1

Global Campus
Talent Development

Do we REALLY want Patient

Centered Care?
When Putting the Patient FIRST, Makes the Provider LAST

2014 The Advisory Board Company advisory.com

Global Campus
Talent Development

Are we willing (and ready) to

Abate Our Profits?

2014 The Advisory Board Company advisory.com

We Love Technologywith a PRICE

Innovations to Come Will Take Very Different Form

IMAGE CREDIT: AUDREY_SEL.

Technology in Brief: Mouse Avatar

Researchers are implanting mice "avatars" with a patient's
tumour or part of the patients anatomy
Different treatments are then tested for effectiveness on mouse
In one test, 12 out of 14 test patients successfully shrank their
cancerous tumours with fewer side effects using drug tested
first on mouse avatar

IMAGE CREDIT:MAYBEMEME

2012 THE ADVISORY BOARD COMPANY- 26086A

Technology in Brief: Bioprinting

Building on 3D printing technologies, researchers in multiple
locations working on ways to print living human tissue

Replacing ink with living cells, scientists printing tailored tissues

suitable for surgery and organ transplant
Simplest experimental prototypes ready for clinical testing in
five years
Source: Hotz RL, Printing Evolves: An Inkjet for Living Tissue, Wall Street Journal,
September 18, 2012; Pollack A, Mice as Stan-Ins in the Fight Against Disease, New
York Times, September 25, 2012; Advisory Board interview and analysis.

What if Better is CHEAPER?

Is There Anything Duct Tape Cant Do?

IMAGE CREDIT: SYIBUS2003.

Study in Brief: Duct Tape

Treatment of the Common Wart

2012 THE ADVISORY BOARD COMPANY- 26086A

Efficacy Comparison of Wart Treatments

2002 study assessed effectiveness

of duct tape occlusion versus
cryotherapy1 for treating common
warts
Results found duct tape at least as
effective a treatment as more
expensive cryotherapy
Cost Comparison of Wart Treatments

85%

488
60%

4
Duct tape
1) Cryotherapy: Liquid nitrogen applied by doctor over 3-6 visits

Cryotherapy

Duct tape

Cryotherapy 1

Source: Focht, D.R., Spicer, C., Fairchok, M.P., The Efficacy of Duct Tape vs Cryotherapy in the Treatment
of Verruca Vulgaris, Archives of Pediatrics & Adolescent Medicine 2002; 156 (10):971-974; Cost Helper
available at http://health.costhelper.com/wart-removal.html; Advisory Board interviews and analysis.

New Model for Patient Services

Innovators Unrestricted by Current Delivery, Payment Models

Iora Health Contracts Directly With

Employers to Deliver Primary Care

Putting the Patient First

Iora Health

Local Employer

GPs, contracted specialists

provide care to employee population
Employer pays fixed PMPM1 fee, clinic
reports outcomes at monthly meetings

2012 THE ADVISORY BOARD COMPANY- 26086A

Iora doctors coordinate care with

hospitalists; hospital provides data back

Weve been worrying about the impact of

our decisions on physicians and hospitals,
but its time to worry about the impact on
the patient. The hospital perspective is not
our problem, its creative destruction.

Rushika Fernandopulle, MD
Iora Health

Case in Brief: Iora Health

Operating the Dartmouth Health Connect clinic for Dartmouth College in Hanover, New
Hampshire, and the Culinary Extra Clinic for the Culinary Health Fund in Las Vegas, NV
Manage top 10 percent of sickest patients using comprehensive, team-based approach
Achieved 12.3 percent decrease in total spending for patients enrolled in 20092
1) Per member per month.
2) 2009; relative to control group created using propensity
matching; gross spending dropped 18%.

Source: Iora Health, available at: www.iorahealth.com;

Advisory Board interviews and analysis.

Global Campus
Talent Development

2012 THE ADVISORY BOARD COMPANY- 26086A

Are we willing (and ready) to

Abate Our Profits?
Abandon Our Comforts?

Health Care Advisory Board CONCLUSION

Not Just One Service, But Many

Managing Three Distinct Patient Populations

HIGH EFFORT
HighRisk
Patients

2013 The Advisory Board Company 27852

Rising-Risk Patients

Low-Risk Patients

5% of patients;
usually with complex
disease(s), comorbidities

15-35% of patients;
may have conditions
not under control

60-80% of patients;
any minor conditions
are easily managed

HIGH SERVICE
and LOW COST

2012 THE ADVISORY BOARD COMPANY- 26086A

1440 Minutes Per Day

24 Hours a Day / 365 Days Per Year

On Demand Technical Help

Initial Help FREE of Charge

Online / On Phone / In Store

1010

Point, Click, and Heal

Real-Time Patient Access to
Physician, Care Providers

Patients submit clinical

questions via mobile wizard1
or web application
Photo or video attachments
provide detail on ailment2,3
Physician or care provider
recommends next care step

Case in Brief: PINGMD

Health care technology startup located in New York, NY
Online platform enables efficient care network communications through secure text,
picture, and video messaging; mobile app notifies user when communications are
sent, received and resolved
Platform reports 100% improvement in customer satisfaction
1) Proprietary.
2) Documented exchanges reduce physician liability; patient acknowledges disclaimer describing proper platform use.
3) The
100%
HIPAA Board
compliant
secure communication,100%
of the time.
2014
Advisory
Company
advisory.com 28600A

Source: PINGMD, available at: www.PINGMD.com, accessed

October 1, 2013; Health Care Advisory Board interviews and analysis.

11

Fastand FREE
On the Phone, All the Time,

Case in Brief:

SCREENSHOT: OSCAR

Prepaid healthcare
offers free televisits,
free generic drugs, and
a limited number of free
PCP visits per year

7 min
Average televisit
response time

Promises response time

of less than one hour

2014 The Advisory Board Company advisory.com 28600A

Source: Creswell J, Start-Up Health Insurer Finds Foothold in New York,

The New York Times, March 28, 2014, available at: www.nytimes.com;
Health Care Advisory Board interviews and analysis.

1212

Catering to an Unmet Need

Patient Portal Access Increases Engagement with Health System
Distribution of Patient Contacts
at Kaiser Permanente Hawaii
5.21

5.61

Case in Brief: Kaiser Permanente Hawaii

Branch of Kaiser Permanente based in
Honolulu, Hawaii; cares for 229,000 members
across the state
Piloted Kaisers patient portal in 2005
Region experienced a 26% decrease in
doctor visits in the two years following
portal implementation

Contacts
per
member

2003

2007

Secure messaging
Scheduled telephone visits
Office visit

2014 The Advisory Board Company advisory.com 28600A

26%

8%

Despite a 26% drop in doctor visits post-portal

implementation, Kaiser Permanente Hawaii
experienced an 8% increase in total patient contact
Source: McCarthy D, et al., Kaiser Permanente: Bridging the Quality Divide with Integrated Practice, Group Accountability, and Health
Information Technology, The Commonwealth Fund, 2009: 1-28; Kaiser Permanente Careers: Hawaii, available at:
http://www.kaiserpermanentejobs.org/hawaii.aspx, accessed April 30, 2013; Health Care Advisory Board interviews and analysis.

Global Campus
Talent Development

2013 The Advisory Board Company 27505B

Are we willing (and ready) to

Abate Our Profits?
Abandon Our Comforts?
Abdicate Our Positions?

No Longer Respected?

2013 The Advisory Board Company 27505B

UnpopularEven When Right

No Longer In Control?

Being Guided by Others

Global Campus
Talent Development

Are we willing (and ready) to

Abate Our Profits?
Abandon Our Comforts?
Abdicate Our Positions?

Global Campus
Talent Development

Three Unique Roles for Us To Play

1)

Servants to Exceed Expectations

Far Beyond Our Work Alone

Treating the (Obvious) Symptoms

Far Beyond Our Work Alone

Treating the (Obvious) Symptoms

Service Happens in the White Space

Addressing Needs Not Activity

Patient Experience Simulations

Global Campus
Talent Development

Three Unique Roles for Us To Play

1)
2)

Servants to Exceed Expectations

Gamers to Encourage Behavior

Profuse apologies for the realities of life, making

amends for service slips, and trying to placate
frustrated patients
Convincing patients that
hard choices and tradeoffs are the best course
Encouraging patients to face
of action for their care
reality and accept care plans
via honest conversations

Celebrations and token

gestures to boost spirits
and reward compliance

Counterintuitively, passive
acceptance is not what we want. We
need patients to be activated,
motivated, and involved in their care
The very uncertainty and lack of
control that causes grief is also the
necessary ingredient for triggering
action!

Global Campus
Talent Development

Three Unique Roles for Us To Play

1)
2)
3)

Servants to Exceed Expectations

Gamers to Encourage Behavior
Entrepreneurs to Envision the Future

Global Campus
Talent Development

Are we willing (and ready) to

Abate Our Profits?
Abandon Our Comforts?
Abdicate Our Positions?

Global Campus
Talent Development

Are we willing (and ready)

to

Are we willing (and ready)

to become

Abate Our Profits?

Abandon Our
Comforts?
Abdicate Our
Positions?

1) Servants to Exceed
Expectations
2) Gamers to
Encourage
Behavior
3) Entrepreneurs to
Envision the
Future