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Streamlining the referral processfor dramatic results.

February 27, 2016Provider Symposium – Health 2.0 ConferencePresented Sept 25, 2016

Anatomy of a Pilot

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Brent Stackhouse Mount Sinai Ventures

Vytas Kisielius ReferWell

Panelists

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Mount Sinai Health System Overview

• Mount Sinai Health System• 7 Hospitals in New York City with 3,500 beds and 135 operating rooms• More than 150 ambulatory locations, 33 Departments• Top ranked Icahn School of Medicine trains over 2,000 students and fellows

• Research program is leading recipient of NIH funding• 36,000 staff, 6,500 nurses, 6,200 physicians, and 2,000 residents and

fellows• More than Over 3.26m patient visits in 2015• Mount Sinai Innovation Partners leading tech transfer and

commercialization initiatives

• Mount Sinai Ventures• Mission to invest in strategic opportunities that improve population health

management• $9m deployed with a $31m return in 6 years

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Tracking patient flow and care coordination is difficult Referral workflows are not consistent Care teams do not have necessary information to make the best recommendation Sooner scheduled, more likely to go Network management is key in risk-based reimbursement arrangements

As a result:

Patients seek care inappropriately, or not at all System loses patients to competitors Receiving provider does not have necessary information Patient hit with out of network cost based on referring provider recommendation

Referral Management Challenges

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Patient

45-65%of referrals are not fulfilled,

costing providers

66%of the time PCPs don’t learn results of referral

55%of the time Specialists get no data or reason

for visit

Payer

Provider

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ReferWell Balances

ComplementaryNeeds

Patient Payer

Provider

Simplify referral process and network conformance Improve care coordination Increase referral visit capture

Improve health outcomes Reduce unreimbursed costs Improve compliance, satisfaction

Increase referrals to high quality/low cost provider

Reduce Out-of-Network visits Decrease inappropriate or

unnecessary treatments

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The Right Doctor, Right Away - Better Patient Compliance - Easy Data Sharing

Appointment at point of care

Specialist who takes my insurance50-92% increase in patient visits

EMR agnostic

Cloud-based

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PILOT RESULTS

• Start: August 2014• End: November 2014• Scope: 100 users, 50 locations• Targeted referrals: 5K • Build integration to Epic & IDX

• Start: November 2014 (soft launch)January 2015 (full launch)

• End: June 2015• Scope: 125 users, 50+ locations• Referrals supported: 24K • Integration to Epic: complete• Integration to scheduling pending

(new interface underway at Sinai)

PILOT PROPOSAL

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Successful Pilot Tips

Recommendations for Vendors

• Preparation: Choose Wisely– Project champion is the keystone– Keep ROI for partner in mind– Ask a lot of questions

• Contracting: Execute Quickly– Legal moves slow, politics change fast– Include post-pilot considerations

• Implementation: Thoroughly Plan– Metrics match everyone’s ROI

• Communicate, Communicate…– Internal and External PR

• Design with Post-Pilot in mind

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Questions to Ask Pilot Organization•How do you maximize adoption of a solution?

•Who are the key stakeholders? (Financial/Clinical/etc)

•What is the process for disseminating information across key stakeholders?

•How does each stakeholder define success?

•What is the procurement process and budget cycle?

•What metrics are used for evaluation?

•Who else has piloted at the organization? What were the lessons learned?

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Vytas Kisielius(302) 897-8768vytas@referwell.com

Brent Stackhouse(917) 608-1268brent.stackhouse@mountsinai.org

For more information