Published on December 19, 2007
Steve Brown, CEO Health Hero Network October 16, 2003 © Health Hero Network
Health Hero Network Inc. q 5 years of experience in implementing chronic care improvement programs in 50 medical centers and 2 languages q Patient education and management content for 15 of the most expensive and prevalent chronic diseases q Secure, robust systems and monitoring technologies adaptable to each client’s best practices and medical knowledge q Fundamental chronic care and remote monitoring patents dating back to 1992
Networks for Patient Centered Care in Chronic Disease 3. Why this is important 4. How to do it 5. Success stories and results 6. Why it is good business today 7. Incremental policy changes to inspire adoption
2001 U.S. Hospital Stays By Condition Condition Discharges Expenditure • Congestive heart failure 1,049,818 $17.6 Billion • Chronic obstructive pulmonary disease 603,352 $8.2 Billion • Diabetes mellitus with complications 461,161 $7.2 Billion • Hypertension with complications 244,320 $4.6 Billion • Asthma 389,530 $3.3 Billion Source: Healthcare Cost and Utilization Project, US Agency for Healthcare Research and Quality
2001 California hospital costs for ambulatory care sensitive chronic diseases ($) Commercia Uninsure Medicare Medicaid l d Other Total Congestive Heart Failure 2,337,745,702 1,617,662,367 317,364,720 317,125,495 31,921,050 53,672,070 Chronic obstructive pulmonary disease 1,164,626,294 796,343,340 175,002,632 152,248,368 14,498,748 26,533,206 Diabetes with complications 1,126,010,626 529,606,510 249,102,139 238,704,453 40,560,566 68,036,958 Hypertension with complications 826,010,222 512,530,192 159,665,770 116,031,548 12,953,115 24,829,597 Asthma 495,632,558 141,085,020 160,507,413 149,895,954 16,945,280 27,198,891 200,270,72 Total 3,597,227,429 1,061,642,674 974,005,818 116,878,759 2 ,950,025,402 Source: Healthcare Cost and Utilization Project, US Agency for Healthcare Research and Quality
Why the current model must change: the age wave is a tidal wave 73% 80% U.S.2000-2020 70% Source: U.S. Census, 2000; Age Wave, 2003 60% 54% 50% 40% 30% 20% 10% 8% 7% 7% 3% 0% -10% -20% -10% Under 14 15-24 25-34 35-44 45-54 55-64 65+
How to do it #1 Focus your attention on chronic patients at risk of being hospitalized • Diagnosis of congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension, asthma • Hospitalized in the past 12 months for a complication related to their chronic illness • Over $25,000 in claims in the past 12 months
How to do it #2 Change your behavior so your high risk patients can change theirs q Provide chronic patients with a support network that includes a care coordinator break the cycle of isolation and crisis q Guide patients in daily health self-assessment while collecting timely, relevant, actionable data before the next crisis starts q Use a systems approach to embed your best knowledge into decision support tools continuously improve quality
Networks for Patient Centered Care enabled by eHealth Technologies
Guided Self-Assessment: the key to patient self-improvement
Additional Data Collection Options Health Buddy® Personal Telehealth Appliance Blood Blood Peak Coagulation Digital Glucose Pressure Flow Meters* Weight Monitors Monitors* Meters* Scale
Informed Caregivers: Decision Support Systems iCare Desktop™ Risk Stratified View of Daily Patient Status
Informed Caregivers: Detailed Results Detailed View of Patient Results
Informed Caregivers: Trend Reports View of Key Clinical Indicators Over Time, and Many Other Reports
Veterans Administration Demonstration • Veterans Health Administration Community Care Coordination Office, Florida • Telemedicine-based care coordination demonstration project • 791 chronically ill veterans enrolled for 1 year, compared to comparison group data
VA – Patient Selection • “High Cost (>$25,000) and High Use” patients • High Use is defined as: • Two or more hospital admissions or • Frequent emergency room visits and/or walk in visits or • 10 or more prescriptions • Most common diagnoses: Congestive Heart Failure, COPD, Diabetes, Hypertension
Veterans Administration Clinical Outcomes • 40% reduction in emergency room visits • 63% reduction in hospital admissions • 60% reduction in hospital bed days of care • 64% reduction in nursing home admissions • 88% reduction in nursing home bed days of care • Significant improvement in Quality of Life (SF36V) Published in: Disease Management, Volume 5, Number 2, 2002
VA - Patient Satisfaction • 96% of the population said “Yes” to the following questions: • Do you think the Health Buddy technology has helped you stay healthy? • Has having staff monitor you make you feel more comfortable? • Would you recommend this project to other Veterans? • Questions aggregated over multiple locations and disease states
VA - Provider Satisfaction • 90% of providers reported that communication between themselves and the care coordinators was timely and appropriate • 92% of providers believed the program was beneficial to their patients • 95% of providers would refer patients to the program Published in: Telemedicine Journal and e-Health, Volume 9, Number 2, 2003
VA – Project Growth • Currently over 1000 patients using the technology platform in Florida alone • VISN 8 renewed program for addition 3 years • Program has been expanded to the Midwest (VISN 19), West (VISN 21), Great Lakes (VISN 10) and upstate New York (VISN 2), with several other sites joining in next sixty days • National VA Office for Care Coordination established in Washington, D.C.
Chronic Care is Good Business Today q Treat chronic patients in an outpatient setting, freeing hospital beds for higher DRG patients q Informed caregivers can be more effective with their time and focus on the right patients at the right time q Reduce liabilities: failure to monitor known high risk patients is starting to be viewed as a patient safety issue q Increase revenues: Chronic care improvement programs are starting to be paid for by public health agencies and insurance q Provide higher quality care in your community
Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time
Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission
Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission #1 Extend existing DRG to 60 or 90 days
Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission #1 Extend existing DRG to 60 or 90 days #2 Offer monthly care coordination fee
Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission #1 Extend existing DRG to 60 or 90 days #2 Offer monthly care coordination fee #3 Redefine patient safety issues and medical errors to include preventable complications in unmonitored high risk patients
Why are all we here today? • We are dedicated to transforming our healthcare systems for the better while facing one of the greatest challenges of our century • We know that the current crisis driven models of care are no longer sustainable and must change to models that offer continuity of care and prevention • We believe eHealth Networks and Technologies are a key enabler of the modernization of this vital public service
Empowering eHealth Patients and Innovations Caregivers
Contact Information Steve Brown, CEO Health Hero Network, Inc. 2570 West El Camino Real, Suite 111 Mountain View, CA 94040 Direct: 650-559-1001 Email: email@example.com Web: www.healthhero.com
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