Developing A Virtual Health

Strategy

Allison Heddon Manager, Center for Clinical

Technology, Sg2

2 Confidential and Proprietary © 2015 Sg2

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Sg2, a MedAssets company, is the health care industry’s premier provider

of market data and information.

Our analytics and expertise help hospitals, health systems, and leading suppliers

understand market dynamics and capitalize on opportunities for growth.

Industry-Leading

Consulting

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Meet Sg2

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Sg2 Defines Virtual Health Very Broadly

Virtual Health Connected care services—including clinician-to-

clinician, provider-to-patient and consumer-driven

interactions— across a spectrum of electronically

enabled consultative, direct patient care, educational

and self-management services; encompasses a

range of different terminologies, including

telemedicine, telehealth, e-health and mobile health

4 Confidential and Proprietary © 2015 Sg2

Breadth of Virtual Health Drives New Value

Opportunities

Virtual consults

Urgent care

Specialty care

Mobile apps

Social media

Geo-tagged devices

Patient web portals

Online support groups

Remote monitoring

Virtual medication

management

Telehealth kiosks

Personal activity

monitors

Patient

scheduling apps

Quality and price

transparency tools

eICU

eED

Prin

ted w

ith p

erm

issio

n

of

Phili

ps H

ealthcare

.

Tele-“specialty”

Virtual conferencing

Clinician to Clinician Provider to Patient Consumer Driven

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The Complex Consumer

Needs include:

Timely assessment

and response

Access to right specialists

Close monitoring

Multidisciplinary support

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Remote Specialist Consults Reduce

Disparities, Expand Reach

MEDICAL UNIVERSITY OF SOUTH CAROLINA

CHARLESTON, SC

Source: Sg2 Interview With Medical University of South Carolina, February 2015.

Reduce

patient time

spent

traveling for

follow-up per site for

computer and

software license

$1,000

to $1,500 virtual consults

360 Saved

53,000 miles of travel

(142 miles per

patient)

Each patient

saves about

2.8 hours

per visit.

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The Chronic Consumer

Needs include:

Coordination across

physicians

Help with multiple

conditions

Support outside traditional

health care settings

Information the patient can

act on to change behavior

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Remote Monitoring Drives

Down Readmissions

LEE MEMORIAL HEALTH SYSTEM, FLORIDA

CHF = congestive heart failure. Source: Sg2 Interview With Lee Memorial Health System, 2014.

$9.1M saved in FY 2013

Program cost

in FY 2013

$388K Readmission rates

for telehealth

patients cut in half

(now 9%–12%)

Control

readmission rates

for patients who

have CHF

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Look Beyond Chronic Patients to

Connect With Their Environment

Smart Home Technologies: Care Innovations™ QuietCare®

Source: CareInnovations. Intel-GE Care Innovations QuietCare Smart Monitoring for Senior Living Communities [video]. YouTube; 2013.

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The Occasional

Consumer

Needs include:

Convenience

Clear, quick information

Systems that know them,

their family, their data

Guidance for relatively

simple conditions

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Virtual Visits Cut Costs, Improve Access to Care

for Low-Acuity Conditions

Source: Yamamoto D. Assessment of the feasibility and cost of replacing in-person care with acute care telehealth services.

Alliance for Connected Care. December 2014.

$136 to $176 Average cost for

in-person consult

1.3 Average number of virtual

health visits/patient/year

PATIENT ISSUES

RESOLVED

DURING INITIAL

VIRTUAL CONSULT

$35 to $50 Average cost of

virtual consult

83% of the time

MOST COMMON

DIAGNOSES FROM

VIRTUAL CONSULT

Sinusitis

Cold/flu/pertussis

Urinary tract infections

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Virtual Urgent Care Improves Patient

Convenience, Grows Primary Care Services

FRANCISCAN HEALTH SYSTEM, TACOMA, WA

Sources: Sg2 Interview With Franciscan Health System, 2013; Sg2 Webinar: Developing Your Virtual Health Strategy,

featuring Franciscan Health System. March 12, 2014 .

Partnered with

telehealth

solutions company

Sequenced

rollout to track

impact, get

internal buy-in

Expand reach

with lower

infrastructure costs

$ Offered 20- to

30-minute

consult for

$35

13 Confidential and Proprietary © 2015 Sg2

Virtual Visits Propel Patients

Toward Consumerism

FRANCISCAN HEALTH SYSTEM, TACOMA, WA

58% would have gone

to an urgent

care center.

21% would have

visited their

PCP.

10% would have

done

nothing.

11% of patients

would have

gone to the ED.

If not for this service…

75%

2,000+ Patients

Served

50,000 Landing Page

Visits

New Patients Who Schedule

a Follow-up Appointment

After a Virtual Consult

Patients Previously

Without a PCP

45%

PCP = primary care physician. Sources: Sg2 Interview With Franciscan Health System, 2013; Sg2 Webinar: Developing Your Virtual Health

Strategy, featuring Franciscan Health System. March 12, 2014.

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Dedicated Virtual Health Departments Are a

Must for Maturing Programs

VIRTUAL HEALTH CENTER, AMC, EAST COAST

20 years of experience,

134 partner sites,

45+ medical specialties

Comprehensive program

with 28 fairly active clinics

AMC = academic medical center; CITO = chief information technology officer; FTE = full-time equivalent. Sources: Sg2 Interview, February 2015; Sg2 Analysis, 2015.

Outcomes

Will have >10,000 encounters

this year

50,000+ encounters to date

Saved 15.7 million miles of

travel

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ORGANIZATIONAL STRATEGY AND INTEGRATION 1. Telehealth Steering Committee

OPERATING UNITS AND DEPARTMENTS

2. Implementation Committee

3. Local Program Teams

TELEHEALTH DIRECTOR (plus program managers and IT)

IT

Marketing

Reimbursement

Legal

Credentialing

Medical Staff

System-Level and Local Teams Interact to

Support Strategy and Operations

Source: Sg2 Interview, February 2015.

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Track Program-Specific Clinical and Process Metrics

Remote Monitoring

Clinical outcomes

Readmission rates

ED and inpatient utilization

In-person home visits

Telespeciality

Response time for consults

Clinical outcomes

Patient throughput

Transfers avoided

Cost per consult

eICU

Length of stay (hospital and ICU)

Mortality (hospital and ICU)

Adherence rates to established

ICU protocols

Patient throughput

Transfers avoided

Virtual Urgent Care

Patient survey data

ED avoidance rates

Time from intake to clinical

assessment

Unique patient counts

Number of new virtual patients

converted to in-person visits or

established relationships with PCPs

17 Confidential and Proprietary © 2015 Sg2

Words of Wisdom From Your Colleagues

Across the Country

“The biggest barrier is we don’t get paid to do the right thing for

the patients—keep them out of the hospital.” —Director, Pediatric Telemedicine Program, AMC, West Coast

“You have to find the right leader, wherever that leader resides,

or the program will never get off the ground.”

—Strategy Market Executive, Health System, East Coast

“It’s not about the technology; it’s about how people

view the world.” —Vice President, Telemedicine, AMC, Midwest

“However long you think it will take to implement the program,

multiply that by 2.” —Department of Surgery, Principal Investigator, Teleconsult Clinic, AMC, East Coast

AMC = academic medical center. Source: Sg2 Interviews, January–March 2015.

18 Confidential and Proprietary © 2015 Sg2

Action Items: Building Your Virtual Health Strategy

Define the value proposition.

Understand current revenue and reimbursement realities.

Broaden view of value.

Assess potential virtual health solutions. Consider the continuum of virtual health technologies.

Target pain points. Prioritize based on recognized gaps.

Put essential infrastructure in place.

Optimize staffing structure and infrastructure needs.

Choose the right platform.

Deploy toward long-term sustainability. Pilot, measure, scale.

Sg2 is the health care industry’s premier provider of market

data and information. Our analytics and expertise help

hospitals and health systems understand market dynamics

and capitalize on opportunities for growth.

Sg2.com 847.779.5300