INNOVATIONS IN CARE MANAGEMENT Michael Burcham, Narus Health
Innovations in Care Management Dr. Michael Burcham, CEO Narus Health
Part 1 Care Management Trends & Headwinds
Four Mega Trends Transforming 1the US Health Care Market Technology Demand for Value Growing Health Economy Government Influence
Innovation Opportunities 2Emerging from These Trends Everywhere Care: Shifting the spectrum of care from hospitals to lower-cost sites Preventative Care: Shifting disease management from reactive to proactive Personalized Care: Shifting offerings from mass generalization to mass customization and precision Aging, Chronic & EOL Care: Shifting focus from institution-based aging to community-supported aging with data & technology support.
3Growing Overlap Between Delivery & Support Telehealth Svcs Disease Mobile Health Care Management Provider Connectivity: There is growing collaboration between the delivery side of healthcare and the care management / coordination side of healthcare. Care Continuum Management Data & Analytics Fusion: Of Claims Administration, Care Management, Data, Consumer Engagement
Mobile & Technology 4Engagement Grows Consumers are Turning to Technology to help them engage with providers and care managers.
Part 2 How Should We Think About Innovation
The Problem Patients & Families Need Access Patients facing a serious medical illness need better access - on their own terms. Their unique medical challenges warrant support from a trusted care resource - an advocate - someone they can turn to that will help them navigate the complexity of the health care system.
The Challenge U.S. Healthcare Spending is Disproportionally Concentrated 5% of members make up 50% of cost. 47% The 50% of members with the least annual spending make up only 3% of cost. 25% 25% 3% Total cost of private insurance spending by members = 1% of members
Advanced Illness A Significant Market Opportunity to Support Patients & Families 1 1 Condition Prevalence New Cases Year Cancer Parkinson s Disease Alzheimers Chronic Respiratory Disease Heart Failure 15.0 Million 1 Million 5.2 Million 18.0 Million 5.3 Million 1.5 Million 0.2 Million 0.5 Million 1.0 Million 0.5 Million Individuals with serious illnesses spend about 20 hours a year with medical professionals. Their family caregiver will spend nearly 2,000 hours caring for them. Over 40 million people provide care to seniors in the US and about 10 million do so at a distance.
Navigating a Fragmented System 1 2 Fragmentation continues throughout our industry - creating additional complexity for patients and families and new opportunities for entrepreneurs. Other Private Pay Services Hospitals and Health Systems Patient Portal (EMR) SNF Outpatient Care Providers Doctor Offices Doctor & Hospital Offices Personnel & Hospital Personnel Community-Based Support Organizations Pharmacies Home Health & Private Caregivers Clinical Trials DME Specialty Medical Providers Hospice
The Law of Disruption While People Change Incrementally, Technology Improves EXPONENTIALLY
When an industry faces disruption, companies often fail to appreciate quickly enough the nature, extent, and velocity of the changes taking place. WHY? Disruptions start at an industry s edge, among small companies that provide specialized value to emerging customer segments. They bring new business models. They leverage new technologies. They change the customer s expectations.
Innovation How people, process and technology come together. 1 5 People Process Technology Develop our team to have deep knowledge of healthcare - not just our sector. Invest in an advisory board with expertise that complements the team. Without process consistency, margins never fully materialize. Healthcare talent is costly, optimizing our operating design for highest-andbest use is necessary to scale. The technology is the catalyst for optimizing process and people. Think social, mobile, cloud, data and interoperability.
Areas for Innovation Healthcare CEO Survey. Areas of Focus PWC Care Access Workflow Clincal Utilization Wellness Devices Price 90% 87% 87% 84% 77% 77% 74% 71% 68% 65% 65% 61% 61% 55% 35% 29% 0% 50%100%
WHAT IS IMPACTING HEALTHCARE TREND? Aging Population Big Data Online Scheduling Near Field Communication Mobile Diagnostics Connected Devices Risk Sharing & Bundling New Entrants in the Space Passive Surveillance Rise of Chronic Diseases Total Cost Consumer Choice Wearable Technologies Life Extending Treatments Wellness Apps Virtual Visits Telemedicine Search Social Media
Fortune 50 Entrants 24 of the Fortune 50 Are New Entrants in Healthcare In their eyes, today s system represents $2.8 trillion in the US alone - but the New Health Economy of tomorrow will include trillions more globally as consumers shop for products and services online. Source: Fortune, 2015
Context & Presence Preferences / Behavior Presentation / Cross Device Integration & Aggregation Alert & Notify Security / Identify Personalization Content Customer Experience Enablers
B2B IS BEING REPLACED WITH B2C The shift from the business-to-business (B2B) model toward a more defined business-to-consumer (B2C) model is already underway. PROVIDERS
$36 Trillion in Stock Market Value is up for RE-IMAGINATION Social Mobile Analytics Cloud 2.4 billion people are active over social media generating immense information every minute. Mobile data traffic will grow 8X to with over 9 billion mobile phone users. Organizations are using analytics to understand and grow their business. By 2018, 78% of all workloads will be processed by cloud data centers.
Part 3 7 Elements of Successful Innovation in Care Management
Model of Innovation 3 Kinds of Innovation The 6 Forces How customers use your innovation The technology that leads your innovation The business model of your innovation
Model of Innovation 3 Kinds of Innovation The 6 Forces 1. Industry Players 2. Funding 3. Public Policy 4. Technology How customers use your innovation The technology that leads your innovation The business model of your innovation 5. Customers 6. Accountability
THIS IS NOT INNOVATION Fax Paper Phone Rolodex
THIS IS INNOVATION Social Mobile Analytics Cloud
The Goal Meaningful Access To Care. To Support. To Insight. To Options. Patients facing serious medical illnesses also have unique challenges that warrant support from a trusted care resource - someone they can turn to that will help them navigate the complexity of the health care system. Patients and families are seeking meaningful access - to care, to support, to answers, to insight - on their own terms.
2 8 What We Do Need To Do Key Areas of Opportunity
1. The Patient Experience Areas for Innovation 2 9 The patient and family experience is our product. We must get better at addressing symptoms, answering questions, facilitating appointments, providing follow up, offering insights. We must deliver continuous, meaningful interactions with the patient and their family - offering trusted support, insights and education throughout the individual's journey within the healthcare system 24/7/365.
2. Help with the Hard Stuff Areas for Innovation 3 0 The soft issues have been shown through research to be highly predictive of individual needs and are the most likely disruptors of care plans (symptom management, family support, access, goal clarity, understanding of benefits). Our job is to become proactive in predicting and mitigating these risks and to resolve these issues for each patient.
3. Structured Care Plans Areas for Innovation 3 1 The market is looking for highly personalized, searchable, consistently applied and reportable care experience. Our care plans must: Capture key personal attribute and patient reported data so the treatment plan can be tailored to the patient s unique needs. Become structured to support search, analysis and bestpractices to optimize program performance.
4. Scalable Service Design Areas for Innovation 3 2 We must learn to optimize a technology-enabled care delivery model that is efficient, affordable and effective. Modes of communication must advance to include: Personal Visits Phone Secure Messaging Video Encounters Our service must be transformed to support the patient and their caregiver throughout their journey through various episodes of illness.
5. Right Resource. Right Time. Areas for Innovation 3 3 Our must adopt acuity-based care designs that ensure that the right resources get to the right patient at the right time. Even having the same diagnosis, rarely are any two individuals needs the same. Our designs must ensure the appropriate level of support for each individual - so much so that we are willing to be risk-partners with other players within the healthcare ecosystem.
6. Patient & Family Content Areas for Innovation 3 4 We must invest in thoughtful and action-oriented materials to help inform patients and families for decision-making: Articles for better decision making and actionable tips Personalized guidance for organizing medical and care information specific to goals and values A marketplace of recommended resources, connections, products and support
7. A High Quality Network Areas for Innovation Perhaps it s time that the best-in-class providers throughout the care management industry decided to create a network - linking us together on behalf of patients and families in a common purpose. Getting us out of our silos and building something innovative for patients and families.
VALUE CREATION FOR OUR CUSTOMERS Competitive Advantage Our ability to outperform our competitors: Valuable, Rare, Sustainable, Hard to Imitate. V P = Halo THE HALO P C = Margin C V = Value to consumer P = Price C = Costs of production
VALUE CREATION FOR OUR CUSTOMERS Competitive Advantage When We Raise Price with No Additional Value, We Reduce the Halo, Becoming a Commodity P C = Margin C V = Value to consumer P = Price C = Costs of production THE HALO
Food for Thought 4 Key Desires Taking the Service to the Family My Data Symptom Reporting Family Messaging Care Team Access We surveyed over 100 families regarding what they thought would enhance their own care management experience. They wanted: Data. Symptom Reporting. Messaging 24/7. Access
COMPASSION A Narus Health Solution Each care manager has their own dashboard to maximize productivity as well as the patient experience. The Navigation Screen includes: Alerts (important messages) Messages (secure text from families) Patients (my patients) Notifications (To Dos) Schedule (Today s Plan)
Patient Record Monitoring Engagement & Encounters COMPASSION Unlike traditional case management tools, the Narus Health platform is specifically designed to manage a longitudinal patient journey - to monitor symptoms and support individuals dayto-day needs as they navigate the health care system. We enhance response time, serve as an extension of the physician, and support the patient and family caregiver.
MPOWER A Narus Health Solution Secure, patient-family-caregiver application Supports patient communication Symptom reporting and pharmaceutical compliance Patient feedback and survey insights Patient education
42 Secure Log In & Navigation MPOWER Our mobile application serves as the lifeline between patients, their families, their doctors and the Narus Health Care Team. Providing a better care experience, and securely enabling reporting of well-being, messaging, delivery of education material, consolidated contacts and key phone numbers. Navigation Screen includes: Home My Data Education Medication More Secure Log In Navigation
43 My Data & Education MPOWER The patient s key data is accessible on their mobile phone. They are able to share their documents with new healthcare providers. This could include information about their advanced directives as well. Additionally, educational content is delivered in two specific categories: Recommended News - Personalized content Illness Specific - Information about my illness My Data Resource Library
44 Medication Profile MPOWER As the Narus Health Care Team interacts with patients and families, a full actual medication list is created, from the prescriptions that have been filled and those the patient is actively taking. This also includes the patient s over-the-counter medications. Interactions with prescription medications with this total list is important to avoid unnecessary complications for persons with complex diseases. Medication List Specific Medications
45 Symptom Monitoring & Managment MPOWER Patients (or caregivers) are able to report symptoms (pain, nausea, anxiety, etc.) to Narus Health - and get support in managing these symptoms. As patients report symptoms, the Narus Health team receives these notices in real time, mitigating symptoms in the home environment, addressing needs that might otherwise require a visit to an emergency room or a hospital admission. Patients (or caregivers) can report symptoms at any frequency throughout the day if they choose to do so. Reporting Symptoms Symptom Rating
46 Secure Messaging MPOWER Narus Health offers secure messaging between the patient and the Narus Health team as well as messaging that can include the family care giver, other family members and medical practitioners. The individual patient approves other family members who are invited to participate in care management conversations. This can be very helpful to family members (children) who live out of the area and wish to be an active participant in care decisions. Secure Messaging 1-to-1 or Group
47 Care Team MPOWER The patient s care team is immediately accessible through the Narus Health app - with the opportunity to interact through a call or a secure message. Key numbers of physicians, pharmacy and other support services are also added - providing the patient and family a single list of the most important contacts for their treatment. Care Team Connection Direct Access
48 Patient Diary MPOWER The diary portion of the mobile tool gives patients the opportunity to post and share important thoughts and notes with family members (and the care management team if they choose to do so). Patient Diary
Customer Value Is Often Inferred in Context of Time & Accessibility The amount of time we have The goal we want to accomplish Our location Our attitude and state of mind
We are not in the health care business. We are in the Human Care business. 5 0 Connect with me. Your Life. Your Way. 2525 West End Avenue Suite 925 Nashville, TN 37203 michael@narushealth.com