moving into the future what’s next
TRANSCRIPT
Marian Walsh, President & CEO, Bridgepoint Active Healthcare
October 30, 2014
Canada’s Forum on Patient Safety & Quality
Moving Into the Future: What’s Next?
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Slated for c
losure
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Kaiser Permanente Model
Supporting Care and
Self-Care
Case Management
Specialist DiseaseManagement
LEVEL 3Highly complex patients5% of patients = 70% of costs
LEVEL 2High risk patients
LEVEL 1Patients with less complex conditions
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Complexity Becoming the Norm
45-64 65-79 80+0
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40 40
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1416
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No diseases1 disease2 diseases3 diseases4+ diseases
Age in years
Perc
en
t of
pop
ula
tion
Proportion of population with one or more chronic diseases, by selected age groups, Canada, 2009
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Growth in ComplexityA Result of Medical Advances
Lon
gevit
y
Early 20th century Late 20th century 21st century
Complex chronic careAcute CarePrevention and
treatment of infectious diseases
The next frontier of healthcare
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Complexity Defined
Clinical complexity
Multi-morbidity Poly-pharmacy High treatment
burden Fragmented care
Social complexity
Social vulnerability Depression Addictions Social isolation Coping & adaptation
challenges
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Meet John
80 years oldMild heart attackHypertensionMild CHFMild depressionMultiple medications
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Meet Mr. McLeod
66 years oldDiabetesKidney failureCongestive heart failureArthritis11 different medications
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Meet Mrs. G
70 years oldDiabetesHeart failureMyocardial infarctionHypertensionOsteoporosis3 adverse drug events
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System Thinking
Standardized
Disease-specific
Acute-focused
FromEmbracingComplexityTo
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The IMPACT Model
Patient + Caregiver
Physician
Chaplain
Pharmacist
Dietitian
Physio-therapist
Occupational Therapist
Social Worker
Nurse
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Different Trajectories
Individual Level
360˚ assessment
Organizational
LevelSeamless care
Systems Level
Measuring results
Managing Transitions
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Don Valley Greenwood &East Toronto Health Links
Hospital
Outpatient Rehab
Community Clinics
Day Hospital(proposed)
CARE Clinic
IMPACT-i
Inpatient Rehab
Bridge to Home Home
Family Doctor
Driving value, reducing costs and improving outcomes
Better patient
outcomes
+
Lower burden of
disease
+
Lower cost of
treatment
=
Better
valueFewer complex patients
Fewer unnecessary patient visits
Lower CCD treatment and
management cost
Treat chronic patients in
appropriate setting
Acute exacerbations of chronic
conditions
Unplanned utilization of hospital
services
Use of ED for non-urgent problems
Unplanned post-discharge
readmissions
Health status – physical, mental,
quality of life
Patient & family engagement
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$100- 150M
$2-3B
$4-6B
Bridgepoint implementation
Ontario roll-out
Full Ontario implementation
net annual
saving
net annual saving
net annual saving
Proof of
concept
• One hospital only
• 9 sites
• Province-wide (~19 sites)
This IS Affordable
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Join the conversation @BridgepointTO
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Thank You