The document discusses strategies for transforming healthcare delivery through population health management, care coordination, and virtual care technologies. It provides examples of how partnerships between healthcare organizations and technology companies have implemented programs utilizing telehealth, remote patient monitoring, and digital platforms to improve outcomes, lower costs, and enable aging in place. Case studies demonstrate how these approaches have reduced hospital admissions and lengths of stay, ICU transfers, mortality rates, and costs while improving quality of life.

1. Hospital of Tomorrow
Disruptive Change:
How to Save the Healthcare System
October 2014

2. Hospital of Tomorrow
Align, Engage, Integrate, Enable and
Partner Across the Health Continuum
Amy Andersen
Healthcare Transformation Services
October 2014

3. Philips Population Health Management
Prevention Diagnosis Treatment Recovery Wellness
Population Health

4. Focusing on human and cultural elements for better
alignment, communication and collaboration.
Align
Driving patient activation and shared decision-making for
better outcomes at lower cost.
Engage
Building highly coordinated multi-disciplinary teams for
patient-centered care across the health continuum.
Integrate

5. Align: Transforming to People-Centered Neonatal Care
Philips Wee Care®: Creating developmentally supportive care environments
Altimier LB, Tedeschi L., Developmental care: changing the NICU physically and behaviorally
to promote patient outcomes and contain costs, Neonatal Intensive Care Vol .17 No. 2
Our approach
• Engage staff in redesign of
environmental and clinical practices
• Educate multidisciplinary team to
deliver the best evidence-based care
• Coach staff to encourage/support
family participation in baby’s care
• Implement and monitor core
measures for sustained performance
People-focused outcomes
• ↑ parent satisfaction
• ↓staff turnover from 15% to 2%
• Improved compliance to outcomes-driven
practices
– Sound levels reduced from 95 to 55 dB
– Light levels reduced from 150 to 50 FC
• ↓LOS from 22 to 32%*
* LOS dependent on gestational age category

6. Engage: Patient Participatory Decision-Making
Prostaid®: Shared decision-making program for prostate cancer patients
People-focused outcomes
• Choice of treatment in the hands of the
patient and his family
• Closer collaboration between patient and
physician
• Improved patient’s sense of control and
satisfaction with choices
The challenge
• Give patients clear, personalized
information about treatments and
side effects
• Ensure patient’s pathway choices
align with quality of life values
• Reduce patient stress and anxiety
Our approach
• Facilitate shared decisions for
patients, family, and physician as
part of clinical workflow
• Create a clear, simple-to-use, web-based
encryption-secured tool
• Combine patient’s values,
preferences and clinical data with
evidence-based medical guidance
Stacey D, Bennett CL, Barry MJ, Col NF, Eden KB, Holmes-Rovner M, et al. “Decision aids for people facing health treatment or screening
decisions,” Cochrane Database Syst Rev. 2011; (10):CD001431;/www.nashp.org/sites/default/files/shared.decision.making.report.pdf

7. Integrate: A holistic transformation of the Stroke Continuum
Multidisciplinary, end-to-end care for vulnerable patients
People-focused outcomes
• Scaled scarce expert resources in a cost
effective manner
• Exceeded core measures performance
exceeding AHA GWTG benchmarks
• Enhanced recovery, treatment compliance
and healthy lifestyles with end-to-end
patient-tailored support
The challenge
• Improve quality of stroke care and
outcomes across care settings
• Reduce care fragmentation that drives
estimated $95B projected cost (2015)
• Support patients in return to a new state
of wellness and healthy lifestyles
Our approach
• Connect pre-hospital providers with
experts for rapid assessment/treatment
• Connect patients, family and providers to
share information through mobile and
app-based technologies
• Design interactive adaptive healing
environments tuned to patient’s needs
hospital through rehabilitation
Westerberg, H., Jacobaeus, H., Hirivikoski, T., Cleverberger, P., Östensson, M.-L.,
Bartfai, A., & Klingberg, T. (2007). Computerized working memory training after
stroke – A pilot study. Brain Injury, 21 (1), 21-29.; Lisbeth Claesson, Thomas Lindé,
Ingmar Skoo, Christian Blomstrand, Cognitive Impairment after Stroke –Impact on
Activities of Daily Living and Costs of Care for Elderly People, Cerebrovasc Dis
2005;19:102–109

9. Partnering with the Hospitals of Tomorrow
Sweden
15 years
USA
15 years
Netherlands
10 years
Belfast
15 years
KUBIN
CLINIC
Austria
8 years
Types of partnering and innovation
 Care transformation and care redesign
 Enterprise quality and care management
 Consumerism and patient engagement
 Co-develop and pilot new technologies
 Collaboration for higher equipment utilization
 Managed services and business model
 Shared performance metrics and risk sharing

10. Hospital of Tomorrow
Jane Lucas, Health Policy Counsel,
Office of U.S. Senator John Thune

11. Coordinated Telehealth &
Care Transformation
“It is not the strongest of the species
that survive, nor the most intelligent,
but the one most responsive to change”.
Charles Darwin
Brian A. Rosenfeld, MD
VP & Chief Medical Officer, Hospital to Home
October 2014

12. Quality of Life
H2H: Higher Quality of Life at Lower Cost
Assisted Living
$1 $10 $100 $1,000 $10,000
Estimated Cost of Care / Day
ACUTE CARE
ED/OBS
Medical/Surgical
Intensive Care
Unit
RESIDENTIAL CARE
Skilled Nursing
Facility
HOME CARE
Independent,
Healthy Living
Aging in Place
Hyper-Chronic
Disease Mgmt
12

13. $40 – $100k
$9 – $30k
$2,583
$248
Healthcare Cost Segmentation
Segmentation
based on healthcare
spending
Percentage
of total
expenditure
Average
expenditure
per patient
per year
50.6%
23.7%
22.6%
3.1%
5%
6-20%
21-50%
50-100%
13

14. Coordinated Telehealth Across the Care Continuum
Home
Emergent care
Home
Perpetual chronic care
Post discharge care
Aging in place
Hospital
ICU, Med Surg,
LTACH, SNF
Telehealth Center
Digital Health Platform
EMR HIE
14

15. 15
Virtual Care Center
15

16. eICU Programs
16

17. Healthcare Productivity: Do More With Less
Wages for
Health
CareWorkers
56%
$1.45 Trillion
Other
44%
$1.15
Trillion
Intensivist
(1)
Critical Care Nurses
(2-3)
Computer Intelligence
eICU: 130-150 ICU beds
“…Unlike virtually all other sectors of the U.S. economy, health care has experienced
no gains over the past 20 years in labor productivity, defined as output per worker.”
Kocher, M.D., Nikhil 17 R. Sahni, B.S. NEJM: 365;15, 1370-1373.

18. eAcute Care Program
• Monitor high acuity patients to
prevent avoidable complications
– reducing hospital LOS and cost
• Use centralized resources to drive
best practices (sepsis, falls)
• Video-visitation: Increase
patient/family satisfaction
• Facilitate transitions from hospital
to home/SNF
Virtual Sepsis Unit
18

19. Hospital in Home: Enabling Technology
Home Environment
• Tele-station in the home
feeds patient data real-time
• Temperature, heart rate,
blood pressure, oxygen
saturation
• Weight Scale
• Point of care testing:
– Glucose
– WBC
• Wound photos
19

20. Patient Engagement: One Size Doesn’t Fit All
Driving behavior change
and enabling Team Care
Phenotype for
patients & families
Patient Portal –
Greater self care
Outcome = ET × A(P+F)
Their Health Team
Their Family
The Person
Multiple chronic illness Aging in place Wellness
20

21. 211 21
Intensive Ambulatory Care Program

22. Fall Prevention and Detection
Lifeline AutoAlert
& GoSafe
Senior Mobility
Monitor
Focused
Rehabilitation
22

23. 23
“Vision without action is just
imagination”

24. Robert Groves, MD, Vice President,
Health Management
Banner Health

25. Banner Health at a Glance
• 25 Acute care hospitals
• Over 35,000 employees
• Over 450 bed tele-ICU
• 55 bed Simulation Medical
Center
• Truven Top 5 large health
systems 3/5 yrs
• $5 Billion in revenue
• Over 1,000 employed
physicians
25

26. Banner’s 2020 Vision
26
Population
Health
Management
Company
Clinical
Quality
Company
Acute
Hospital
Company
“Our Steps to the Future”
Industry
Leadership
2016-2020
Innovation
2016-2020
Growth
2007-2010
Performance
2003-2006
Turnaround
2000-2002
LEAD
IT!
CHANGE
IT!
GROW
IT!
DO
IT!
FIX
IT!

27. Working Harder Isn’t Always the Answer…
27

28. 28

29. 1. Identify adverse trends and intervene before they become
adverse outcomes
2. Respond quickly to requests for help
3. Monitor and assist with “evidence-based practice” and reliability
4. Measure performance across the system
5. Use data (real time and retrospective) to drive performance
improvement
Five Areas of Focus…
29

30. Longitudinal ICU & Hospital Mortality
30

31. eAcute Pilot Results
“ Application of the eICU care
model to the medical surgical
patient population reflects an
impact on patient outcomes,
throughput and costs…”
Baseline eHospital
Average LOS 3.96 days 3.30 days
Cases / month 307 389
Cost / case $6161 $5166
ICU Admissions
from general ward
First 24
hours 0.9% 0.8%
After 24
hours 1.1% 0.6%
Discharge status
Death or
hospice 2.7% 2.0%
Home 84.1% 86.5%
Falls per 1000 days 3.3 2.1
31

32. Banner iCare Acute Care
ICU 2013
• >20,000 fewer ICU days than predicted
• >50,000 fewer Hospital days
• >$68,000,000
• >2,000 lives saved (APACHE 0.42)
eHx
• ICU Transfers dropped from 1.1% to 0.6%
• $4.5 M saved
32

33. Remote Skilled Nursing Facility Care
33
Telehealth Center

34. Home: Higher Quality of Life at Lower Cost
Quality of Life
Assisted Living
$1 $10 $100 $1,000 $10,000
Estimated Cost of Care / Day
ACUTE CARE
Specialty Clinic
Community
Hospital
Intensive Care
Unit
RESIDENTIAL CARE
Skilled Nursing
Facility
HOME CARE
Independent,
Healthy Living
Comfortable
Setting
Chronic Disease
Mgmt.
Cost Effective
34

35. Banner Health Network Solution
BH
35
Future - Fourth
Network

36. Integrated Population Health Management
Health Management
Delivery
System
Care Mgmt/
Corp Svcs
Banner
Health Network
36

37. Enabling Technology
Intelligent Monitoring Population Management
Continual Surveillance
Mobile Care Tools
Event Management
Web-enabled Remote 2-Way Video with Audio
Consult
37

38. 38

39. Data Overview
55 members: 3-month follow-up
Months -12/0 -11/1 -10/2 -9/3 -8/4 -7/5 -6/6 -5/7 -4/8 -3/9 -2/10 -1/11
Pre 2443 2941 4601 2488 1965 2704 2547 2278 2200 2675 3009 1627
Post 2395 840 972 729 627 491 0 0 0 0 0 0
39
Banner iCare™ period

40. Member Needs Assessment Center
360 Omni-Channel Health Management
40

41. Population Management & Coordinated
Care Center
41 41

42. Any Patient, Any Provider, Any Time
42

43. “If you don’t like change,
you will like irrelevance even less.”
Eric K. Sinseki, Former U.S. Army General Chief of Staff
43

44. Question & Answer Session
Brian A. Rosenfeld, MD

45. Thank you!