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Anatomy of a Health System:
St. Joseph Health and The Innovation Institute
Darrin Montalvo
Bill Russell
Larry Stofko
November 7, 2013
St. Joseph Health
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Indicator SJH
Net Revenue $5.3 Billion
FTEs 25,000
Acute
Discharges
165,000
Acute
Hospitals
14
Integrated
Medical
Groups
Nine – 550+
Physicians
Distinct
Communities
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MISSION To extend the healing ministry of Jesus in the tradition of the Sisters of St. Joseph of Orange by
continually improving the health and quality of life of people in the communities we serve.
• We will transition our business model to a balance of great hospitals and great community care.
• We will embrace both an illness and a wellness model.
VISION We bring people together to provide compassionate care, promote health improvement
and create healthy communities
VALUES
Dignity We respect each person as an inherently valuable member of the
human community and as a unique expression of life.
Service We bring people together who recognize that every interaction is a
unique opportunity to serve one another, the community, and
society.
Excellence We foster personal and professional development, accountability,
innovation, teamwork and commitment to quality.
Justice We advocate for systems and structures that are attuned to the
needs of the vulnerable and disadvantaged and that promote a
sense of community among all persons.
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Population Health
Management
SJH Vision of U.S. Health Care
• Because health care provides a foundation for human dignity to flourish, everyone has a right to basic health care
• As part of the common good, health care must take its limited place among other basic goods that protect dignity – education, stable economy, environment, jobs, etc.
• Individuals have a duty to promote and protect their health; society has a duty to provide a sustainable health care system
• We aspire to a health care system that: – Is health-promoting and preventive – Is transparent and accountable in its inevitable
rationing decisions – Is a genuine system, integrated and coordinated
across our national community – Allocates its resources across a balanced
continuum of care – prevention, acute, emergency, end-of-life, mental, long-term care, etc.
– Dedicates health resources to acute care, minimizing spending on administration
– Is evidence-based
– Is financed according to ability to pay – Keeps inflation at a level that is sustainable
• We commit ourselves, with our communities, to make this vision of human dignity a reality
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Planning for the Future
While the Mission, Vision and Values are the foundation for SJH’s strategic planning as well as a guide for all decisions, in 2006, SJH recognized the need to transform our
organization.
• We will transition our business model to a balance of great hospitals and great community care
• We will embrace both an illness and a wellness model
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TRANSFORMATIONAL STATEMENTS
To align efforts across the organization and measure our success in carrying out our Mission and
achieving our transformation, SJH also introduced three long-term goals in 2006 called
Mission Outcomes.
Sacred Encounters Every experience will be experienced as a sacred encounter
Perfect Care All patients will receive perfect care
Healthiest Communities The communities we serve will be among the healthiest in our nation
MISSION OUTCOMES
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Fee-for-service:
Current
Care delivery
Care coordination
Care tracking
Patient engagement
Population health:
Future
Patient engagement
Care tracking
Care coordination
Care delivery
Confidential 6
We are in a Transition
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Transformation 2018
FY2014-2018 Dimensions of Performance
VISION We bring people together to provide compassionate care, promote health
improvement and create healthy communities.
VALUES Dignity Service
Excellence Justice
MISSION OUTCOMES Sacred Encounters
Perfect Care Healthiest Communities
MISSION To extend the healing ministry of
Jesus in the tradition of the Sisters of St. Joseph of Orange
by continually improving the health and quality of life of people
in the communities we serve.
What are we Designing to Meet Our Mission &
Accomplish our Vision of U.S. Health Care?
To:
• Integrated delivery system
• Sickness and wellness
• Improving the health of the communities we serve
• Reducing Cost of Care
• Improving the Care Experience
From:
• Fragmented,
Siloed Care
• Sickness
• Patients
• Cost vs. Quality
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FY2014-2018 Strategic Goals
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Dimension of
Performance FY2014-2018 Strategic Goal
Population Health
Management
We embrace population health management and take accountability for our
communities’ health and healing, while promoting wellness and caring for each individual’s
needs.
Physician
Partnership
Our physician relationships are mutually-beneficial partnerships, founded on shared
Mission and Values, as well as aligned goals and incentives, in the management and
promotion of quality health services.
Network of Care By partnering with others, we provide an integrated, accessible and comprehensive
network of care that benefits the health and well being of those we serve in our regions.
Value We excel in quality/safety, efficiency and the patient experience, demonstrating what
can be achieved when we focus on stewarding our communities’ health resources.
Engaged People The community of St. Joseph Health co-ministers are highly engaged and thriving,
integrated with Mission, Values and expectations in the delivery of quality health services.
Information
Sophistication
We apply technology to empower the communities we serve to manage their health and
wellness and SJH to deliver the highest efficiency, reliability and value.
Essentiality St. Joseph Health will be an indispensable partner to those who use, provide and
purchase health services. We will use our influence to be a voice for the voiceless in
responding to the needs of our communities.
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• Increase share of communities’ care
• Reduce the prevalence of access difficulties
Increase the primary
care providers
participating in the
management of care
through the health
information exchange
• Increase formation
participation
• Maintain top decile
employee engagement
• Improve quality, safety
and patient experience
• Year over year reduction
in the cost of providing
services
• Provider adoption of physician
portal
• Member/patient adoption of
electronic health record / health
portal
Each region has seamless
partnerships in place for an
integrated, accessible and
comprehensive network
• Improve the health status
of a defined population
• Grow the number of
members in the SJH
network
FY2014-2018 Measures of Success
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What happens when…
…we can know, quite precisely what people are
eating?
Tellspec is a laser scanner that reads chemical composition of food.
…we can remotely administer therapies?
MIT Thermoelectric Band that raises perceived body temperature remotely.
…apps and devices band together to create
solutions?
My Fitness
Pal
Runtastic products integrate with MyFitnesPal, as do dozens of other apps and
devices.
…mHealth meets the Smart Home?
So what happens?
We don’t know.
We can’t know.
Here’s what we do know.
How fast I move
My altitude
My friends
My insurer
How I exercise
My blood oxygen
My insulin levels
How my blood flows
How much I weigh
Where I live
Where I travel
Anything I’ll share
What I eat
Where I go
How I move
How I sleep
What I eliminate
How my heart beats
My body
temperature
My skin
temperature
How I feel, emotionally
How I feel,
physically
How stressed I am
How busy I am
Here’s what we do know.
Data quality
Cultural acceptance
Integration hassle
Effort required
Wearability
Cost/functionality
time
=
Moore’s Law Metcalfe’s Law
+
It’s not in our control.
So we have to be great at listening for, looking
at, learning from and linking to the innovation of
others.
And we need a system to organize what we learn.
A Platform for Innovation
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SJH Portal Principles for Innovation
© 2013 The Innovation Institute
Anatomy of a Health System –
St. Joseph Health & The Innovation Institute
Larry Stofko
EVP, Innovation Lab
November 7, 2013
iHT2 Health IT Summit
Innovation Institute’s Goals
The Institute was conceived with two overarching goals: Growth and Innovation Potential
• Growth – New Revenue Streams
– Growth through Building Networks of Partnership with Non-Profit Healthcare and Other Innovators
– “Do More, with Less, for More People”
• Innovation Potential – Advance Innovation Design
– Transform the Traditional Healthcare Model
– Harness Synergies with Industry Participants
– Unleash the Creativity of Investor’s Employees, Physicians and Partners
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Business Model
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Innovation Lab
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Innovation Lab
• Collector of Ideas
• Idea Developer
• Technology Accelerator
• Showcase Destination
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Participation Opportunities
Challenges
Individual
Partner Originates
Idea
Specific Inventor
Ideas
Participate with
Partners
Team
Disclosure
Evaluation
Monetization
Provider Originates
Idea
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Enterprise Development Group
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EDG Value Proposition
Guaranteed cost savings
Conversion of cost center to revenue center
Profit sharing interests and capital appreciation
Faster decision-making process and execution
Capital funding source for new projects
Capitalize as investment vs. expense line item
Access to debt capital as for-profit company
Ability to share “Best Practices”
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3
2
1
8
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Innovation Fund
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Investment Lifecycle
SEED EARLY MID/
EXPANSION
LATE/
MEZZANINE EXIT
Angel
Venture
Fund
Debt Investments
Mezzanine
TIME
Breakeven Point
Lab
RE
VE
NU
ES
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The Spread of Innovation
Culture
Collaboration
Individual
Community
Recognize and reward the individual.
Create a “culture of innovation” for members.
Have broad reaching impact on communities.
Collaborate with like minded
organizations.
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Questions
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