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Building Health 2.0
into the Delivery System



            Scott Shreeve, MD
             Chief Executive Officer
                     April 14, 2009
Agenda
                           / Intro
                           / Panelist
                           / Discussion
                           / Presenters
                           / Discussion

Integrated/GH       Academic/BIDMC    Group/DHCM    Independent/RenH



Integrated/Kaiser          Interdependent/Myca     Independent/Google
The Cathedral and the Bazaar



             vs
Cathedral Care
Vertical       Characteristics:
               • Kaiser, Group Health, Geisinger, etc
 Ancillary
               • Optimization at the system level
 Services

               • Full coordination of care
               • Information technology supports
 Hospital
 Services
               • Incentives aligned for outcomes
               • Reward for results
               • Patient consumer for life
Physician
Services
               • Consumer is guided through process

 Patient
Services
Bazaar Care
Non - Integrated            Characteristcs:
                            • Fee for Service
             Ancillary
                            • Optimization at the component level
             Services
                            • Disease Care
                            • Lack of coordination
  Hospital
                            • No Accountability
  Services

                            • Consumer left to navigate
                            • Incented for volume not value
                Physician
                Services

Consumer
 Services
  (None)
Transformation



Current           Future
System            System
           H2.0
The Bazedral
                    Virtual     Health 2.0 Opportunity:
                                • Software/services integration layer
                    Ancillary
                                • Coordinates patients, providers, and payment
                    Services

                                • Dramatic increase in health care value
Organizing Entity




                    Hospital
                                Key points of “Virtualization”
                    Services

                                • Financing (payment / business models)
                                • Delivery (new types of arrangements)
                    Physician
                    Services
                                • Incentives (increased $ for increased value)

                    Consumer
                     Services
                      (None)
Perspectives

  James Hereford               Dan Caruso, MD
  • VP Quality, Group Health   • Med Director, Dartmouth
  • Integrated Delivery System • Community Group Practice

  John Halamka, MD          Rushika Fernadouplle, MD
  • CIO, BIDMC              • Founder, Renaissance Health
  • Academic Medical Center • Individual Medical Clinics



Integrated    Academic             Group       Independent
Cathedral or Bazaar?



         vs
Ferrari Medicine
Ferrari Medicine
Independent or Systemic?



           vs
Vertical or Virtual?
Vertical                              Virtual

                                        Ancillary
 Ancillary
                                        Services
 Services




                  Organizing Entity
 Hospital                               Hospital
 Services                               Services

             vs
Physician                               Physician
Services                                Services



                                       Consumer
 Patient
                                        Services
Services
                                         (None)
On or Off the Grid?


         vs
Presenters
                 Roni Zieger, MD
                 • Project Manager, Google Health

                Sean Khoizon, MD
                • Medical Director, Hello Health

                Ted Eytan, MD
                • Clinical Innovation, Kaiser Permanente



Independent/Google       Interdependent/Myca        Integrated/Kaiser
Free Flow or Gated Stream?



            vs
Sustaining or Disruptive?
     1. Enabling technology




                              Performance
     2. New Business Model
     3. Value Based Network


                                                       Incumbents win
New Measure of




                                                               Time
 Performance




                                                                 “Almost always,
                                                                 disruptive innovations
                                                                 such as these have
                                                                 been ignored or
                                                                 opposed by the leading
                                                                 institutions in their
                                            New Entrants win     industries for perfectly
                                                                 rational reasons”
                                                     Time          - Clayton Christensen
Tethered or Untethered?
                  PHR
                               Phrm     Provider




      EHR               vs            PHR




            PHR              Payor          Patient

PHR
Takeaway Memes

1.Health 2.0 from just Promise to the Practical

2.Innovation from Inside as well as Outside

3.Relationships from Paternalistic to Participatory

  The enabling tools and technology of H2.0 are
creating the next Generation Health System NOW
Join In!
Building Health 2.0 Into the Delivery System

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Building Health 2.0 Into the Delivery System

  • 1. Building Health 2.0 into the Delivery System Scott Shreeve, MD Chief Executive Officer April 14, 2009
  • 2. Agenda / Intro / Panelist / Discussion / Presenters / Discussion Integrated/GH Academic/BIDMC Group/DHCM Independent/RenH Integrated/Kaiser Interdependent/Myca Independent/Google
  • 3. The Cathedral and the Bazaar vs
  • 4. Cathedral Care Vertical Characteristics: • Kaiser, Group Health, Geisinger, etc Ancillary • Optimization at the system level Services • Full coordination of care • Information technology supports Hospital Services • Incentives aligned for outcomes • Reward for results • Patient consumer for life Physician Services • Consumer is guided through process Patient Services
  • 5. Bazaar Care Non - Integrated Characteristcs: • Fee for Service Ancillary • Optimization at the component level Services • Disease Care • Lack of coordination Hospital • No Accountability Services • Consumer left to navigate • Incented for volume not value Physician Services Consumer Services (None)
  • 6. Transformation Current Future System System H2.0
  • 7. The Bazedral Virtual Health 2.0 Opportunity: • Software/services integration layer Ancillary • Coordinates patients, providers, and payment Services • Dramatic increase in health care value Organizing Entity Hospital Key points of “Virtualization” Services • Financing (payment / business models) • Delivery (new types of arrangements) Physician Services • Incentives (increased $ for increased value) Consumer Services (None)
  • 8. Perspectives James Hereford Dan Caruso, MD • VP Quality, Group Health • Med Director, Dartmouth • Integrated Delivery System • Community Group Practice John Halamka, MD Rushika Fernadouplle, MD • CIO, BIDMC • Founder, Renaissance Health • Academic Medical Center • Individual Medical Clinics Integrated Academic Group Independent
  • 13. Vertical or Virtual? Vertical Virtual Ancillary Ancillary Services Services Organizing Entity Hospital Hospital Services Services vs Physician Physician Services Services Consumer Patient Services Services (None)
  • 14. On or Off the Grid? vs
  • 15. Presenters Roni Zieger, MD • Project Manager, Google Health Sean Khoizon, MD • Medical Director, Hello Health Ted Eytan, MD • Clinical Innovation, Kaiser Permanente Independent/Google Interdependent/Myca Integrated/Kaiser
  • 16. Free Flow or Gated Stream? vs
  • 17. Sustaining or Disruptive? 1. Enabling technology Performance 2. New Business Model 3. Value Based Network Incumbents win New Measure of Time Performance “Almost always, disruptive innovations such as these have been ignored or opposed by the leading institutions in their New Entrants win industries for perfectly rational reasons” Time - Clayton Christensen
  • 18. Tethered or Untethered? PHR Phrm Provider EHR vs PHR PHR Payor Patient PHR
  • 19. Takeaway Memes 1.Health 2.0 from just Promise to the Practical 2.Innovation from Inside as well as Outside 3.Relationships from Paternalistic to Participatory The enabling tools and technology of H2.0 are creating the next Generation Health System NOW