THE FUTURE OF HEALTHCARE TECHNOLOGY CareTech Solutions

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THE FUTURE OF HEALTHCARE TECHNOLOGY 1

THE FUTURE OF HEALTHCARE TECHNOLOGY NTT SmartShirt Records vitals to enhance athletic performance Real time monitoring of vital EKG, EMG, Respiratory Rate, Muscle Strength, Reaction time Used to rate prospects in NFL combine Can be adapted to track real time vitals of patients 2

JAMES DEREN James Deren is Director of Information Technology (IT) Healthcare Planning for CareTech Solutions. Mr. Deren has more than 36 years of IT experience, including 26+ in the IT healthcare industry. Jim Deren, PMP, CPHIMS Director of IT Planning CareTech Solutions Troy, Michigan Jim has presented at a number of national healthcare conferences including The 2016 AHA Rural Health Care Leadership conference, 2012 HIMSS national convention, the AHA Center for Governance Fall Symposium, 2010 HIMSS Virtual conference, 2009 Fall Midwest HIMSS conference and 2009 CHIME conference. He has earned a B.S. degree in education/computer science from Eastern Michigan University. 3

LEARNING OBJECTIVES The session will provide attendees with timely insights on: Past, current and future uses of technological tools by healthcare providers The drivers behind technology changes with predictions on healthcare trends and initiatives that will best engage multiple generations of consumers Ways a healthcare organization can fully leverage technology in order to achieve their business goals Strategies that utilize technology to fully engage patients, providers, and staff 4

WHERE WE WERE TYPICAL HOSPITAL IT COMPONENTS - 1990 5

WHERE WE ARE TYPICAL HOSPITAL IT COMPONENTS - 2016 6

EMR MATURITY - HIMSS EMR ADOPTION MODEL HIMSS Analytics EMR Adoption Model Stage Cumulative Capabilities 2005 2008 Q1 2011 Q4 2013 Q3 2015 Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 0.0% 0.3% 1.0% 2.90% 4.20% 2015 Stage 6-7 31% Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 0.0% 0.5% 3.5% 12.40% 27.1% Stage 5 Closed loop medication administration 0.0% 2.5% 5.9% 22.00% 35.9% Stage 4 CPOE, CDSS (clinical protocols) 0.8% 2.5% 10.7% 15.50% 10.1% Stage 3 Stage 2 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 1.7% 35.7% 48.4% 30.30% 16.4% 47.5% 31.4% 14.1% 7.60% 2.6% M A T U R I T Y Stage 1 Ancillaries - Lab, Radiology, Pharmacy 20.5% 11.5% 6.7% 3.30% 1.7% Stage 0 All three ancillaries not installed 29.4% 15.6% 9.60% 5.50% 2.1% Data from HIMSS Analytics TM Database 2015 n=4000 n=5166 n=5275 n=5458 n=5454 2005 Stage 6-7 0% 7

WHY EMR MATURITY MATTERS BEST HOSPITALS Select 140 top U.S. hospitals Categorized by size All rank stage 6 or 7 on HIMSS Analytics scale KPIs Risk adjusted mortality Risk adjusted complications Patient safety Reduced re-admissions Reduced mortality Reduced LOS Operating margin profit Patient satisfaction scores BEST TECHNOLOGY HIMSS Analytics Stage 6 and 7 29% of U.S. hospitals Complete EMR Interoperability with all providers Data continuity with ED Data warehouse with advanced analytics and decision support Online physician documentation with structured templates Integration with PACS Technology plan 8

THE NEW PATIENT EXPERIENCE EVOLUTION OF PATIENT ROOM 9

THE NEW INFRASTRUCTURE EVOLUTION OF AN IT DATA CENTER 10

THE NEW PATIENT EXPERIENCE BLOOD PRESSURE MONITORS 11

PATIENT INFORMATION THE PATIENT HEALTH RECORD 12

FUTURE FOCUS - WHAT IS THE NEW NORMAL? Prevention Adverse Event Diagnosis Home School Wellness Treatment Providers Long Term Acute Care Environment Rehab Work Hospital Follow Up Education Behavior Change Rehabilitation Specialty Care Center 13 CareTech Solutions 2015

DRIVERS OF HEALTHCARE TECHNOLOGY THE HITECH ACT REGULATORY REQUIREMENTS Payer reform driven by quality vs. quantity Transparency of healthcare costs Provider collaboration Preventative medicine NEW DELIVERY MODELS Retail health clinics Shift from hospital to ambulatory services PATIENT ENGAGEMENT Social media connecting healthcare Patient access to their own healthcare data Patient education 14

DRIVERS OF HEALTHCARE TECHNOLOGY 900 800 700 600 500 400 300 200 100 0 Healthcare Environment Trends 7123 6965 6649 5810 5756 5686 1970 1980 1990 2000 2010 2015 Medicare Enrollees (millions) Physicians (thousands) Office based visits (thousands) Physician Assistants (thousands) Nurse Practitioners (thousands) Hospitals Increased: Office visits Caregivers Medicare Enrollees Decreased: Hospitals 15 Source: National Healthcare Survey, U.S. Census Bureau

CRITICAL IT COMPONENTS TO ADDRESS DEMANDS More complete electronic health records Interoperability & integration of data Leveraging data analytics Personal / portable consumer access Increased IT infrastructure reliability IT strategic portfolio management IT security safeguards End user customer support and education 16 Source: Caretech Solutions, Gartner Research, KLAS

INNOVATION BUILDING BLOCKS Quality Community Safety Continuity Portfolio Project Management System Technology 17

18 INNOVATION BUILDING BLOCKS Safety Innovation Positive patient ID increases security Reduce time to access information Touchless facial, fingerprint technology reduced infection (Supports Ohio 2 factor identification) Increased accuracy Can work in smaller space Reduce infections (Spine fusion robot - used at Miami Valley Hospital)

INNOVATION BUILDING BLOCKS Quality Innovation Remote access to specialists Support when needed Patient convenience Emergency and real-time care (Cleveland Clinic mobile stroke unit) Reduce costs & increase convenience Create artificial limbs Create complex human tissue Improved diagnostic capabilities Organ replacements Better quality, quicker treatment 19

INNOVATION BUILDING BLOCKS Continuity Innovation Real-time monitoring of vital signs Condition specific feedback Ability to transmit to PHR Awareness and alerts Patient convenience Timely access to healthcare Reduce waiting Transparent and reduced costs (~250 retail clinics in Ohio 25+ telehealth) 20

INNOVATION BUILDING BLOCKS Community Innovation Quick access to healthcare information Improved knowledge of consumers Increased involvement in patients own care Numerous resources with best practices Determine action for best results Serve a particular population Data to forecast and predict outcomes Support pro-active planning 21

EXPERIENCE THE FUTURE OF: ENDOSCOPY Traditional System 140 170 degree field of vision Can miss 25-40% of polyps Multiple camera split screen is difficult to view Advanced Technology 5 camera endoscopy system 360 degree field of vision Complete view of the GI tract Advanced spatial awareness Better early detection of cancer 22 www.saneso.com

BUSINESS ANALYTICS MATURITY Optimization Improved Decision Making degree of intelligence Why is this happening? What will happen next? Forecasting Predictive Modeling What is the best that can happen? What Actions are needed? Statistical Analysis What if these trends continue? Alerts Standard Reports Ad-Hoc Reports Query Drilldowns What Happened? How often, how many? Where exactly is the problem? Improved Business Value Competitive Advantage 23 Lucrum Analytics Maturity Model

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COGNITIVE COMPUTING IBM WATSON FOR HEALTHCARE Healthcare Cloud Launched by IBM in 2015 that provides a secure, open platform for physicians, researchers, insurers, employers, and patients focused on health and wellness solutions Recently dedicated 2000 resources to advance capabilities HOW IT WORKS. First Watson learns a new subject All related materials are loaded into Watson, such as Word documents, PDFs and web pages Question and answer pairs are added to train Watson on the subject Watson is automatically updated as new information is published Then Watson answers a question Watson searches millions of documents to find thousands of possible answers Collects evidence and uses a scoring algorithm to rate the quality of this evidence Ranks all possible answers based on the score of its supporting evidence 25

IMAGINE A HOSPITAL WITHOUT: 1970s 1980s 26

CURRENT TECHNOLOGY TO CARE FOR PATIENTS 27

FUTURE AND EMERGING HEALTHCARE TECHNOLOGIES 28

ENGAGING PATIENTS & CAREGIVERS GENERATIONAL IMPACT Millennials 1981 - current 31% 30% Baby Boomers 1946-1964 19% 20% Generation X 1964-1981 Greater Generation pre 1946 29 Source: Smith & Jones; Healthcare Consumers, the New Reality

Low - High ENGAGING PATIENTS & CAREGIVERS GENERATIONAL IMPACT Desire quickness Prefer choices Use many providers High tech users Value / cost conscious Trust providers Millenials Generation X Baby Boomers Pre Baby Boomers 30 Source: Smith & Jones; Healthcare Consumers, the New Reality

TECHNOLOGY IN HEALTHCARE - RISKS SECURITY Growth linked to electronic records & social media Healthcare identity theft worth 100X credit card information COST OF TECHNOLOGY WORKFLOW & CULTURE Rural hospitals must meet same EHR requirements as others Average capital investment per hospital: $10-70 million; $15-75K per provider Process change linked to automation is lagging Complex technology difficult to implement and learn PATIENT BEHAVIOR Caregivers have limited control on patient behavior Increasing unhealthy lifestyle trends of the population LOSS OF PERSONALIZATION Clarity of follow up may be misunderstood without face to face interaction Regulations reduce time caregiver has with patient 31

2015: THE RISE OF CRIMINAL ATTACKS ON HEALTHCARE DATA for the first time, criminal attacks are the number-one cause of healthcare data breaches. Criminal attacks on healthcare organizations are up 125% compared to 5 years ago. In fact, 45% of healthcare organizations say the root cause of the data breach was a criminal attack, and 12% say it was due to a malicious insider. Fifth Annual Benchmark Study on Privacy & Security of Healthcare Data, Sponsored by ID Experts Independently conducted by Ponemon Institute LLC, May 2015 32

IT TRANSFORMATION Traditional Model Infrastructure Reactive Limited Availability Governance No IT Strategy Unclear Committee Charters Culture Hospital Centric Inadequate Information Staffing Lack Skills and Experience No Accountability Applications Financial Based Departmental Silos Processes Redundant Not Linked to Technology Innovative Model Infrastructure Pro-active monitoring 24 x 7 Support Governance IT Linked to Hospital Goals Define Measurable Objectives Culture Patient Centric Information Excellence Staffing Expertise When Needed Service Levels for Performance Applications Full EMR Community Based Integration Processes Optimized for Technology Process Improvement 33

CONNECTING A HEALTHY FUTURE 34 Source: Kaiser Permanente

TOP 10 HEALTHCARE IT TRENDS FOR 2016 1. PHI Security 2. ICD-10 Compliance 3. HIE / Interoperability 4. Clinical Decision Support Capabilities 5. Patient Portals 6. EHR Adoption (MU) 7. Population Health Management 8. Secure / Unified Messaging 9. Mobile Computing 10. Revenue Cycle Management Automation 35 HealthIT Outcomes 2016

Any Questions? 36

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