Moving Forward: Healthcare Without Walls

The Network for Excellence in Health Innovation (NEHI) and the Kaiser Permanente Center for Total Health sponsored an event on May 10, 2017 “Health Care Without Walls”

Susan Dentzer President and CEO, NEHI said, “In the future, the healthcare system will require a visionary approach needed to draw on current technologies to address healthcare needs and human factors not only in the home, but also in the community and workplace.”

The fact is that the future is going to require implementing new modes of care delivery involving the latest in technology to bring healthcare closer to all consumers but also bring special care to vulnerable populations, underserved areas, rural communities, and the elderly.

Future innovative thinking and ideas will have to address the shift towards value-based care, reimbursement issues, lowering costs, study regulations and licensing issues, human factors, and how to effectively develop the health workforce for the 21st century.

Continuing the conversation, Keith Montgomery, Executive Director, Kaiser Permanente Center for Total Health, presented a vision for the future through a video describing a fictional experience involving Leo a dementia patient.

Discussion followed the video on how to best build on that vision of care using mainly new innovative technology platforms. Questions asked by several attendees discussed how technology can and should be used and when and where the human touch is really needed.

A panel discussion moderated by Susan Dentzer, tackled a number of issues involved in looking at future technology. For example, James Weinstein MD, CEO and President of Dartmouth-Hitchcock Health (D-H) reports the D-H wireless health monitoring service called ImagineCare technology  is going to usher a new age of proactive personalized healthcare at D-H.

ImagineCare can monitor the health of chronically ill people, measure blood pressure, and oxygen, and glucose levels through wearable sensors. The information is transmitted via smartphones to nurses and health navigators who then analyze the data along with the help of other data sources

Recently, D-H has sold the assets of ImagineCare to LifecareX, a digital health company that will adapt the technology for the Swedish market as a test bed before commercializing the technology in other markets.

Patrick Conway MD, CMS Deputy Administrator for Innovation and Quality and the Director for the Center for Medicare and Medicaid Innovation (CMMI),, said, The State of Maryland is modernizing Maryland’s unique all-payer hospital rate-setting system for services that will improve patients’ health and at the same time, reduce costs.

The initiative will also update the state’s Medicare waiver to enable the state to adopt new policies to improve patients’ health.

Vermont is testing an all-payer payment models where the most significant payers in the State including Medicare, Medicaid, and commercial healthcare payers. Health outcomes under the same payment structure for the majority of providers in the state’s care delivery system will be the focus.

Last January, Steven Stongwater MD, President and CEO, Atrius Health announced, that Atrius Health was selected to participate in the 2017 Next Generation Accountable Care Organization initiative sponsored by the CMS Innovation Center. Atrius will work closely with CMS to provide care at lower costs.

To further reduce costs, Atrius Health has initiated their “Hospital at Home” program that enables patients in the program to be seen at home by specially-trained nurses and available 24/7. The patients are then monitored by phone when they no longer require home visits. Readmission rates have yielded significant reductions for patients.

In addition, Atrius is using an analytic model to continue to help reduce hospital readmission rates with the goal to not only to treat more patients at home but to also  to incorporate behavioral health providers as needed to address mental issues and help with social determinants that drive up costs.

Keith Dunleavy MD, CEO and Chair of the Board at Inovalon, a cloud enabled company, discussed the importance and the vital part that data is and will continue to play in future health and medical care. For example, a study is being conducted on individuals with dementia to determine the factors that may appear early in some patients. The data produced will help researchers better understand the early indicators.

According to Donald Trigg, President, for Cerner Health Ventures, “Cerner is a large IT company with R&D opportunities to use algorithms that can be used for many reasons but the end result is to improve provider’s productivity so more patients can receive care at a lower cost.

Taking the use of data a step further, Amit Rastogi MD, Senior Vice President for Strategy, Growth, and Innovation, for the Inova Health System, discussed how Inova’s new genomics laboratory now provides in-house state-of-the-art genomics testing and personalized patient care which is pushing the limits of precision medicine. The laboratory is now expanding the menu of services to support patient care in Inova hospitals, institutes, and outpatient facilities.

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