March 2012 Presented by Shawn McKenzie HFMA Northern California Spring Conference 2012 Silos to...
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Transcript of March 2012 Presented by Shawn McKenzie HFMA Northern California Spring Conference 2012 Silos to...
March 2012Presented by Shawn McKenzie
HFMA Northern CaliforniaSpring Conference 2012
Silos to Synergy
Next Generation
Health Information Technology Budgeting
The Allegory of the Cave…The Allegory of the Cave…
Time to alter our reality?
Our Industry is Unique… not differentOur Industry is Unique… not different
Healthcare Has a Culture
Science and TechnologyFinance Hospitality
We combine them all
In the beginningIn the beginning
Physician’s Guild & ApprenticeshipPhysician’s Guild & Apprenticeship
Patient Focused
Competitive Silos… The beginning of the Scarcity ParadigmCompetitive Silos… The beginning of the Scarcity Paradigm
Practice Focused
Single Shingle
Continued Growth of Silos and ScarcityContinued Growth of Silos and Scarcity
Competing Interests in a Fixed Demographic
The Status Quo Business Culture of HealthcareThe Status Quo Business Culture of Healthcare
We conduct our business in the throws of the Scarcity Paradigm• Protectionist• Fiercely Competitive• Narrowly Focused
1% to 2%Market Share
Market Catchment
DemographicMostly
StagnateGrowth
Enterprise ~ The Ultimate SiloEnterprise ~ The Ultimate Silo
IDN-1
IDN-3
• Same Community• Duplication of Services• None or Limited Systems Interoperability
Scarcity Paradigm is our RealityScarcity Paradigm is our Reality
The culture of silo delivery is now culturally baked into healthcare!
• Critical patient information is now a hook
• Continuity of care struggles against the healthcare business culture
• Patients and physicians are left to bridge the gaps
• Physicians are forced to act on partial data
• Costs in duplicative diagnostic studies rise
• Decision support is minimized
• Organizations spend millions on competing services
Three Legs of Healthcare DeliveryThree Legs of Healthcare Delivery
Clinical Care Delivery is Wanting of change. More interoperability and sharing of critical patient information regardless
of the source
Technology is Working on solutions to create,
secure, share and trend clinical information regardless of the
source
The business element of healthcare delivery is
Waiting for the axe to fall and holding onto the same old model
The Changing Healthcare Landscape The Changing Healthcare Landscape
Explosive, Uncertain, Unpredictable, Multi-directional, Heated, Threatening, Ominous
The Changing Patient DemographicThe Changing Patient Demographic
Patient Demographic• Less Tolerant• Expectant• Advocating• Critical
There is a growing discontent with the delivery model of healthcare. Patient advocacy groups have developed internationally to create a unified voice and express concerns that healthcare requires more transparency, oversight, uniformity and interoperability.
With Significant Cost Reduction
Archimedes Movement
AARP
The Changing Technology LandscapeThe Changing Technology Landscape
Technological Movements• Integration• Consolidation• Interoperability• EMR/EHR• Health Information Exchanges• PHR – Social Exchange
The technology available today is capable of supporting the goals of interoperability
Technology Can Bridge the Silos But it Will Not Transcend The Business Culture of Scarcity
The Changing Policy of Healthcare ReformThe Changing Policy of Healthcare Reform
Government Authority and Policy• ARRA• HITECH• Meaningful Use• ACO• HIE
The political platforms evident in Washington see “Reform” as a cost savings action focused on altering the fee for service model while promoting an improved care continuum and interoperability effective through the adoption of health information technology
With Expectations of Lower Cost and Higher Quality
Reforms Driving Change… (The carrot and the stick)Reforms Driving Change… (The carrot and the stick)
(ARRA) - Recovery Act Funding and Meaningful Use• The “green glue” and the “Race for the Mercedes”• Funding more silos?• Seeking standardization (SNOMED-CT, RADLEX, ICD-10)• Attempting to accelerate IT adoption in the care continuum (providers and patients) • Improve care and drive down costs
Accountable Care Organization (ACO)• Payment structure changing (Episodic)• Financial distribution is yet to be defined• Care continuum is fluid• Cost, Care, Outcomes and Patient Satisfaction
Private and Public Health Information Exchange (HIE)• Philosophically a great concept • Creates opportunities and challenges for a sustainable business models • Rudderless and adrift
Technology and public sentiment related to care delivery supported by government reforms, funding and policy, will force change to the
business model pervasive in healthcare today
With the fluid ability to cross-pollinate and share patient data across entities, affiliated or not, the business model of healthcare will shift to a
Synergistic Paradigm
Budgeting for Next Generation HITBudgeting for Next Generation HIT
Tyranny of the Urgent• ICD-10• FDA – 5010• Meaningful Use• SB-1237 Radiation Dose Monitoring• ACO
EHREHR
EHREHR
EHREHR
Budgeting for Next Generation HITBudgeting for Next Generation HIT
• Adopt Standards as part of every system build (SNOMED-CT, RADLEX, IHE) • Systems consolidation (Shrink your footprint)• Fewer independent systems (Boutique, Best of Breed, Proprietary) Cardiology is a perfect example• An enterprise systems and archive strategy capable of interacting with an “exchange”• Operational cost versus Capital cost
Budgeting for Next Generation HITBudgeting for Next Generation HIT
Does your organization have an articulated & codified HIT Strategy taking into consideration reform mandates and business objectives?
Does this strategy have a clear step-wise approach to the roadmap including procurement requirements that address the future of healthcare?
Do each of your purchase decisions utilize an “end game” analysis?
Strateeegery
Will your strategy address business outside of your silos?
Budgeting for Next Generation HITBudgeting for Next Generation HIT
EMR Portal Interface
Single
ViewerLifecycle
Management
Envision your technology enabling function beyond the walls and corridors of your organization or business affiliations
Think
Health Information Exchange
(Private and Public)
Technology Supporting Community MedicineTechnology Supporting Community Medicine
Creation of Community Health Interoperability
Business Model with Complete ExchangeBusiness Model with Complete Exchange
EMR Portal Interface
Single
ViewerLifecycle
Management
When patient data of all types is available to any provider, regardless of affiliation through the exchange, the need to
repeat studies, duplicate efforts and treat on partial information disappears.
So Does the Scarcity Paradigm Business Model
If we have data sharing, what happens to the revenue stream? How do we create a business model to support being everything to everybody
when the cash flow diminishes?
A Financial Exercise using the Synergistic ParadigmA Financial Exercise using the Synergistic Paradigm
Dialogue and DiscussionDialogue and Discussion
Next Generation Health Information Technology Budgeting
Shawn McKenzieCEO, Ascendian Healthcare [email protected]