Here to Stay: Virtual Urgent Care Prepared for Northwest Telehealth - PowerPoint PPT Presentation

Here to Stay: Virtual Urgent Care Prepared for Northwest Telehealth Resource Center 2015 Annual Conference Matt Levi, MHA, MPH Ben Green, MD Director of Virtual Health Services Director of Clinical Innovation CHI Franciscan Health Carena April 1, 2015

Agenda CHI Franciscan Health • Franciscan Virtual Urgent Care overview • Results • Implications and health system next steps Carena • Evolution of virtual care • Market forces • Clinical experience delivering virtual urgent care / 2

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Franciscan Virtual Urgent Care Service Overview • 24/7 care options through web portal or toll free # • Integrated with Franciscan’s: – Primary care clinics – Main website – Patient access team • Help patient choose the appropriate Franciscan care • Assistance to schedule follow-up care and/or find PCP / 5

Franciscan Virtual Urgent Care Development timeline  Launch of after-hours option for existing patients  Answer PCP clinic phones after-hours for patient care,  Launch of direct to referring patients back to  Expansion to growth markets consumer subscription PCPs for follow-up service 2012 2010-2011 2013 2014 2015  Transition to employed  Development and launch of providers  Franciscan Anytime web portal and regional  Insurance coverage service for FHS, FMG and marketing campaign local CHI employees and  Additional access points  Expansion to 24/7 virtual dependents offering, and additional patient access components / 6

Why 24/7 Virtual Urgent Care Strategic rationale • Enhance patient experience • Drive new patient acquisition & retention • Strengthen primary care practice • Innovate for population health / 7

CHI Franciscan Health Primary care options • Appropriate care, setting, and cost • CHI Franciscan access points: - Emergency Room • Avoid as primary care option - Prompt Care/Urgent Care • Used for urgent needs - In-clinic Primary Care - Virtual Urgent Care • Episodic consultative care and referral to PCP for follow-up / 8

Franciscan Virtual Urgent Care Web Portal Activity 50,000 45,000 40,000 35,000 30,000 25,000 Website Visits 20,000 New Visitors 15,000 10,000 5,000 - Q3 Q4 Q1 Q2 Q3 Q4 2014 2013 2014 2014 2014 2014 /

Franciscan Virtual Urgent Care Volume of completed care requests Engaged Visitors 1800 1600 1400 1200 1000 800 Engaged Visitors 600 400 200 0 Q3 Q4 Q1 Q2 Q3 Q4 2014 2013 2014 2014 2014 2014 /

Franciscan Virtual Urgent Care Volume of virtual visits (stacked line graph) 1,000 900 800 700 Franciscan Anytime 600 patients 500 Afterhours PCP 400 patients 300 Virtual Urgent Care 200 patients 100 - Q3 Q4 Q1 Q2 Q3 Q4 2014 2013 2014 2014 2014 2014 /

Franciscan Virtual Urgent Care % of patients unaffiliated with a PCP No System PCP 90% 80% 70% 60% 50% No System PCP 40% 30% 20% 10% 0% Q3 2014Q4 2013Q1 2014Q2 2014Q3 2014Q4 2014 /

Franciscan Virtual Urgent Care Patient demographics Engaged Visitor Age 40 35 Engaged Visitor Insurance Type 30 25 20 15 Self Pay 10 Unknown 17% 5 21% 0 Government Insured Engaged Visitor Demographics 11% Unknown Commercially 2% Insured Male 51% 34% Female 64% /

Franciscan Virtual Urgent Care Volume of patients requesting help finding a new PCP Patients requesting a new PCP 500 450 400 350 300 250 Patients requesting a 200 new PCP 150 100 50 0 Q3 Q4 Q1 Q2 Q3 Q4 2014 2013 2014 2014 2014 2014 /

Franciscan Virtual Urgent Care Delivery on value equation, through September 2014 • Enhance patient experience – Patients saved an estimated 4,200 hours in travel and waiting room time – Patients saved an estimated $600,000 health care costs • Drive new patient acquisition & retention – New patients receiving a virtual visit resulted in 75 hospital visits and an estimated contribution margin of $160,000 – New patients not receiving virtual visits resulted in 118 hospital visits and an estimated contribution margin of $338,000 • Strengthen primary care practice – 1,472 referrals for new PCP – 50% reduction in pages to our on-call PCPs • Innovate for population health – Clinical acceptance, internal champions, and a growing market for virtual care New patients are those patients who have not had a clinical encounter within the 24 months prior to their earliest FVUC engagement. Contribution Margin reflects revenue less direct costs and is calculated as gross / charges multiplied by a conversion factor for any hospital based encounters.

CHI Franciscan Health Next steps for Franciscan Virtual Urgent Care • Transition virtual visit care to CHI Franciscan clinicians • Insurance coverage • Kiosk access points / 16

Ab o ut Ca re na T e a m o f me dic a l, te c hno lo g y, a nd c o nsume r se rvic e pro fe ssio na ls c o mmitte d to c re a ting the b e st he a lthc a re e xpe rie nc e po ssib le . We pro vide the so ftwa re , 24/ 7 sta ffing , a nd o pe ra tio ns e xpe rtise fo r he a lth syste ms to de plo y te le me dic ine – Vir tual Clinic . T o da y o ur Se a ttle -b a se d me dic a l Virtua list a nd Pa tie nt Co nc ie rg e te a ms o pe ra te c lie nt-b ra nde d Virtua l Clinic s tha t se rve o ve r 8M pa tie nts. Mission Re de fine he a lthc a re b y c ha ng ing ho w c o nsume rs a c c e ss c a re a nd ho w pro vide rs de live r it. Carena, Inc. , Confidential | 17

Ca re na ’ s E vo lutio n into Virtua l Ca re 2009 Virtua l House Ca ll 2000 House Ca lls 2013 He a lth Syste m Solutions F o unde d b y Prima ry Ca re MD se e king to T e c hno lo g y-e na b le d ho use c a ll de live ry. E mpo we ring syste ms to o ffe r b ra nde d c re a te g re a t pa tie nt e xpe rie nc e s. c o nsume r-frie ndly virtua l se rvic e s. E xpa nde d re a c h a nd inc re a se d va lue Pa tie nt-frie ndly a lte rna tive tha t re duc e d witho ut c o mpro mising pa tie nt c o sts a sso c ia te d with po o r a c c e ss. e xpe rie nc e . Care na, Inc . , Co nfid e ntia l | 18

T he n… 1925 : Sc ie nc e and I nve ntio n ma g a zine Carena, Inc. , Confidential | 19

…a nd no w Apr il 2014: “ Mo de l Po lic y o n the Appro pria te Use o f T e le me dic ine T e c hno lo g ie s in the Pra c tic e o f Me dic ine ” June 2014: “Co ve ra g e o f a nd Pa yme nt fo r T e le me dic ine ” “The number of doctor-patient video consultations will nearly triple from this year to the next, from 5.7 million in 2014 to over 16 million in 2015, and will exceed 130 million in 2018 ." - Harry Wang, Director, Parks Associates* *So urc e : http:/ / www.pa rksa sso c ia te s.c o m/ b lo g / a rtic le / c hs-2014-pr10 Carena, Inc. , Confidential | 20

T a c kling the I ssue s o f the He a lthc a re Co nsume r • QUAL Y de fine d b y c linic a l sa fe ty & e xc e lle nc e IT • ACCE SS de fine d b y c o nve nie nc e & a va ila b ility • T de fine d b y a re spe c te d b ra nd the y a lre a dy RUST kno w & c o nfide nc e tha t the ir c o nditio n c a n b e ma na g e d • CL Y de fine d b y simplic ity & tra nspa re nc y ARIT • CONNE Y a s de fine d b y the inte g ra tio n o f the ir CT IVIT o nline e xpe rie nc e with the ir b ric k & mo rta r e xpe rie nc e 21

Y : T he Virtua list E stablishing QUAL IT Car e na Vir tualist T e am • E mplo ye d te a m o f b o a rd-c e rtifie d F a mily Me dic ine MDs a nd ARNPs • De vo te d to a n e xc lusive te le me dic ine pra c tic e • De ve lo p a nd a dhe re to Virtua l Pra c tic e Guide line s (VPGs) a t the po int o f c a re • All pro vide rs lic e nse d in e a c h sta te in whic h c a re is de live re d • Co lla b o ra tive c linic a l c ulture • Co mpe nsa tio n b a se d, in pa rt, o n pa tie nt sa tisfa c tio n a nd a dhe re nc e to VPGs • Virtua l Ca re tho ug ht le a de r • E mpo we ring the He alth Syste m Pro vide r to de live r Virtual Care Carena, Inc. , Confidential | 22

Y : Virtua l Pra c tic e Guide line s E stablishing QUAL IT • Dia g no sis-spe c ific virtua l c a re c rite ria a nd tre a tme nt g uide line s fo r urg e nt a nd prima ry c a re • Ba se d o n a n a na lysis o f 35,000 Ca re na ho use c a ll e nc o unte rs & na tio na l sta nda rds o f pra c tic e • E mpha size s pa tie nt sa fe ty, b e st pra c tic e s, a nd c linic a l q ua lity • E mb e dde d into pro prie ta ry po int-o f-c a re c linic a l so ftwa re pla tfo rm • Ba sis fo r c linic a l a nd a c tua ria l re vie w a nd study Carena, Inc. , Confidential | 23

Y : QAI P E stablishing QUAL IT INT E GRAT E D QAIP PROGRAM* • Clinic a l Appro pria te ne ss o f Virtua l Visit • Adhe re nc e to Virtua l Pra c tic e Guide line s • Ong o ing mo nito ring o f pre sc rib ing pra c tic e s a nd a ntib io tic ste wa rdship pro c e sse s PROCE SS • 5 me mb e r Ca re na c linic ia n c o mmitte e • Qua rte rly Re po rts • Blinde d re vie ws o f ra ndo m a nd ta rg e te d dia g no se s * Appr o ve d by WA State De pt. o f He alth as a Ce r tifie d Quality Impr o ve me nt Pr o gr am Carena, Inc. , Confidential | 24

Y : 5 Da y F o llo w-up Ca ll Outc o me s E stablishing QUAL IT Clinic a l Sta tus Subse que nt Ca re Re quire d PCP No 12% Change 4% None 82% Re solve d 46% UC Wor se 3% 2% E R Be tte r 0% 48% Othe r 3% Carena, Inc. , Confidential | 25