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High Tech, High Touch Health CareFebruary 5, 2015

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Tectonic Shift in Care Delivery

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Home is the fastest growing care setting in the US.

Source: AHRQ, Agency for healthcare research and quality

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Care is Moving Home

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13.6M# of patients age 65

years or older discharged annually in

the US1

19.6%% of Medicare beneficiaries

rehospitalized within 30 days of discharge2

$33.6BLoss in productivity

attributed to employees caring for ‘aged

dependents’3

1. CDC, National Hospital Discharge Survey, number and rate of hospital discharge, 20102. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. New Eng J Med 2009;360:1418–283. Metlife Mature Market Institute and the National Alliance for Caregiving

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CMS bundled payment models

Managing larger at-risk populations

Desire to move patients to lower cost care settings – sooner

The Tectonic Shift

Hospitals will be responsible for readmissions

Value-based reimbursement for health systems

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The Tectonic Shift

➡ Chronic Care Management (CCM)

➡ Transitional Care Management (TCM)

New emerging care models

Continuous, informed care in the home

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Chronic Care Management (CCM) in the Spotlight

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Effective January 1, 2015 Medicare will begin reimbursing eligible providers for remote chronic care management under CPT Code 99490

Average payment of $40.39 per patient, per month

Total Medicare potential CCM reimbursement in 2015 $16B

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Chronic Care Management Requirements

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Two or more chronic conditions

Provider must establish comprehensive

care plan

Provide at least 20 minutes of non-face-

to-face care

Provider must have five specific capabilities to perform CCM:

Use a certified EHR

Maintain an electronic care plan

Ensure access to care

Facilitate care transitions

Remote coordination of care

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Enabling Technologies Powering Chronic Care Management

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Seamless Connectivity Platforms (RPM)

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1 C. Bock, L. Carnahan, S. Fenves, M. Gruninger, V. Kashyap, B. Lide, J. Nell, R. Raman and R. Sriram, “Healthcare Strategic Focus Area: Clinical Informatics,” National Institute of Standards and Technology, Technology Administration, Department of Commerce, United States of America, pp.1-33, September, 2005.2 Population Health Management, Volume 0, Number 0, 2014a, DOI: 10.1089/pop.2013.0107 5

Interoperability Security Scalability

Benefits / Outcomes• Interoperability among healthcare ICT systems would deliver a

national annual savings of $77.8 billion1 • Remote monitoring reduces readmission by 44%2

• Secure exchange of vital information across health care settings

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Exception-Based Management

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1 Weintraub AJ, Kimmelstiel C, Levine D, et al. A multicenter randomized controlled comparison of telephonic disease management vs automated home monitoring in patients recently hospitalized with heart failure: SPAN-CHF II trial. Program and abstracts from the 9th Annual Scientific Meeting of the Heart Failure Society of America, September 18-21, 200, Boca Raton, Florida. Recent and late breaking clinical trials.

Remote monitoring integration and

visualization of data

Reflex algorithms - near real-time alerts

Smart dashboards for efficient care management

Benefits / Outcomes• Reduce rehospitalizations for HF by as much as

72%1

• Deliver population level interventions • Focus resources based on documented needs • Manage large at-risk populations effectively

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Asynchronous Communication

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1 de Jong CC, Ros WJ, Schrijvers G, The Effects on Health Behavior and Health Outcomes of Internet-Based Asynchronous Communication Between Health Providers and Patients With a Chronic Condition: A Systematic Review, J Med Internet Res 2014;16(1):e19 2 Steventon A, Bardsley M, Billings J, et al. Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial. BMJ 2012;344:e3874 doi: 10.1136/bmj.e3874 (Published 21 June 2012)

Secure record sharing Near real-time therapy and medication adjustments

Dynamic care plan

Benefits / Outcomes• Decrease in physician visits1

• Increase in self-management/self-efficacy1

• Fewer emergency admissions (20% reduction)2

• Decrease in mortality rates (45% reduction)2

• Improve clinical collaboration

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Qualcomm Life CCM Solution

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Dynamic care plan

Secure access and sharing

Asynchronous communication

On-line medication management tools

Symptom tracking programs

Wireless remote patient monitoring

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Opportunity to Set New Standards

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High Tech, High Touch Best Practices

Brad TritlePresident/CEO,vitaphone