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Judy Murphy, RN, FACMI, FHIMSS, FAAN
Chief Nursing Officer
IBM Global Healthcare & Life Sciences
September 1, 2016
Patient Engagement to
Promote Population
Health Management
Housekeeping
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What we will cover
• Evolving healthcare landscape – what is changing and
why we need to change too
• Population Health Management
• Reimagining Health and Healthcare with Mobile
• Population Health Management requires Patient
Engagement
• Emerging Consumerism and eCommerce
• The Need for Analytics
• The Era of Cognitive Computing
4
Healthcare transformation is happening, driven by fundamental shifts
in expectations and critical drivers
Expectations for better
quality, value and outcomes
Escalating incidence and cost
of chronic disease
Changing demographics
and lifestyles
Globalization of health care
Critical resource shortages
Increased competition and
new entrants
Advances in technologies
and treatments
5
Old Healthcare New Healthcare
Fee for service Pay for performance
Volume Value
Delivery Quality Outcome
Employer-centric Consumer-centric
Prices unknown Cost transparency
One way dialogue Engaged & mobile
Transactional Brand loyal
Data poor & disconnected Integrated rich “big” data
Reactive Predictive & prescriptive
Standards Personalized & optimized
This transformation is an evolution …to a new model for healthcare
6
Healthcare is moving to a system focused on value, coordinated around
the individual, and integrated into our communities
Focus is on value, coordinated
around the individual and
integrated into communities
Emphasis is on proactive care
to help meet health needs
Payment will be based on
value and outcomes
Care is standardized
according to evidence-
based guidelines
We measure quality and will
make rapid changes to
improve it
Data and Information
Understand and
influencetheir
populations
Evidence-based andstandardized care planning
Coordinationacross
boundaries-- share care,
accountabilityand risk
Individualengagement
andempowerment
Quality measurement
andperformance
reporting
Social Worker
BehavioralHealth
Family
Community
Palliative Care/
Hospice
Rehabilitation
Home Care
Specialists Intensivist
Physical Therapist
Dietician
Case Manager
Caregivers
Transportation
Housing
Medications
Funding and
Payment
Primary
Care
7
The new model is Value Based Care – centered around the patient
Value = ExperienceCost
Taking steps to achieve better results, and improve customer (patient) satisfaction
Reducing waste, reducing
errors, managing risk, improving efficiency and quality
Organizations
are on a journey to improve value
8
Population Health Management
HEALTHY / LOW RISK CHRONICAT RISK
ACTIVE
DISEASE
No or very-low touchMedium to
high touchLow touch
High
touch
40-60% 5-15%20-25% 2-3%
60+
5-10% 30-40%15-20% 40-50%
RISK
STRATIFICATION
POPULATION
RELATIVE
COST
ENGAGEMENT
Fully automated
Validate from data
Blended -
retail outlet,
care mgt,
automated
Mostly automated
with email, call,
text, mobile app
Active
Case
MgmtOUTREACH
Capability Needs
• Data (internal-external)
• Scalable platform/data
management
• Risk analytics &
management
• Insight analytics
• Similarity analytics
• Cost of care analytics
• Actuarial analytics
• Marketing analytics
• Marketing management
• Predictive modeling /
next best action
• CRM
• Campaign
management
• Outreach advisor
• Remote data capture
• Mobile apps
• Network analytics
• Care coordination tool/
clinical integration
~20% of population
drives ~80% of cost
ENTIRE
POPULATION
9 http://archive.ahrq.gov/research/findings/factsheets/costs/expriach/expendria.pdf
Reimagining Health Care with Mobile
1
0
Mobile is being exploited to:
Facilitate anytime anywhere access to data and extend services beyond traditional settings
Develop new engagement techniques and health strategies with patients and consumers
Gain insights to provide more personalized, proactive interventions; bring analytics to the point of care
11
Imagining Care Anywhere Vision
https://www.youtube.com/watch?v=UOMtWFeyscg
12
The Power of Patient Engagement:
Population Health Management requires Patient Engagement
Capture and incorporate
preferences
Personalize offerings
and services
“Know me”
“Engage me”• What’s my history?
• What are my preferences?
• How will I respond?
• What will motivate me?
• Respect my privacy• Engage in the preferred dialog
• Be relevant (“right information”)
• Be consistent across touch points
• Show sincerity -- “you care”
Innovate to deliver quality,
convenience and total
experience
“Empower me”
• Give me the information I need
• Connect me with relevant communities
• Simplify control and access
• Enable action and convenience
13
Trends Supporting Greater Patient Engagement
The way we pay for and deliver care is changing.
Health IT adoption has reached a tipping point.
Technology is getting better, cheaper,
faster and more ubiquitous.
Consumers increasingly expect online
engagement, in all aspects of their lives.
14
Integration of health in our lives
https://www.youtube.com/watch?v=-zh9fibMaEk
15
So what is driving “Consumerism” in healthcare?
• Cost shifting – “out of
pocket” costs are increasing
for individual healthcare
consumers
• There is an increase in the
use of High Deductible plans
and Health Savings Accounts
(HSAs), leading to more
consumer price sensitivity
• New business models for delivering care are emerging, providing people with more “choice”
16
http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/cvs-caremark/what-retail-clinic-growth-can-teach-physicians-about-pat
Health Plan Engagement App Demo
https://www.youtube.com/watch?v=brtucoXRbTA
Consumer “Shop & Buy” activities
17
Successful healthcare organizations thrive by using analytics
as a core strategic foundation
Early and accurate insights on member
health risk and utilization to inform Financial / Actuarial decisions
Patient-360 insights to inform Medical Management in
chronic disease & episode
management
Insights into referral patterns and
provider quality to support Network
Design and Management
Inform program design & operations for Marketing &
Sales and Customer Service with insights on consumer preferences &
triggers
PopulationHealth
Risk Management
ConsumerEngagement
ProviderRelations
Su
pp
ort
B
usin
ess
Fu
nc
tio
ns
Imp
ac
t C
on
tin
uu
m o
f C
are
Sample Analytics Applications
Facilitate insights exchange &
messaging across care team members. Inform
incentives design.
Enabling analytics to empower ACOs and
providers to succeed in value-based payment transformation
Next best action analytics leveraging
near real-time data to optimize omni-
channel consumer engagement
Provide tools to providers to enhance risk
stratification andclinical decision
making
Care Path Mining
Network Optimization
Personality Insights
Consumer Segmentation
RiskStratification
Utilization Prediction
Cost Patten Detection
Channel Optimization
Resource Allocation
18
What are the treatment
options based on the
latest literature for my
patient’s clinical
profile?
Why is this the best
option?
Basic
Reporting
What
happened?
When and
where?
How much?
Foundational
Analytics
Who is at risk? What is happening? How can we improve? What is the Right
Data? What actions to take?
Enterprise –Wide Data InsightsRetrospective
Reporting
Proactive Interventions
Data Governance
Centralize Data
Structured and
Unstructured
Data Sharing
Cost of Care Intelligence
High latency
reporting
Spreadsheets
Limited view reports
Dept data marts
Population Health
Analytics
Evidence-based
medicine
Streaming Analytics
Similarity Analytics
Natural language
understanding
Guided consumer
experience
Watson Applications
Clinical Content Analysis
Personalized Healthcare
Dynamic Learning for Optimal Care Guidance
Predictive &
Prescriptive
What could happen? How can we pre-empt? What is the likely outcome?
Who would be best at
managing this patient?
What is the anticipated
response to potential
medications?
Cognitive The Healthcare Analytics Journey
19
Analytics strategy must span both knowledge & data-driven methods
20
Trusted Information Platform
Predictive
Dashboards
Natural Language
Cognitive Computing
‘Big Data’ Volume, Velocity, Variety…
Patient Similarity
Healthcare Analytics Progression
21
Watson is ushering in a new era of computing
1900 1950 2011
22
Cognitive Systems Era
Discover and Decide
Interact Naturally
Learn and Reason
23
Questions?
24
Contact Info:
Judy Murphymurphyja@us.ibm.com
@JudyMurphyHIT
Thank You!
25
THANK YOU!The recording and handouts will be sent to you via email within 2 business days
Questions? Contact Shawn Auer at sauer@us.ibm.com
Join us for our next IBM Watson Health webinar!
Quality Incentive Programs: Huntsville Hospital's Experience
Hosted by: Amy Yearwood, Quality Manager for the Physician's Network at Huntsville Hospital
Wednesday, September 14, 2016 | 12:00 - 1:00pm ET
Register here> http://watsonhealth.ibm.com/QualityIncentivePrograms-Sept14-Webinar.html
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