Digital Health Futures: Advancing person-centred, tech-powered innovation in community health

Digital Health Futures Advancing person-centred innovation

June, 2019

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Workshop Agenda 1. Introductions • •

Nancy LeFebre, Senior Vice President, Chief Clinical Executive, SE Health Rodney Burns, Chief Information Officer, Alliance for Healthier Communities

2. Case Studies • •

SE Health Alliance for Healthier Communities

3. Discussion • •

Wicked Questions Q&A 4

Disclosure: I have a vested interest in a sustainable healthcare system

I am motivated in my work by my personal interest of my children’s, children’s, children (acknowledgement of Indigenous Grandfather teachings) My professional (and personal) focus is an efficient and effective healthcare system. It is my position that this can only be achieved with meaningful involvement of individuals as a member of their own care team As a person that pays for and uses the healthcare system, I have a myriad of self-serving interests! Be forewarned…

BTW – there is no such thing as e-Health or digital health…

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Vision The best possible health and wellbeing for everyone in Ontario.

Mission We champion transformative change to improve the health and wellbeing of people and communities facing barriers to health.

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Information Management Strategy v2.0

Personal Health Records & Collaboration CIHI Canada Health Infoway (PrescribeIT) Connecting Ontario e-Consult e-Referral e-Notification

1.

2.

3.

4.

“Get Electronic” “Share your Data” “Promote Collaboration” “Improve Health”

BIRT

Mental Health & Wellbeing Outcomes CI Resource & CIW

Quality Improvement

CHC Case Costing Panel Size % Admin

ACCESS

PS Suite EMR/ Meaningful Use

CONNECT

INFORM

PROTECT

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Alliance Consumer Health-’e’ Strategy Guiding Principles 1.

2.

3.

First, the Trust Paradigm 24/7 • Remove time and geography challenges • A part of all stages and transitions in life • More than a medical perspective Quadruple Aim Evaluation • Client Experience • Cost (all perspectives!)

• Value – cost & outcomes • Clinician Experience

4.

5.

6.

7.

Democratization of healthcare • Shifting power differential Four Dynamic Client Archetypes: • Healthy/Motivated* • Healthy/Unmotivated • Unhealthy/Motivated • Unhealthy/Unmotivated Collective Impact Approach Community-based digital capacity building

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Alliance Consumer Health-’e’ Strategy Consumer Digital Healthcare Hierarchy of Needs*

* Based on Maslow’s Hierarchy of Needs

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Information Governance

“Without data,

you’re just another person with an opinion” J. Edwards Deming

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Holistic Approach to Health System Transformation Health & Wellbeing for All Policy Change

Advocacy Knowledge Translation & Communications

Research & Program Evaluation App.s, Business Intelligence, Decision Support

Data, Standards, Operational Excellence

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Digital Healthcare - Considerations • Digital Humanism • The Age of False News and Alternative Facts • Artificial Intelligence, Machine Learning • Privacy & security of Personal Health Information

• Sustainability • Personal affordability

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Wicked Questions for Discussion 1. Can technology enhance person-centred healthcare?

• •

What accommodations are needed for adoption?

What are considered ‘low-hanging fruit’?

“The blockbuster drug of the century [is] an engaged patient” (Kish, 2012)

2. In an era of digital footprints & Big Data, is there such a thing as ‘privacy’?

3. Will ‘Value-Based Healthcare’ policy further digital healthcare?

4. Any other advice/thoughts as we move forward?

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Questions?

Comments?

To request a copy please contact: IMS@allianceON.org 19

Information Governance Model

EMR Vendor relationship management Provincial OMD baseline specifications

Information management strategy

Model of Health & Wellbeing Evaluation Framework & ENCODE FM Performance Management Framework

Data sharing agreements: CHCs authorize Alliance to share data Data partnerships (CIHI, ICES)

Business Intelligence Reporting Tool including an indicator dashboard

Performance reporting for accountability

Executive Leadership Networks Data Management Coordinators Performance Management Committee Regional DS Specialists Information Management Committee Staff Training

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Digital Health Futures Advancing person-centred innovation

110 Years in Health Care 9,000 Employees Nationally 20,000 Homecare Visits/Day Growth through Diversification

Creating the Brighter Future of Health at Home Bringing our knowledge, vision and expertise to how people live and age at Home.

Spreading Hope and Happiness Our people, our culture.

Home Care

Business Focus

Seniors Lifestyle

Family Caregivers

Areas of Impact

Empowering Patients and Caregivers

Mobilizing Communities

Transforming Care Systems

Educating for Excellence

Honouring End of Life Journeys

Inspiring Possibilities

Innovating for 110 Years

Future of Health

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Central paradigm: The system

New paradigm: The Person

Future of Health

$

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Central paradigm: The system

New paradigm: The Person

Future of Health

$

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Central paradigm: The system

New paradigm: The Person

Future of Health Today: System TIMING

Reactive, sick care Proactive, preventative, predictive

PRECISION 1 size fits all, crude, analog

Personalized, intelligent

MODALITY Institution-centred

Digi-cal | decentralized

DURATION Episodic, intermittent, silo’d

Continuous | team

Provider

People-powered

CURRENCY Volume, inputs, costs

Value, outcomes

POWER

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Future: Person

Human Anatomy & Physiology

Hippocrates

500 BC500 AD

5001500

Black Plague

10 Source: Adapted from PWC Health

1628

Smallpox vaccination

Microbes & disease

1796

1870s

1670

Microscopy of cells

1799

Anaesthesia

Antibiotics

1895

X rays

1928

DNA structure Watson & Crick

1948

1953

WHO established

by UN

1st "test tube baby“

Human Genome

1978

2003

1971

Medical Imaging MRI, CAT

1983

HIV virus causes AIDS

2008

Digitization

Healthcare’s Boldest Moves Into the Next Decade DIGITAL HEALTH IS EXPECTED TO GROW TO 380 BILLION DOLLARS INTERNATIONALLY IN THE NEXT 5 YEARS 11

Shift Enablers‌.

Shifter

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Opportunity / Impact Digital Assistants

The future is voice

Hospital in the home

Smart Homes: Connected health

Digital therapeutics

Changing behaviours

Data age

Predictive, personalized, preventative

Data fusion

PHI + EMR + Environment

New relationships

Partnerships

Human / Machine

Shifting: From Internet of Things to Intelligence of Things Early Detection‌ New Care Pathways

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Shifting Knowledge Into The Hands of the Consumer

Changing the conversation: Two Way 14

Shifting from Institutions to Care Anywhere Innovative service delivery models: New Tools

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Shifting: How We Age Enabling independence: Aging in Place

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OUR SWEETSPOT DESIRABILITY

Can we CAPTURE value?

• Solution-market fit?

• Sustainable business model?

• Finance-able?

• SE uniquely positioned to win?

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VIABILITY

Can we CREATE value?

• Problem-solution fit?

• Address users pain points or gain points?

• Can they use it seamlessly?

FEASIBILITY

Can we DELIVER value?

• Operationally feasible?

• Requires new capability, processes?

• Can tech be leveraged?

• Legally feasible?

Innovation Process

Starting with the Product

Starting with the Problem

Frame Intent

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Deep Dive

Generate Concepts

Test

Is this a good problem for SEFutures to tackle?

What are the key Opportunity Spaces?

Do we have concepts(an MVP) that are ready to be tested?

Is our concept ready to be made into a product?

Is this a good opportunity for SE?

How will the product work?

Will the product generate new value for SE?

Are we ready for a pilot?

Are we ready to scale?

Testing, Learning and Designing with Digital Health

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Post-Acute Model of Care: Special Populations PPATH

Putting Patients at the Heart

2 Days

Cardiac Surgery Bundled Care Success

Length of Stay

38% Integrated Care Integrated Coordinators Patient Record (ICCs)

Readmission Rate

Virtual Care & Tele-monitoring

13% Follow-Up Clinic

Virtual Rounds 20

24/7 Phone Line

Overall Costs

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Adapting Dutch Buurtzorg Model to Ontario

H.O.P.E Model for Home and Community Care

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0 2

Self-Directed Teams

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Comprehensive, 24/7, Client/Family Centred Care

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Informal Care & Community Supports

Knowledge Network, Entrepreneurial Innovation, Powered by Simple Processes & Technology

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Seniors Like Steve

$27000

Average after tax income of a

Canadian

<20%

Have 5 years of savings

How might we provide affordable spaces for seniors that optimize personal seniorliving citizen agency and meaning?

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Advancing Person Centred Innovation .

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Determine the starting point

•

Step up Innovation

•

Reimagine programs and models of care – Digital First, Physical Second

BE BOLD 23

The Future is Here!

Nancy Lefebre nancylefebre@sehc.com @nancylefebre

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