS CONFIDENTIAL AND SUBJECT TO THE ATTORNEY/CLIENT PRIVILEGE – DO NOT DISTRIBUTE
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