1 Building Transformation | April 21, 2018 | CCPL Vancouver

VALUE-BASED HEALTHCARE IN CANADAAN INDUSTRY PERSPECTIVE

NEIL FRASERPRESIDENT, MEDTRONIC CANADA

November 8, 2018

MEDICAL TECHNLOLOGY IS WHAT WE DO. IT’S WHAT WE’VE ALWAYS DONE.

And although you may know us as the pacemaker company, the diabetes pump maker, or deep-brain stimulation experts

we do so much more.

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Last year, Medtronic technology improved the lives of more than 70 million people.

That’s 2 people every second.

Value-based Healthcare in Canada | November 8, 2018 | CCCF

VALUE DEFINED

HARVARD

“The health outcomes achieved that matter to patients relative to the cost of achieving these outcomes.”

VALUE =OUTCOMES

COSTSClinical, Functional, PRO/Satisfaction, Surrogate

People, Equipment, Space, Consumables

HEALTHCARE PROVIDERS

Right Treatment Right Patient Right Time Provider Well-being

PATIENTS*

Affordable (for out-of-pocket) Timely appointment Confidence in the provider's

expertise Conveniently located

**https://patientengagementhit.com/news/how-do-healthcare-consumers-define-value-in-patient-centered-care

4 Building Transformation | April 21, 2018 | CCPL Vancouver

VALUE: AN INDUSTRY PERSPECTIVE

Co-founder, Earl Bakken, 1924-2018Seen here in his garage

EVALUATING VALUE VANCOUVER GENERAL HOSPITAL REVIEW OF COMPUTER ASSISTED SPINE SURGERY

Canadian Health Policy Institute:

HIGHER LEVEL OF ACCURACY WITH SCREW PLACEMENT: 95% VS 87%

LOWER RE-OPERATION RATE: 2 VS 15

FAVOURABLE ECONOMICSCOST SAVING AFTER 255 PROCEDURES/YR

PORTER’S 5 STRATEGIES FOR SHIFTING TO VBHC

1. Organize into integrated practice units

2. Measure outcomes and costs for every patient

3. Move to bundled payments for care cycles

4. Integrate care delivery across separate facilities

5. Expand excellent services across geography

6. Build an enabling IT platform

October 2013

6 Value-based Healthcare in Canada | November 8, 2018 | CCCF

LESSONS LEARNED FROM THE NETHERLANDS TO ACCELERATE VBHCMAY 2017

BIGGEST CHALLENGES

1. Measuring outcomes

2. Move to bundled payments (and away from fee-for-service)

3. Change culture + stimulate leadership

Published May 2017

GOALS100% patient access to digital EMR by 202050% of outcomes measured by 2021

©Medtronic plc 2016 All Rights Reserved.No further copying or dissemination without permission of Medtronic.

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THE PATH TO VALUE-BASED HEALTHCARE

Better experience (outcomes) + maximize resources (cost)

SYSTEM OPTIMIZATION

Better outcomes with guarantee

THERAPY OPTIMIZATION

Focus on population health & improved care models, including prevention

CHRONIC CARE MANAGEMENT

More integrated care across the continuum

EPISODIC CARE MGMT

44% reduction in mean wait time

14% increase inOR capacity

80 – 100% reduction in infections

38% reduction in readmissions

28% fewer post-surgery ED visits

82% more patients in glucose control

51% decrease in hospital readmissions

Value-based Healthcare in Canada | November 8, 2018 | CCCF

LESSONS WE HAVE LEARNED ALONG THE WAYCHALLENGES TO IMPLEMENTING VBHC

1Lack of

standardization

of outcomes

measurement

2Data (outcomes

& cost)

collection and

analysis are

challenging

4VBHC

procurement

process is in its

early stages; needs

development &

refinement

3Physician buy-in

and partnership

is critical for

success

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Implementing VBHC is hard work – it requires a new way of thinking, dedication, and heavy lifting

5Incentives

should be

aligned for all

parties

Value-based Healthcare in Canada | November 8, 2018 | CCCF

LESSONS FROM VBHC DESIGN DAY

Stop pursuing perfect

cost/outcomes data (repurpose existing)

Stop pursuing conceptual perfection

Decrease funding of pilots and consider

path to scale

Seek lessons learned from other industries

Work together earlier, particularly

with patients

Strengthen value-based procurement

capacity

Identify priority problems to solve

HOW YOU CAN HELP SUPPORT THE SHIFT TO VBHC

Be a agent of change

Focus on outcomes & costs, with data

Lead & collaborate

11 Value-based Healthcare in Canada | November 8, 2018 | CCCF

Q A

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