Standard Handout

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Creating a 21st CenturyIntelligent Health
System in Louisiana
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Newt GingrichFounder, Center for Health
TransformationBobby JindalGovernor, Louisiana
The Future of Health and Healthcare in Louisiana
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Panel I Designing an Effective and
Efficient Health Delivery System in Louisiana
Moderator Alan Levine, Secretary, Louisiana
Department of Health and Hospitals Panelists N
orm Nichols, General Manager, Unisys William
Pinsky, MD, Chief Academic Officer, Ochsner
Health System Shannon Robshaw, MSW, Executive
Director, Louisiana Health Care Quality
Forum Russ Thomas, JD, Chief Operating Officer,
Availity
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Alan Levine SecretaryLouisiana Department of
Health and Hospitals
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Norm NicholsLouisiana Executive Account
ManagerUnisys
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Key Recommendations

• Design Health Information Data Interoperability
• Across multiple agencies
• With multiple providers
• With multiple benefit designs
• Architect Health IT for
• Provision for provider patient portals
• Robust electronic medical record

Sponsor Logo
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Key Recommendations

• Establish Health Information Technology that has
• Ability to implement what if changes quickly
  and simply
• Policy
• Program
• Benefit plan
• Payment methodology

Sponsor Logo
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William W. Pinsky, M.D.Executive VP for System
Medical Affairs and Chief Academic
OfficerOchsner Health System
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Key Issues

• Medical information sequestered in Doctors
  offices, hospitals, and other provider locations
• Medical information not routinely available to
  patients
• Health information not consistently provided
  in a timely manner to patients
• Too much variability in preventive care and
  disease management

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Key Recommendations

• With the patient in the center, as a participant
  and custodian, information is available outside
  practice confines
• Patient information needs to be interoperable,
  i.e. the PHR concept
• PHR through a Patient Portal with intelligence
• Hospital information through a Doctor Portal
• EHR to include decision support for both
  Providers and Patients

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Shannon Robshaw, MSWExecutive DirectorLouisiana
Health Care Quality Forum
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Key Principles for HIT / HIE Adoption and
Expansion in Louisiana

• HIT and HIE adoption and expansion should
  demonstrate measurable improvements in health
  care quality or efficiency.
• HIT and HIE adoption and expansion should be
  patient-centric and empower both consumers and
  providers.
• HIT adoption should be standards-based
• HIT and HIE expansion should leverage and build
  upon lessons-learned.
• Providers and stakeholders should embrace HIT and
  HIE.
• Governance and collaborative models should be
  used for public/private HIT and HIE initiatives.

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Roadmap for Success

• Make clinical data available for quality
  assessment, program evaluation, and outcome
  evaluation.
• Engage and inform health care consumers and
  promote consumer ownership of health information.
  
• Leverage existing HIT assets capabilities
  assess interoperability readiness.
• Facilitate provider adoption of the electronic
  health record.
• Establish a public-private collaboration
  /coordination framework for HIE initiatives
  statewide, and support a locally controlled
  governance model at the community level.
• Simplify the HIE process by leveraging common
  infrastructure when possible, and implementing a
  model which ensure technical feasibility and
  scalability.
•  

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Russ Thomas Executive Vice President Chief
Operating OfficerAvaility, LLC
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Availity Connecting Communities
Availity Health Information Network
gt50,000 Registered Sites
gt150 Direct Payers gt1,150 Indirect Payers

• Administrative
• Clinical
• Financial

gt1,000 Hospitals
gt400 Vendor Partners - Clearinghouses -
Practice Management Systems - Electronic
Medical Record Systems
27,000,000 Owner Members
100,000 Owner Employers
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Drive Efficiency and Prove Return on Investment
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Panel II Achieving Optimal Health and
Wellness for a Productive Louisiana
Moderator Reed Tuckson, MD, Executive Vice
President and Chief of Medical Affairs,
UnitedHealth Group Panelists Bill Ellis, RPh,
MS, Executive Director and CEO, American
Pharmacists Association Foundation Dr. Lawrence
Goldman, Vice President, ValueOptions Michael
Gorton, MS, JD, Chief Executive Officer, TelaDoc,
Inc.
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Reed Tuckson, MD Executive Vice President
Chief of Medical AffairsUnitedHealth Group
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William M. Ellis, RPh MSExecutive Director
CEOAmerican Pharmacists Association Foundation
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Key Recommendations

• Provide access to self-management coaching for
  patients in relevant lifestyle areas, such as
  smoking cessation, diet, exercise and nutrition
  to reduce the incidence and risk of uncontrolled
  chronic disease
• Improve patient access to needed health care
  services by waiving or reducing co-pays (i.e.
  medications for chronic disease)
• Provide at least one annual pharmacist-delivered
  medication therapy management review for every
  patient and more frequent reviews for those
  taking a significant number of medications
• Align incentives between payers, providers and
  patients to receive these services

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Dr. Lawrence Goldman VP, Strategic Planning and
DevelopmentValueOptions
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Key Recommendations

• Create a coordinated, organized behavioral
  health system across the state with multiple
  access points to services and health information
• Develop a program that is focused on recovery and
  resiliency that increases health literacy,
  empowers shared decision making, with
  person-centered planning and person-directed
  services across the lifespan
• Build a system with creativity in service
  delivery not just case management, but care
  management

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Key Recommendations

• Build a system with strong outreach to all
  stakeholders from consumers to families to
  advocates to providers.
• Create the system that understands the
  behavioral health connection to physical health
  disease states leverage systems that address the
  decreased lifespan of those who suffer serious
  mental illness

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Michael Gorton, MS, JD Chief Executive
OfficerTelaDoc, Inc
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Telephone Based Cross Coverage

• Employer/Patient Benefits
• Physician Access within 30 Minutes
• Availability 24 / 7 / 365
• Reduced healthcare costs
• Reduced absenteeism
• A proactive health benefit
• Recruiting and retention tool
• Enhances wellness programs
• Enhances disaster preparedness
  initiatives

• Physician Benefits
• Better Pay
• Physicians get Lifestyle Through Shorter/More
  Controlled Hours
• Simple Delivery System
• All Tools Provided
• Medical Malpractice Provided
• Fully-portable EHR free for all participating
  physicians
• Cross Coverage Now Paid

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Key Recommendations

• Work with Legislature to develop Model Language
  defining Standards of Care.
• Implement Statewide program to save dollars and
  improve patient access, while producing more
  physician revenue.
• Develop emergency response and pandemic protocols.

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Panel III A Community Approach to
Managing Diabetes and Obesity
Moderator Tim Church, MD, MPH, PhD, Pennington
Biomedical Research Center Panelists Laura
Fields, PharmD, Associate Vice President,
Metabolism Marketing, sanofi-aventis Jay
Hedlund, Head of Medicare Diabetes Screening
Project, Novo Nordisk Sayeed Ikramuddin, MD,
Director, Gastrointestinal Surgery, University
of Minnesota, (for Covidien)
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Tim Church, MD, MPH, PhD Director of Preventive
MedicinePennington Biomedical Research Center
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Diabetes Trends Among Adults in the U.S.
4-6
6-8
8-10
gt10
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Costs of Diabetes

• Stroke
• Heart attack
• Cancer
• Kidney failure
• Neuropathy
• Amputation
• Retinopathy
• ETC, ETC, ETC
• 2007 Total economic costs of diabetes estimated
  to be 174 billion
• 23.6 million Americans have diabetes (_at_8 of
  population)

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Laura Fields, PharmD Associate Vice President,
Metabolism Marketingsanofi-aventis
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Jay Hedlund Director, Medicare Diabetes
Screening ProjectNovo Nordisk
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Key Recommendations

• Define your target Make your task manageable
  Medicare beneficiaries at risk for diabetes
• Use the tools you already have available
  Medicare screening benefit prevention studies
  network of senior organizations health care
  providers and community health officials
• Involve all the constituencies who care Go
  where people live, work, play and pray include
  non-traditional allies

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Key Recommendations

• Create actionable tools for supporters to use
  brochures, church bulletins, flyers, palm cards,
  health fairs, community events
• Support public and private policies that invest
  in screening and prevention

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Sayeed Ikramudin, MD Director, Gastrointestinal
SurgeryUniversity of Minnesota (for Covidien)
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Dr. Claude Bouchard Executive DirectorPennington
Biomedical Research Center
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Newt Gingrich FounderCenter for Health
Transformation
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Panel I Designing an Effective and
Efficient Health Delivery System in Louisiana
Moderator Alan Levine, Secretary, Louisiana
Department of Health and Hospitals Panelists N
orm Nichols, General Manager, Unisys William
Pinsky, MD, Chief Academic Officer, Ochsner
Health System Shannon Robshaw, MSW, Executive
Director, Louisiana Health Care Quality
Forum Russ Thomas, Chief Operating Officer,
Availity
39
Panel II Achieving Optimal Health and
Wellness for a Productive Louisiana
Moderator Reed Tuckson, MD, Executive Vice
President and Chief of Medical Affairs,
UnitedHealth Group Panelists Bill Ellis, RPh,
Executive Director and CEO, American Pharmacists
Association Foundation Dr. Lawrence Goldman,
Vice President, ValueOptions Jamie Schlottman,
Market President, Louisiana and South
Mississippi, Humana
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Dr. Lawrence Goldman VP, Strategic Planning and
DevelopmentValueOptions
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Key Recommendations

• Create a coordinated, organized behavioral
  health system across the state with multiple
  access points to services and health information
• Develop a program that is focused on recovery and
  resiliency that increases health literacy,
  empowers shared decision making, with
  person-centered planning and person-directed
  services across the lifespan
• Build a system with creativity in service
  delivery not just case management, but care
  management

42
Key Recommendations

• Build a system with strong outreach to all
  stakeholders from consumers to families to
  advocates to providers.
• Create the system that understands the
  behavioral health connection to physical health
  disease states leverage systems that address the
  decreased lifespan of those who suffer serious
  mental illness

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Panel III A Community Approach to
Managing Diabetes and Obesity
Moderator Tim Church, MD, MPH, PhD, Pennington
Biomedical Research Center Panelists Laura
Fields, PharmD, Associate Vice President,
Metabolism Marketing, sanofi-aventis Jay
Hedlund, Head of Medicare Diabetes Screening
Project, Novo Nordisk Sayeed Ikramuddin, MD,
Director, Gastrointestinal Surgery, University
of Minnesota, (for Covidien)
44
Tim Church, MD, MPH, PhD Director of Preventive
MedicinePennington Biomedical Research Center
45
Diabetes Trends Among Adults in the U.S.
4-6
6-8
8-10
gt10
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Costs of Diabetes

• Stroke
• Heart attack
• Cancer
• Kidney failure
• Neuropathy
• Amputation
• Retinopathy
• ETC, ETC, ETC
• 2007 Total economic costs of diabetes estimated
  to be 174 billion
• 23.6 million Americans have diabetes (_at_8 of
  population)

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Sayeed Ikramuddin, MD Director of Bariatric
Surgery University of Minnesota, Minneapolis
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Saydah, S.,et al. JAMA 291 335-342
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• p lt 0.001
• University of MN Unpublished data

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Weight loss and diabetes resolution
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• Bariatric surgery is the best tool available for
  sustained weight loss in the obese diabetic
  population
• Success should be measured not only by weight
  loss reduction but also by co morbidity
  resolution.
• Follow up for bariatric surgery should be
  lifelong, scheduled and mandatory
• Follow up should be a package plan
• Statewide bariatric registry is best option to
  track outcomes and recognize complications

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Creating a 21st CenturyIntelligent Health
System in Louisiana