“Health Care 2020 Planning for changes in how and

where care is delivered”

Wesley Valdes DO Wesley.valdes@gmail.com

LinkedIn Profile

Wesley Valdes DO

• No financial conflicts of interest to report

• I will be referencing various for profit companies and their products

– I do not work for nor do I have financial relationships with any of them.

– I attempt to use generalized identifies instead of specific companies or products where possible

– Suggestions and feedback are encouraged

•“To transform healthcare delivery, we

must first transform ourselves.”

Key Takeaways

• Awareness of the growth of the online care delivery market

• The value of clinical call center as a resource for large healthcare systems

• Concepts for the patient room “of the future” to enhance hospital safety and reduce costs

Healthcare delivery is undergoing a paradigm shift …

This is what we think

of when we say “see

a Doctor”.

This is what patients

are quickly beginning

to think of when they

say, “see a Doctor”

“By 2017, eight of

ten office visits will

be done virtually”

– Don Berwick

Consumerism?

• From the historical viewpoint – Principles of Economics (Consumer Sovereignty)

• Carl Menger (1871)

– Theory of the Leisure Class • Thorstein Veblen (1899) – Conspicuous Consumption

– Hidden Persuaders and Waste Makers • Vance Packard (1957, 1960) – Creative Waste

– Mr. Consumer, the real boss and beneficiary • Ludwig Von Mises (1944) – Ruthless consumer

• John Bugas (Ford Motor Company - 1955)

Consumerism?

• From the health sector viewpoint

– High deductible health plans (CDHP)

– Clarity in explanation of benefits

– Educate on preventive care

– Drive engagement and use of patient portals

– Greater access about network information

– This is not a bill … • http://www.whatmattersbywellmark.com/eob.php

Consumerism?

• From the Consumer point of view – Choice where to get healthcare services

• Retail (Walmart, Walgreen’s, CVS, etc)

• Online (TelaDoc, MDLive, American Well, etc)

• Traditional healthcare system

– Access to information (instantly) • Quality

• Economic

• Convenience

• Geographic considerations

Why it matters…

– The business model that matters most is the business model of the consumer

• They have information

• They have choice

• They have technology

• Collectively they change the landscape

12

One Critical Access Hospital – Grande Ronde, Oregon

•Reverse Hub and Spoke

– Hospitalist coverage from Israel and France

– eICU coverage from St. Louis

– Local coverage for some specialties

– Contract with anyone who is qualified to provide the service at the cost the hospital can manage.

Cardiac Surgery

Average US

• $44,000 - $200,000

• Mortality 2.4% (STS Nat’l)

• Infection rate 3.4%

• Post Sx bedsore (8-40%)

Narayana Health

• $1,500 (50% less than 13 years ago)

• Mortality 1.27%

• Infection rate 1%

• Post Sx bedsore < 1%

• Performs 12% of all cardiac surgeries in India

The new way …

Evolution: species come and go through time,

while they exist they change.

Common descent: organisms are descended

from one, or several common ancestors and

have diversified from this original stock

Species multiply: the diversification of life

involves populations of one species diverging

until they become two separate species; this

has probably occurred billions of times on

earth!

Gradualism: evolutionary change occurs

through incremental small changes within

populations; new species are not created

suddenly.

Natural selection: evolutionary change occurs

through variation between individuals; some

variants give the individual an extra survival

probability.

Evolution: systems come and go through time,

while they exist they change.

Common descent: organisms are descended

from one, or several common ancestors and

have diversified from this original stock

Species multiply: the diversification of life

involves populations of one species diverging

until they become two separate species; this

has probably occurred billions of times on

earth!

Gradualism: evolutionary change occurs

through incremental small changes within

populations; new species are not created

suddenly.

Natural selection: evolutionary change occurs

through variation between individuals; some

variants give the individual an extra survival

probability.

Call Centers

1.Bring a level of efficiency and customer service not attainable otherwise

2.With the appropriate supportive infrastructure, can be utilized for more than taking patient calls

3.Can provide virtual clinical services

Call Center Examples

Mercy Virtual Hospital

• 120,000 sq ft facility

• 300 clinicians

• To open March 2015

Sutter Health

• 160,000 sq ft

• Two buildings

• 900 employees

• Growing for several years

Extending TeleHealth Programs for Internal Efficiency and Cost Savings

• Facilitates delivery of a number of internal virtual services

• Live chat with families from hospital room

• Video call routing, security, and management

• Infrastructure leveraged for patient services

www.romanoriginals.co.uk