Using Telemedicine to Improve Outcomes and Collaboration Within Hospitals and Health Systems

Transcription

1 American Hospital Association Leadership Summit Using Telemedicine to Improve Outcomes and Collaboration Within Hospitals and Health Systems Please note that the views expressed by the conference speakers do not necessarily reflect the views of the American Hospital Association or Health Forum.

2 LOOKING FOR SOLUTIONS. $1 Trillion annual U.S. healthcare spend flows through hospitals and healthcare delivery systems Top 10 strategy trends to follow the money Avera Health s strategy: Addressing challenges with sustainable solutions Source: Becker s Hospital Review. The #1 thing you need to know from the 2017 JP Morgan Healthcare Conference: Follow the money.

3 PLANNING FOR CHANGE. Revenue Diversification Ventures New Business Lines New Ways of Doing Business

4 VISION New Models of Care Delivery & Partnerships

5 TREND #1 WORKFORCE IN THE FUTURE Low resource settings Staffing to peak census Burnout Recruitment & Retention

6 SOLUTION WORKFORCE 24/7 Collegial Support Paradigm of Using APP s Recruitment & Retention Equipping Medical Students

7 Business Case Study MacKinney AC, Ward MM, Ullrich F, Ayyagari P, Bell AL, Mueller KJ. The Business Case for Tele-emergency. Telemed J E Health Dec;21(12):

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9 Avera ecare Emergency Simulation Video

10 TREND #2 GEOGRAPHIC EXPANSION & INCREASED ACCESS TO CARE Growing networks Diversity of expertise Strengthen the brand

11 SOLUTION IMPROVE ACCESS Access to Expertise Specialists & Subspecialists as Needed Available 24/7 to Expedite Care

12 ecare ICU Case Study: 12-bed mixed medical surgical ICU Avg APACHE Scores Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Avg APACHE Scores Linear (Avg APACHE Scores) APACHE score reflects acuity of patients monitored: higher scores means higher acuity patients being cared for. Scores for this unit trended up reflecting an increased acuity population Actual: Predicted ICU LOS Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 A:P ICU LOS Linear (A:P ICU LOS) APACHE system provides actual to predicted length of stay (LOS) comparisons. Result below 1 indicates ICU stays shorter than predicted. ICU LOS trend was downward indicating shorter ICU stays ICU Actual: Predicted Mortality Ratio Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 ICU A:P Mortality Ratio Linear (ICU A:P Mortality Ratio) APACHE system also provides actual to predicted mortality information: result of 1 means that patient mortality was the same as predicted. Results below 1 mean fewer ICU deaths. This hospital saw mortality decrease even though acuity increased. Vent Days/Vent Pt Vent Days/Vent Pt Linear (Vent 0.5 Days/Vent Pt) 0 Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 The graph indicates the number of days vented patients spent on ventilators. This wasn t an indicator that the hospital chose to pursue aggressively, but we saw a slight downward trend in ventilator days.

13 Lives Saved ICU Days Saved Avera ecare ICU Clinical Quality Impact Ventilator Days Saved Avera ecare ICU Outcomes Length of Stay LOS reduced by 3.38 hospital days & spent 13 hours less on ventilator ICU Days Saved 27,650 ICU days saved through faster response times to complications Lives Saved 1,743 Lives Saved with ecare ICU Healthcare Savings $78 Million dollars saved

14 TREND #3 PATIENT CENTERED & PATIENT EXPERIENCE. Consumerism Consumer Engagement Patient Activation

15 SOLUTION PATIENT CENTERED CARE Care Anywhere Convenience Patient Directed Care

16 AveraNow

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18 TREND #4 CARE TRANSFORMATION. ACA and Move to Value-Based Purchasing Gaps in Care Patient Centered

19 SOLUTION TRANSFORMING CARE Right care, Right time, Right setting Thinking differently Partner with low cost care settings

20 Shifting our Focus. From Volume to Value. ecare Senior Care Prevent Unnecessary Hospitalizations & ED visits Treatment in Place Reducing Costs Right Care. Right Time. Right Setting

21 Avera ecare Emergency Clinical Quality Impact UTILIZATION Aspirin Compliance Door to ECG Avera ecare Emergency Outcomes Faster Care In 28% of all Emergency cases, the hub physician was available prior to the local physician. In these cases, the hub physician was available an average of 21 minutes sooner than the local physician. STEMI DOOR IN TO DOOR OUT 2X Better Door to TPA EMERGENCY INTUBATIONS 33% Door In Door Out Better Outcomes For 18% of all Emergency video connections, the patient is able to avoid an unnecessary transfer. Avoided Transfers $3,823 dollars saved per transfer in Emergency 18 Min 36 Min Recruitment & Retention 81.5% of clinicians believe Emergency helps with recruitment & retention

22 TREND #5 CONSISTENT QUALITY. Striving for 100% Compliance Patient Safety Public Reporting

23 SOLUTION QUALITY Focus on quality initiatives Evidence-based protocol Extends expertise & resources

24 Avera ecare Pharmacy Clinical Quality Impact Serious Safety Events Avera ecare Pharmacy Outcomes Avoidance of Serious Safety Events ecare Pharmacy has improved medication safety for more than 1,043,179 patients. Avoided Drug Events A total of 35,764 potential drug events have been avoided with the support of ecare Pharmacy. Monthly Avoided ADE s Average Turnaround ecare Pharmacy reviewed over 3 million orders with average turnaround time of 12 minutes. Healthcare Savings $95 Million in healthcare dollars saved by preventing adverse drug events.

25 TREND #6 MANAGE MARGINS & REDUCE COSTS. Reimbursement uncertainty Escalating costs of brick & mortar Reduce waste & improve efficiency

26 SOLUTION INNOVATION Improve staff efficiency Increase throughput Breaking down walls

27 WHAT ARE YOUR PAIN POINTS?

28 HOW CAN TELEMEDICINE BECOME PART OF YOUR SOLUTION?

29 WHAT IS OUR RESPONSIBILTY AS HEALTHCARE LEADERS?

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32 A view from the bridge. Thank you.

33 Fera: Our one millionth Avera ecare patient

34 It s all about the patients.

35 THANK YOU FOR YOUR TIME. Deanna Larson Chief Executive Officer