Innovating in Health - The Austin Opportunity

Maninder Kahlon, PhD (Mini)

Vice Dean for Strategy & Partnerships

.A once-in-a-lifetime opportunity

Put health front & center

Context: A “Regular” Medical School

• Care

• Research

• Education

Context: US Healthcare & Health

Why are we paying so much?

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. IOM, Sept 2012

But who will pay for a better

system?

Payer, Provider, Consumer - Disconnect

Complex & Hard to Change

Jonathan Cohn, New Republic, with help from Kaiser Family Foundation

Context: US Healthcare & Health

Cost of a lower

back MRI

Cost of a

lipid panel

So how do we fix it?

Do we have to wait on national

policy and legislation?

What if

We could create a miniature health

ecosystem more amenable to redesign?

What if

A vibrant growing city invests in change.

Innovators are drawn to the region.

Stakeholders choose to be more flexible.

The Austin Opportunity

We envision … a vital, inclusive health ecosystem

Vital. Vigorous, animated, full of life and energy, dynamic.

Inclusive. Open to everyone

Ecosystem. The complex of a community and its environment

functioning as a system.

So how do we transform our

health system?

Do we have to wait on national policy

and legislation?

What if

A vibrant growing city invests in change.

Innovators are drawn to the region.

Stakeholders choose to be more flexible.

Could we create a miniature health

ecosystem more amenable to redesign?

Austin as Population Health Platform

Strategy: PEOPLE

1. Draw leaders self-selecting for care redesign/population

health mission.

2. Recruit expertise not traditionally in medical school but

necessary for mission (population health, health

economics, design, etc)

Strategy: CARE

3. Design & demonstrate value-enhancing health

projects.

4. Address business model upfront – bring the payer in

5. Engage the broader community in care redesign

• Hospital partner/s

• Broader community of practitioners

Strategy: PRODUCTS

6. Use care redesign settings to inspire and validate new

technologies

7. Redefine models of academic/private partnership to

accelerate product development.

1. Draw leaders self-selecting for mission.

2. Recruit expertise needed for novel mission

• Population Health

• Employer Health

• Health Economics & Biomedical innovation policy

• Design Institute for Health

• …

3. Design & demonstrate value-enhancing health projects

• Reducing need for knee and hip replacement

• Predicting and managing risk for second pregnancy

• Managing long-term chronic illness in children

• …

4. Address business model upfront – bring payer in

• Establishing a shared risk approach for private partner

(Seton) with public partner (Central Health) to rationally

begin allocating $ to value-focused projects.

• Partnerships with Insurers – statewide, on pregnancy

outcomes with Superior Health (80% of Medicaid in Tx)

• Self-insured employer partners – School district, UT

System, other companies (Dell?) etc.

5. Engage the broader community in care redesign

Eg. Hospital Partner

Practitioners – Physicians, Nurses, Pharmacists, etc

Decision-makers: CMO/CFO

Caring Wisely results

• 143 project ideas generated in the first round.

• Three projects selected: total cost $225K.– IV to PO Switch – Pharmacist leader.

– “Nebs No More After 24” – Physician leader.

– Reduction of RBC Transfusions – Nurse Leader.

• Total savings in first year $4 M.

Achieved:

• Value-oriented clinical projects aligned with

hospital goals.

• Culture change!

Eg. University students/UT Campus

Model Healthy Campus

Improve signage for stairs!Provide healthier vending machine options!

Removing tanning booth option from Bevo Bucks…

Eg. Broader community of practitioners

Anyone proposes value-oriented care redesign project

< Who saves?

< Does society save?

< Can we measure?

< Can it be scaled?

< Evidence?

Payer pays for innovation

Payer decides

• 6. Use care redesign settings to inspire and validate new technologies

7. Redefine models of academic/private

partnership to accelerate product

development.

• Anchor to care and health opportunities

• Enable teams developing across traditional boundaries

• Easy plug-and-play for a range of partners depending on

projects

• Defined approaches to sharing in proceeds

Reinvent Care

Improve health; lower

costs

Innovate New Products

Austin: A Health Redesign Platform