Redefining the Delivery of Care

by Healthbox06-06-2017

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Redefining the Delivery of Care

Healthbox held its bi-annual Forum this May to bring together thought leaders and innovators around the topic of “Redefining the Role the Home in Healthcare”. The event featured insights from Healthbox leadership, a keynote address from Arthur Spiegel, group activities, and concluded with a group panel and discussion.

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The Current and Future State of the Hospital in the Home

To get the day started, Healthbox President Neil Patel and CMO Eric Louie, MD gave a joint presentation that looked at the current state of the hospital in the home and discussed what the future would, ideally, look like or what factors should be considered, as well as discussed who are the players and technology that are driving these changes forward. Dr. Louie presented a conceptual framework of the patient journey across 5 drivers - cost, comfort, context, continuity, and caring/carers - and outlined how these need to change moving forward. He next outlined where care is delivered now across the system of care, highlighting the vast cost and care inefficiencies that exist across both location usage and acuity setting. He proposed that in the future, the Hospital in the Home will merge together at ends of the continuum and the inpatient facility/hospital will play a more specific role, only for the most acute and specific episodes, rather than the catchall role that it plays now.

Neil then walked through some of the trends that are allowing these types of changes to be possible. He began by highlighting the shift in savings that have occurred for both payors and consumers as services move out of the inpatient setting and are performed instead in an outpatient setting. Next, Neil expounded on the digital health landscape that is emerging and growing. Harkening back to the cycle of continuous preventative care and maintenance care that Dr. Louie highlighted, Neil discussed how technology is enabling the driving of the ideal cycle of care in a few key areas of innovation: patients can be “connected” anywhere, the emergence of virtual and voice assistants, and on-demand healthcare, either in-person or via telehealth.

Finally, Dr. Louie talked about the aspiration timelines for these types of technology: 

  • Near term: Sensors and biometric wearables
  • Medium term: Future tech and nano-robotics
  • Longer term: patients empowered to guide their own therapeutics. Needs are being commoditized – enabling global reach and access to care for those previously without access
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Keynote by Arthur Spiegel

Following the presentation, Arthur Spiegel, Veteran Healthcare Entrepreneur, gave a keynote address. The main crux of Art’s presentation was navigating and managing cultural changes in organizations. Art highlighted key lessons learned based on his personal and professional experiences, notably that “values matter” and that employees want to believe and feel that they are making a difference. To empower an organization with these values, Art stated that real leaders are relentless on all fronts: values, impact, people, growth, innovation, and financial performance.

Further, Art emphasized the power of ideas: create a culture that empowers ideas, regardless of who you are and where you have been and culture should be about what you think and what you bring to the table. Art concluded his presentation with an admonishment to the leaders in the room, reminding them that everything, including culture, is an evolution and they should be prepared to keep growing and dealing with changes.

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Exploring the Future State of Care Delivery

Building off the momentum of the opening from Neil and Dr. Louie and the inspiration from Art, the event moved into a Future-State visioning exercise wherein the guests separated into small groups. The groups were assigned a scenario and asked to design what they believed, predicted, or hoped the future of the “home in healthcare” would look like for a patient in one of the following vignettes:

  • 5 years from today (Healthy, Chronic Care, Acute/Episodic Care)
  • 15 years from today (Healthy, Chronic Care, Acute/Episodic Care)

Teams spent an hour brainstorming ideas and synthesizing these ideas across the continuum of care: Home, emergency department, inpatient facility, outpatient facility, rehab/transition, community/school, or “other setting”. Each team came up with incredible ideas and it was a fascinating exercise to see where many ideas overlapped while others were greatly divergent. The report outs were followed by a lively group discussion, the questions being around metrics and accountability measures for Care Teams, alignment of values and incentives at a system level, Patient/Consumer choice and behaviors, and the future of non-healthcare companies such as Amazon or Walmart driving innovation through advanced expanded technology.

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Stakeholders Share Their Unique Perspective

The events of the day concluded with an attendee stakeholder panel that featured:

  • Christopher Cornue, Chief Strategy & Innovation Officer, Navicent Health
  • Nimesh Jhaveri, Division Vice President, Walgreens
  • Cheryl Matter, Director of Diversified Health Technologies, Blue Cross MN
  • Travis Messina, CEO, Contessa Health

The discussion on the panel focused on three main topics. First, how to go about engaging patients no matter where they are in the system care via connected care – focusing on the blending of care and being setting agnostic. A topic that was argued for needing more attention was enabling human-centered design approaches – understanding the patient’s need and putting the person at the center of the hub of care, not just the data and quantitative aspects, but also the qualitative data in order to share the story. Finally, digital innovation is the enabler, but the trust still lies with the providers

The second point of discussion was around partnerships, namely that care coordination and social care partnerships need to be integrated into the community in order to create healthy communities. Close to 70% of people live within walking distance of a Walgreens and therein lies a huge opportunity to provide access to affordable and convenient healthcare to the masses. Partnership opportunities also exist in the workplace, where there is a captive audience and employers benefit from a reduction in absenteeism and there exists an additional opportunity to offer health services, both mental and physical, at the workplace or through partnerships. 

Lastly, the panel concluded with a discussion around incentives across the continuum of care. Panelists discussed how value based care is currently built around clinical care, episodic care, and cost drivers but it does not include the function of lifestyle for the patient. The group agreed there needs to be a role for the community in owning the incentives around value creation and that there must be change with respect to the financing vehicles in order to change the trajectory of risk. In closing, the panel rapped about how Health systems need to know the total cost of care for each episode of care to drive down cost.

Thank you again to all that participated and we look forward to the takeaways and learnings that we’ll explore at our next Forum this fall.

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