Becker's Hospital Review

Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 Disruptive Innovation in Healthcare: Examples From 3 Top Health Systems (continued from page 1) leader in the area of innovation. Disruptive innovation transforms an existing market or creates a new market by making processes simpler and improving access. Englewood, Colo.-based Catholic Health Initiatives, Salt Lake City-based Intermountain Healthcare and Appleton, Wis.-based ThedaCare have all employed disruptive innovation to improve quality and lower costs in the new healthcare environment. Here, leaders from each organization share some examples of how the system has created radically new models to disrupt unsustainable practices. Catholic Health Initiatives Healthcare delivery infrastructure CHI has created a new infrastructure for the delivery of healthcare that shifts the central focus from the acute-care hospital to outpatient facilities and the home. "The healthcare delivery infrastructure is being replaced, at least conceptually, by new structures that revolve around physicians and other primary care service providers having more direct responsibility for patient care," says Juan Serrano, senior vice president of payer strategy and operations at CHI. CHI has expanded its relationships with physicians and has acquired other ambulatory organizations, including a home care services organization, to offer more outpatient care. Focusing on outpatient care and care closer to home signals a shift from only treating sick patients to preventing sickness and maintaining people's health in addition to treating sick patients. "We're organizing our physicians, hospitals and ambulatory healthcare delivery network providers into a more rational system. We're not waiting for people to become patients to serve them; we're establishing more robust relationships in our communities to help people achieve and maintain their care while ensuring that essential medical care is delivered in the most appropriate settings — even when that means arranging for care outside our hospitals and specialist services," Mr. Serrano says. One of the keys to this new infrastructure is access to more data on patients that allows providers to manage population health. For example, CHI can access data on what services patients have accessed across the system, from their primary care physician to the emergency department to specific service lines. Consumer orientation Another disruptive innovation at CHI is an orientation toward patients as consumers and a greater connection between the system and community. "We are moving into a customer relationship management phase, investing time and energy resources in connecting with our patients and with consumers who are part of either employer groups or other defined populations that subscribe to our health system," Mr. Serrano says. "As we identify people who are affiliated with the health system, we are [forming] connections intended to help address barriers to care." For instance, CHI may help patients arrange transportation to a medical appointment or help navigate financial assistance programs to pay for medications. Intermountain Healthcare In June, Intermountain Healthcare received a $9.7-million, three-year contract from CMS through its Health Care Innovation Awards for a project titled "Disruptive Innovation @ Intermountain Healthcare." "Through the shared accountability initiative, [the goal is] to really accelerate the transformation of healthcare," says Lucy Savitz, PhD, director of research and education of Intermountain Healthcare's Institute for Health Care Delivery Research. Intermountain's project focuses on three areas: physician compensation modeling, patient activation and population management. While the health system has not developed a definitive reimbursement model for physicians, it will incorporate incentives for quality and service and will move away from a strictly fee-for-service system. Patient activation The patient activation part of the project focuses on engaging patients in their healthcare decisions. Intermountain will use a tool called Archimedes Indigo to give providers and patients access to patients' individual health information at the point of care. The tool will help patients visualize their condition and treatment options and will encourage their involvement in their own care. 9 For example, for a patient with diabetes, the tool would use the patient's data to estimate the likelihood of developing other health complications and the effectiveness of different interventions in preventing these complications. The tool may show that quitting smoking may reduce the patient's risk of death by a certain percent, and taking fish oil may reduce the risk by a different percent, Dr. Savitz says. "It helps the patient understand what the patient's role is in shared accountability in a way that's not just general statistics; it looks at what is your risk based on your data," she says. "It makes it more real, and the information more accessible. It helps take the dialogue in joint treatment planning between the physician and the patient to another level." Population health management/ Hot spotting Another focus area of Intermountain Healthcare's innovation project is population health management and "hot spotting" — identifying health trends in the community and implementing solutions to improve health. For instance, Intermountain identified a geographical area that included a senior center that had a large number of people go to the emergency department. To reduce the number of potential unnecessary ED visits, Intermountain plans to staff an advanced practice nurse at certain hours at the center to provide easy access to care. "It's really thinking about healthcare differently," Dr. Savitz says. "We're not just thinking about healthcare; we're thinking about wellness. We're not just thinking about patients; we're thinking about people." As with CHI, increased access to data is one of One case of Legionnaires' disease can threaten your bottom line. Protect Patients and guard against costly emergency clean-uP and legal liability. 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