Track 2: Tecnologías para la transformación del sistema sanitario 2.2. Impacto de las TICs en la gestión de la cronicidad

1. USING INFORMATION TECHNOLOGY TO ACHIEVE THE
TRIPLE AIM: A GLOBAL PERSPECTIVE
KIP WEBB, MD, MPH
MAY 24, 2012
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2. Two imperatives for change:
The few cost the most
% of Population % of Total Healthcare Mean Annual
Expense Cost per Person
1% 29%
$101,000
9%
39%
$15,000
20%
21%
$3,700
70%
11%
$580
Source: Thomson Reuters Marketscan Database, National sample of 21 million insured Americans, 2003-2007
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2

3. Two imperatives for change:
We are not delivering optimal care, every time
Cumulative Improvement in Health Status
Each year, 20-30% of the
healthcare budget is spent on
The Goal wasteful, redundant, and
potentially harmful care
Overuse
Waste
The
Industry
today
Cost
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4. The Triple Aim
Improve Population Health
Source: Institute for Healthcare Improvement
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5. WHO eHealth Study
Use of Technology is on the Rise
• Used Center for Health
Market Innovations data
to study eHealth in 16
low/middle income
countries with thriving
private healthcare
sectors
• 176/657 health
programs were
“technology enabled”
Source: E-health in low- and middle-income countries: Findings from the Center for Health Market Innovations
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6. WHO eHealth Study
Technology is used for a Variety of Purposes
Source: E-health in low- and middle-income countries: Findings from the Center for Health Market Innovations
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7. WHO eHealth Study
Technology-enabled programs, by Health Focus
Source: E-health in low- and middle-income countries: Findings from the Center for Health Market Innovations
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8. Using Technology to Achieve the Triple Aim
Rwanda: Phones for Health
“Phones for Health” is a public-private partnership that utilizes
mobile-phone based solutions for HIV/AIDS care and
treatment in PEPFAR-supported countries.
• The system allows health workers to
report data from the field using their
mobile phones as well as PCs, PDAs and
other handheld devices.
• Once entered, the data is mapped and
analyzed by the system and immediately
available to health authorities at
multiple levels via the web.
• The system also supports SMS alerting
and notification and tools for
communication and coordination with
field staff.
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9. Using Technology to Achieve the Triple Aim
USA: Standardizing Care in a Hospital System
• 50+ community hospitals
• HIMSS Analytics EMRAM Stage 4-6 ICT capability
• Goal: Cross-facility standardization of care
• Four phased approach
1. Governance
2. Templated approach to achieving best practices
3. Application to clinical questions
4. Analytics
• Results to date:
– Sepsis program has saved > 200 lives in first 6 months and
generated $17 M
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10. Using Technology to Achieve the Triple Aim
Republic of Ireland: National Paediatric Hospital
• Demography: 4.1 Million
inhabitants over 70,000
square kilometers
• Concept: Single hospital
leveraging a hub and
spoke model and enabled
by technology
• Technologies include:
– Electronic Health Records
– Telemedicine
– Remote monitoring
– Patient enablers
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11. Using Technology to Achieve the Triple Aim
Smart Devices, Biosensors, and Wireless
• Smart Devices
– Scales
– Peak Flow Meters
• Biosensors
– Cardiac Monitors
– Contact Lenses
– Smart Pills
• Wireless
– Graphical displays
– Communication
with Caregiver
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12. Closing Thoughts
• In countries all over the world, healthcare costs are too
high relative to patient experience and population health
• The concept of the “Triple Aim” urges us to design
programs that improve the patient experience and
population health while also lowering costs
• Information and Communication Technologies are being
increasingly used to achieve the “Triple Aim”
• Predictors of successful programs include:
– Strategic focus
– Leadership
– Widespread deployment of relatively low cost ICT
– Change enablement
– Payment reform
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