Strategies for Startups to Partner with Healthcare Systems

A View from Geisinger

Gregory J. Moore, MD, PhD Chief Emerging Technology and Informatics Officer Director, Institute for Advanced Application Twitter: @GJMooreMDPhD

gjmoore@geisinger.edu

Geisinger  Health  System  coverage  area  

Revised  7-­‐25-­‐12.  Geisinger  PR  &  Marke7ng  Department  

Geisinger Health System

• 3.5 million patients in service area • 1,120+ physician FTEs, 700+ advanced practitioners FTEs • 78 community practice sites • 7 hospitals • 480,000+ member health plan • Institute for Advanced Application Center for Reengineering Healthcare

Center for Emerging Tech and Informatics Center for Clinical Innovation

• Center for Health Research

GEISINGER–An Integrated Health Services Organization

Provider Facilities

$2.3B

Physician Practice Group

$1.2B

Managed Care Companies

$2.5B

Geisinger Medical Center & Geisinger Shamokin

Area Community Hospital

Geisinger Wyoming Valley Medical Center

Geisinger Community

Medical Center

Geisinger Bloomsburg Hospital

2 Nursing Homes

4 Surgery Centers

~80K admissions/OBS & SORUs

1,623 licensed beds

Multispecialty group

~1,120 employed physicians

~700 advanced practitioners

78 primary & specialty

clinic sites

~3M clinic outpatient visits

~420 residents & fellows

~490K members (including ~77K

Medicare Advantage members)

~112K Medicaid

Managed Care Projected Membership (GHP

Family)

Diversified products

~39K contracted providers/facilities

43 PA counties

Geisinger Institute for Advanced Application 3 Centers, 9 Labs, Informatics and Technology Trials Office, High Performance Computing Core

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Organized for Synergy: •  Predictive Analytics •  Human Factors Engineering •  Diagnostics

A National Laboratory For Healthcare Transformation ($6B R&D Lab) Leading through continual innovation

•  Novel data streams and big data analytics •  Re-engineering via IsysE approach •  Emerging technology and Informatics •  Rapid clinical innovation •  Remote assessment/diagnostics/treatment

•  Transforming patient care

•  Engaging patients

•  Improving the healthcare value proposition

Center for Clinical Innovation

Center for Emerging Technology and

Informatics

Center for Re-engineering

Healthcare

Data Generation

Data Aggregation

Performance Measurement

Insight and Action

Clinical Transformation

and Reengineering

Knowledge Generation

•  Care by- product

• Transactional

•  Required for performance measurement

•  Establishes current state

•  Deployed as visualization,

alerts and reminders

•  Basis for new models of care

delivery

•  “What to do in a patient like

mine?”

Natural

Language Processing

Data

Warehousing

Dashboards

Anticipate

and Mitigate

Automation

Machine Learning

Enhancing the Data Value Chain

Six Drivers of High Cost, Poor Quality Care

•  Mistakes •  Unjustified variation •  Fragmented care •  Perverse payment incentives •  Patient is a passive recipient of healthcare •  Supply-demand mismatch

Patient Engagement Objectives

Understand My Health

Manage My Visit

Control My Condition

Patient Engagement

Value of Patient Engagement

Patients engaged in their health tend to have better outcomes and potentially

lower cost (Dentzer, 2013)

•  Fairview Health Services study showed patients with a Patient Activation Measure (PAM) of level 1 were 21% more expensive than patients with a level 4 score (Hibbard & Greene, 2013)

•  Shared decision making study of 60,000 patients showed patients participating had 5.3% in cost savings, 12.5% less inpatient admissions and 21% fewer heart problems (Veroff & Wennberg, 2013)

Using Technology for Patient Engagement

To activate patients, you have to meet them where they are.

(Hibbard, 2013)

“Only 1% of a person’s life is

spent with healthcare professionals”

(Chase, 2013)

Empowering Patients Through Transparency:

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Perspective The Road toward Fully Transparent Medical Records Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D. December 4, 2013 DOI: 10.1056/NEJMp1310132

Patient Portal Access to Providers’ Progress Notes

>85% of outpatient providers participating

•  90% of patients understand their health and medical conditions better

•  84% of patients take better care of themselves

•  91% of patients feel more in control of their healthcare

Regular Care

100% Care Processes and Protocols (Digital)

Automation Patient Activation

Populations

Workflow Modification

Patients and Conditions

Population Identification

Bundle Development

Delegation and

Algorithms

Low Efficiency and Reliability High

Reengineering and Disruptive Innovation

Healthcare Transformation: Empowering Patients

Potential Opportunities? •  Enabling Data Sharing by Patients

•  Patients and Caregivers as co-writers/editors of medical notes with healthcare providers

•  Transparency in medical costs and outcomes

•  Sharing Predictive Analytics with Patients How?

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Health Care Systems

Choose Your Partner Type Based on Needs/Goals

•  Traditional Academic

•  Hybrid Integrated-Clinic Model

•  Provider Only Systems

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Know your Health System Partner

•  Be aware of your healthcare system partner’s capital and budget cycles

•  Be aware of your partner healthcare system’s pain points

•  Be able to clearly articulate in a prioritized list what specific types of value you seek from your healthcare system partner including “must haves” and “nice to have”

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First Steps

•  Getting the Opportunity-Contacts

•  Getting the right people on the call/in the room

•  Be Prepared-Anticipate Questions/Needs

•  Be Respectful of Time

•  Prompt/Relevant Follow-up

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The Perfect Pitch

•  Clear and compelling vision

•  Convey your team’s ability to deliver

•  Highly relevant management team

•  Strong/credible market opportunity (size and growth)

•  Product Differentiation-better mouse trap or disruptive

•  The Solution-solve real pain point/must have

•  Financials-credible, clear, open, defensible

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Terms of Partnership - Part 1 of 2

Be clear on what value you are willing to bring to the table at time of first discussion:

•  Cash •  Non-Cash Equity Exchange •  Technology •  Services •  Preferred Licensing •  Future Royalties •  Other?

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Terms of Partnership - Part 2 of 2

Be clear on your ask of the Healthcare System partner at time of first discussion:

•  Determining the Value Proposition of the Intervention •  Demonstrating Utility in a segment test-bed or “safe sandbox” •  Utilizing Healthcare System Brand/Endorsement •  Providing/Defining Market Opportunity (through Healthcare System

Dissemination Partnerships) •  Co-Development & Integration assistance (EHRs etc) •  Clinical Trial for regulatory clearance (FDA) •  Demonstration Site •  Future Customer relationship •  Cash Investment •  Other?

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Questions? Strategies for Startups to Partner with Healthcare Systems

Gregory J. Moore, MD, PhD Chief Emerging Technology and Informatics Officer Director, Institute for Advanced Application Twitter: @GJMooreMDPhD

gjmoore@geisinger.edu