Impact and Management of Consumer Driven Clinical Services - PowerPoint PPT Presentation

Impact and Management of Consumer Driven Clinical Services Paradigm Shift in Service Delivery? Paul Ryder

What are the impacts of changing consumer demands on service delivery models & IT Are we prepared?

A survey conducted by Deloitte in the US recognised different healthcare consumer types: 1. Casual and Cautious (34%) – not engaged in their own health, no immediate need to consume healthcare service and cost conscious 2. Content and Compliant (22%) – happy with their provider and service delivery. Tend to be compliant with care plans and direction. 3. Online and On-board (17%) – keen to learn about health services Emergence of online, happy but looking for alternatives and new technologies Consumerism 4. Sick and Savvy (14%) – looking for alternative options and services. Communicate and partner with treatment decisions 5. Out and About (9%) – looking for alternatives options and prefer to tailor the services 6. Shop and Save (4%) – Looking to save money, willing to switch products and services for better value. As the computer literate generation of Consumers are becoming more informed and seeking greater say in their health and wellness, the consumer distribution is changing

We can’t sit still, we need to accept the issues and facilitate the change: • The cost of healthcare continues to rise at an alarming rate. • Demand for services isn’t diminishing. • We need to better understand how we can maximise the available resources, including providing alternative service delivery methods, e.g. Chronic disease monitoring, immunization, etc. provided through local pharmacy Consumer • The attitude, approach and priorities of the different type of consumer will impact the way they address health and Target wellness issues, and how they consume products and services. • How we service these requirements will influence future organisation structures, communities and, most of all, healthcare costs. • Need to be clear what Consumer we want to target! Which may be different depending on service organisation

Do we understand the commercial proposition, do we care? eHealth Consumer Commerce Market Potential

To change the way Providers and Patients Consumers interact:  Can be achieved :  Through People-centered Innovations Healthcare  Having Interoperability across healthcare Vision ecosystem  By promoting Standards and Policies  By creating a Coordinated Health Alliance  By providing Consumer access to records

There will be impacts on Healthcare Organisations:  Managing regulatory changes and maintain compliance  Being able to provide care without adversely impacting costs – we need to fully understand the implications  Endorse and support a move to personalized healthcare  Need to be able to better harvest person centric clinical information and provide real-time analytics in support of Organisational research Changes  Facilitate availability & reliability of services – need to maximise available resources  Ensure that we can secure provider and consumer relationships  Maintain provider affiliation  Create clinical and financial data transparency

We need to recognise where and how we can reform:  Impact of a changes to reimbursement model for service and care delivery  Address State and Commonwealth healthcare payment issues  Ensure we provide the necessary focus on large ticket items, e.g. chronic disease and aged care management Healthcare  Create sustainable Business Models through partnering Reform across disparate care delivery entities, GP’s and pharmacists working as a single entity  Recognise the risk to healthcare if there is lack of support for coordinated or aligned delivery of care  Legislation issues around expanding healthcare service delivery of existing provider’s. e.g. pharmacy reforms around access to extended services

Healthcare is a complex process that involves many different professionals and organisations • Patients receive care not by one person but by a multi- disciplinary array of care providers often in different locations. • Care delivery is most often reactive and delivered based on priorities and availability of providers. • Connected Patients are disempowered by the system and are left wondering if the care that they get is correct, appropriate and cost efficient. Healthcare  Connected healthcare is a key component in the evolution of healthcare delivery, benefits include: Community  Reduction in cost  Increase in patient safety  Improved coordination in delivery of care  It enables the move from a reactive model to a proactive and preventative model of healthcare delivery  Increased engagement by patients leads to better self management and consequently better outcomes Collaborative Care requires communication and collaboration :

Collaboration can only be delivered through ICT:  Hospital and Specialist Care needs to link with Primary & Community based care rather than continuation of silo based healthcare  Collaboration and Coordination across care providers should be mandatory not optional Limitation of  Healthcare IT is essential to deliver accurate and timely Current patient information access Initiatives  Clinical Data Repositories provide the mechanism for sharing of information  Managed Clinical Information provides the proactive management needed to reduce costs and improve outcomes

Does this mean we have a new IT headache?  A move to Consumer based solutions doesn’t require a Paradigm shift in technology it requires a shift in approach, all parties are involved in the design, control and service delivery  We need to utilise the systems we have to build trust and a more collaborative environment with participation that includes: • Government • Health Service Providers We have the • N.G.O’s • Industry Solutions • But most of all ….. Consumers  We need to better utilise the information available rather than reinvent new data capture solutions  We require agile solutions that are tailorable, provide flexible personalized user portals delivering information at the point of need, integration is essential to maximise information usage.  We also need to incorporate other services that consumers are demanding, such as complimentary and alternative medicines.

• More of us than ever are using the web to seek help about an ailment before or instead of visiting the doctor. • There is a plethora of health-related websites, tools and social networks available to support the demand. The Digital • Unfortunately, the Internet allows anyone to share, sell or post Age information, and there is no control on reliability or accuracy of information or services offered. • Only 25% of people check the reliability of health information they Dr “Google” find online by looking at the credibility of the source. will see you • A typical online medical consultation follows this trajectory: • 1) I have a problem, now … • 2) I do a Google search, • 3) I believe the first result that confirms my expectations. • Smoking helps a person's brain work more effectively, 'It helps with cognition, stimulation and relaxes” …. fact or fiction

Consumers interact with a variety of agencies, people and systems to manage their healthcare needs. Most consumers cannot navigate through this environment with ease leading to distress, poor outcomes and large expenses. Care Agencies Creating a Healthcare Websites Consumer Healthcare Marketplace Community Nurse Consumer Diagnostic Centres Pharmacy Health Care Insurer Doctor Support Group

A curated approach: A system that constructs a consumer healthcare profile based • upon available clinical assessments and personal data, it is used to curate or filter a marketplace of services matching need. Enables consumers to be appropriately informed and take • control of their own healthcare requirements. A Curated The system uses assessments to initiate care activities based • upon pre-defined protocols, care plans and modalities of care, Healthcare to manage care such as: reminders, appointments, medications, vital signs, weight, etc.. Marketplace Consumers create their own care networks, similar to social • networks, to include relatives and friends and the system ensure that these networks are notified of shared important healthcare based events. Ensuring those with long term conditions, the elderly, receive the • help and support from their own care networks.

This model creates an Integrated Care Management approach, which assesses and evaluates an individual’s needs, aligning them to care plans and suggested services. Providing Integrated Integrated Care Management understands: WHAT is required – based on needs aligned with service delivery • Care WHEN it is required – schedule intervention based on care • Management pathway and best practice WHO is required – identify and notify the providers responsible • for delivering service intervention. Consumers are also informed on pending care activities.

Mobile Access New Solution Consumer Patient Portal - PHR Professional Portal Portal eHealthStreet curates the eHealthStreet Healthcare marketplace. Products, services, tele- Healthcare Marketplace consults that are available and curated eHealthStreet matches the requirements by CareVigilance and preferences of the consumer based upon their individual health profile and Consumer Portal health needs.