Telehealth Services for better information, better Decisions and better Health

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Transforming Healthcare Through Connected Health
Technology - A Story from the United States

• Robert L. Jesse, MD, PhD
• Professor, Internal Medicine Cardiology
• Virginia Commonwealth University Health System
• and
• Chief, Office of Academic Affiliations
• Veterans Health Administration

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Disclosures

• Robert L. Jesse, M.D., Ph.D.
• Has no financial interest or relationships to
  disclose

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Healthcare Will Transform
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Why Healthcare Must Transform

• Priorities are changing
• People will embrace health as a personal
  attribute
• Cost to the individual will be an important
  driver
• Commoditization will occur at multiple levels
• Quality will be a given Efficiency will be the
  rule
• Individuals will own and manage all of their data
• Trusted health information will be the new
  currency
• Access will be defined through engagement

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Re-Envisioning Healthcare

• Health care becomes personalized according to an
  individuals needs and values Precision
  Health
• Still evidence-based care but individualized
  for me
• Quality for an n of 1 safety and prevention
  of harm
• Control shifts from health systems to the
  individual
• Individuals own the entirety of their health
  information
• That record is agnostic to the source and
  inclusive of all data generated by providers and
  by the individual
• Access is defined by whom patients choose to
  help
• Support health promotion, prevention and well
  being
• Navigate complex healthcare decisions

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Innovations Driving Healthcare Change

• Team-based care - PCMH (VA calls it PACT)
• Moving from encounters to sustained relationships
• Transactional coherent health information
• Health Management Platforms vs EMRs
• Data big and small
• Relationship-based care is Connected health

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Connected Health

• Connected Health is about sustaining the
  relationship between patient and healthcare
  system beyond the traditional bricks and mortar
  walls and thus empowering patients to manage
  their own health

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VA Connected Health TechnologiesProudly Serving
Veterans since 1984

• Telehealth Services
• Clinical Video Telehealth
• Home Telehealth
• Store and Forward Telehealth

• My HealtheVet Patient Portal
• VA Secure Messaging
• VA Blue Button
• Veterans Health Library
• Rx Refill/Tracking

• VA Mobile Health
• Patient Mobile Apps
• Provider Mobile Apps/ Devices
• Annie Text Messaging

The Phone The Smart Phone The Dumb Phone !
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Telehealth Services

• Services Provided in 2014
• 2.1 million episodes of care to 717,000 VA
  patients
• 45 of these patients live in rural areas
• 150,000 patients case-managed by home telehealth
• 250,000 patients used clinical video telehealth
  between VA clinics
• 4,000 received clinical video telehealth visits
  directly into their homes
• 380,000 used store and forward telehealth
  technology
• 75,000 implanted devices monitored remotely

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Connected Health Technologies - FY14
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VA App Store http//mobile.va.gov/appstore
VA Mobile Theres an App for That
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Telehealth Services - Impact

• Travel Reduction Savings
• Clinical Video Telehealth 34.45 per consultation
• Store and Forward Telehealth 38.81 per
  consultation

• Home Telehealth
• 54 reduction in bed days of care
• 32 reduction in hospital admissions
• 2,000 savings per annum per patient
• Video Tele-Mental Health
• 35 reduction in acute psychiatric bed days of
  care

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VA TeleMental Health Services FY 2003-2014
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The Health Care Reality

• Health care is an information business
• Its increasing - and increasingly complicated
• Most of which patients cant access
• or understand

The current Healthcare industry thrives on
information asymmetry
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Changing Dynamics of Healthcare

• Patients engage (us) as partners in their care
• We focus on preventive health
• We focus on chronic disease management
• We focus on patient outcomes
• They demand convenient, local and timely care
• They demand complementary/alternative care
• They demand readily available information
• including the ability to contribute to that data
  set

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What Will Healthcare of the Future Be?

• Healthcare is an information business
• Coherent and transactional - Logistics and scale
• Data big and small not just in the EMR
• As information asymmetry is reduced then
  Commoditization accelerates - the role of AI
• Managing data and information exchange is the new
  value proposition in healthcare
• Connected Health is the platform for this

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Better InformationBetter DecisionsBetter
Health
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END