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The Institute For Innovation In Health uclaInnovates.org
It’s A New Game Now –
Molly Joel Coye, MD, MPH
Chief Innovation Officer
UCLA Health System
iHT2
November 2013
The Institute For Innovation In Health uclaInnovates.org
How did CBS fail to see opportunities CNN saw?
Why didn’t IBM create the PC operating system?
Why didn’t AT&T invent AOL?
How did GM miss the minivan?
How did Sotheby’s get upstaged by eBay?
Why didn’t Borders Books produce amazon.com?
It takes effort to stand in the future and see new possibilities
Courtesy: The Doblin Group
Why Innovate?
The Institute For Innovation In Health uclaInnovates.org
Innovation in large organizations = oxymoron?
The Institute For Innovation In Health uclaInnovates.org
In healthcare, we’ve innovated new technologies and products –
While innovation in service and business models has lagged.
The Institute For Innovation In Health uclaInnovates.org
Innovation can accelerate change in ways recognizable to us
The Institute For Innovation In Health uclaInnovates.org
And innovation can adopt and scale entirely new models of care
The Institute For Innovation In Health uclaInnovates.org
Core Challenges
• Serve larger populations with less resources– Risk-based population health management– Tertiary-quaternary excellence
• Get over the need to invent everything. We assume that the vast majority of innovations we deploy will have been invented elsewhere.
• Measure our success by the rate at which we identify, pilot and deploy innovations that “move the needle”
12
The Institute For Innovation In Health uclaInnovates.org
• UC-CARE• Cigna• HealthNet• Aetna• Anthem• United• SCAN• Evolent• Others
Growth Strategy - Evolution of the UCLA Health System
• Practice Re-Design• Increase Covered
Lives• Expansion• Collaborations• Replication
Secondary Strategy and Affiliations
Tertiary and Quaternary Strategy &
Relationships
Insurance Partners
Primary Care Innovation
Model
Affiliations and
Partnerships*
• Physicians, medical groups
• Hospitals, health systems
• Insurance• ACO/MSSP
relationships• “Virtual Medical
Foundation”
• Define aligned inpatient/ancillary capacity
• Physician services at off-site practices
• Seamless links/ expedited access
• Bilateral quality, service, IT, price commitments
• Value proposition to health systems, medical groups
• Referral and transfer support• Single call access• Telemedicine linkages• Bundling + pricing alignment• Bilateral quality, service, IT,
price commitments
Growth Strategy Phase II- September 2012 – March 2013UCLA Strategic Response Includes Innovation
The Institute For Innovation In Health uclaInnovates.org
The UCLA Innovation Life Cycle
• Use the organization’s goals and strategies as your lodestone
• Find your target opportunity = define the impact you want
• Identify and design innovations to achieve this
– Strategy-driven innovations
– (Beg, borrow and steal shamelessly)
– Partner: other health systems, health plans, investors and developers
• CHARTER the innovations
Define Design Charter Pilot Scale Evaluate Exchange
Innovation Life Cycle
The Institute For Innovation In Health uclaInnovates.org
The most important innovation has been the process!
Planning Phase Design Phase Implementation Phase Operations Phase
Define Design Charter
• Advanced Primary Care Medical Home + population health management• Five clinics in six months: 33,000 patients• Rapid replication through 24 more clinics to reach 200,000 patients• Platform for continuous introduction, design, testing and deployment
The Institute For Innovation In Health uclaInnovates.org
Results + Physician Enthusiasm
UCLA Primary Care Innovation Model:
Initial results at 6 months, 1000 patients:•Hospital admissions 19%•Emergency Department admissions 29%
•Care coordinators in each clinic: non-clinically licensed •Behavioral health associates •Clinical pharmacists•92% physician satisfaction and enthusiasm for PCIM new model of care•Next phase: In-Home Palliative Care
The Institute For Innovation In Health uclaInnovates.org
Patient voice : BPH experience
Patient Interviews
The Institute For Innovation In Health uclaInnovates.org
•Scanning for innovations that achieve net savings of 2% or more in total healthcare expenditures
•Convening innovators to share learnings, producing “deep-dives” to accelerate adoption
•Welcoming nominations of high value innovations in December 2013 at www.uclainnovates.org
Frugal Innovation for Sustainable Healthcare
The Institute For Innovation In Health uclaInnovates.org
Seventy-five percent of Americans nearing retirement age in 2010 had less than $30,000 in their retirement accounts
More than a third of households have no retirement coverage during their work lives
Almost half of middle-class workers – 49% - will be poor or near poor in retirement, living on a food budget of about $5 a day
Center for Retirement Research Boston College, 2013
The Institute For Innovation In Health uclaInnovates.org
“Patient engagement is the blockbuster drug of the 21st century.”
Dave Chase’s Forbes blog