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Boundaryless Hospital - Rethink and Redefine Health Care Management New Chains of Value Creation Partner and Head of McKinsey Hospital Institute Cologne, Germany Sören T. Eichhorst, MD PhD PROPRIETARY Any use of this material without specific permission of McKinsey & Company is strictly prohibited
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Boundaryless Hospital -

Rethink and Redefine Health Care

Management

New Chains of Value Creation

Partner and Head of McKinsey Hospital InstituteCologne, Germany

Sören T. Eichhorst, MD PhD

PROPRIETARYAny use of this material without specific permission of McKinsey & Company is strictly prohibited

McKinsey & Company | 1

Quantitative network analysis reveals hospital boundaries

SOURCE: McKinsey Hospital Akademie

Number of quotesn = 287

Individual staff

Medical unit

Functional unit

Nursing staff

Administration service

Administration

McKinsey & Company | 2

A gap exists between medical evidence and clinical practice

SOURCE: McKinsey Hospital Institute

Clinical practice

No generally accepted

quality metrics

Outcome-oriented

quality initiatives

Interfaces only

partially optimized

Seamless external

cooperation

Hospitals built around

professionals

Patient-centered

approach

Truly integrated

care still a vision

No sector

boundaries

Suboptimal internal

communication

Close exchange of all

professionals

Quality aspiration

McKinsey & Company | 3

The focus needs to be on value creation

SOURCE: McKinsey Hospital Institute

CostAccess

Quality

VALUE

McKinsey & Company | 4

Five major trends for value creation in hospitals

SOURCE: McKinsey Hospital Institute

Patient experience matters and can

be monetized

11

22

33

44

55

McKinsey & Company | 5

Factors influencing a patient’s choice of hospital

Patient experience matters…

SOURCE: 2007 McKinsey survey of >2,000 U.S. patients with commercial insurance or Medicaid and >100 U.S.

physicians; McKinsey Hospital Institute

Focus on clinical outcome and effectiveness

Care deliveryCare delivery

Clinical qualityClinical quality

Patient experiencePatient experience Focus on perceptions of care

Would you request a hospital if it wasdistinctive on patient experience?

Physician’s decision 21

Location18

Hospital reputation

20

Patient experience

41

In percent

Might or might not request

44

Would definitely request

56

In percent

McKinsey & Company | 6

… and can be monetized

SOURCE: 2007 McKinsey survey of >2,000 U.S. patients with commercial insurance or Medicaid and >100 U.S.

physicians; McKinsey Hospital Institute

Dimensions of patientexperience

Impact on hospital recommendation

Hospital recommendation

Best practice recommen-dation score

85%

Improved recommen-dationscore

81%

Improve-ment of high impact elements

13%

National average

68%

0

0

0

1

2

Physician communication

Responsiveness

Medication explanation

Facilities

Noise level

Pain management 10

Aftercare 15

Nurse communication 15

McKinsey & Company | 7

The way we see patients is changing

SOURCE: McKinsey Hospital Institute

Today Tomorrow

Population

based

approaches

Prevention and

prediction

Informed and

active patients

McKinsey & Company | 8

Five major trends for value creation in hospitals

SOURCE: McKinsey Hospital Institute

Patient experience matters and will

be monetized

11

Value based health care is key and will

be paid for

22

33

44

55

McKinsey & Company | 9

Comprehensive disease pathways are a tool for value creation

SOURCE: McKinsey Health Systems Institute – CRC Improvement Network project team

Surveillance and follow-up

Treatment/ management of disease

Palliative/end of life care

Primary prevention

Diagnosis and screening

▪ Prevention to end-of-life care

▪ Full range of interventions

▪ Comprehensive international evidence base

▪ Prioritize how resources are allocated

▪ Efficacy

▪ Cost

▪ Specific diseases

▪ Condition groups

Focused

Comprehensive End-to-end

Evidence-based

McKinsey & Company | 10

Levels of cost are distributed across the pathway

Individual

cost buckets

Pathway stage

total spend

Cost waterfall tool – absolute cost waterfall colorectal cancer improvement network

SOURCE: McKinsey Hospital Institute

McKinsey & Company | 11

Five major trends for value creation in hospitals

SOURCE: McKinsey Hospital Institute

Patient experience matters and will

be monetized

11

Value based health care is key and will

be paid for

22

Health care starts to converge towards a

provider-payor-life science continuum

33

44

55

McKinsey & Company | 12

Health care starts to converge towards a provider-payer-lifescience continuum

Example globally integrated player Fresenius

SOURCE: Fresenius website; McKinsey Hospital Institute

Vamed

5

Kabi

Helios

17

24

Medical Care

54

100% = 20.4 bn EUR

▪ Medical Care - dialysis machines and

dialysis centers

▪ Kabi - infusion therapy, clinical nutrition

and home care

▪ Helios - integrated health care provider

(hospitals, rehab clinics)

▪ Vamed - consulting, planning, developing

and running of health care facilities

▪ Netcare - IT services, business processes

solutions

Fresenius’ Business Units

Revenues in percent

McKinsey & Company | 13

Medtech and Pharma companies use support services to deepen partnerships with providers

Business modelHospital needs Example

Improve operating margin

Debottlenecking and implemen-tation of new clinical pathways

Reduce burden on balance sheet

Pay-for-usage models

Optimize patient referrals

Support referral networks

SOURCE: McKinsey Hospital Institute

McKinsey & Company | 14

Five major trends for value creation in hospitals

SOURCE: McKinsey Hospital Institute

Patient experience matters and will

be monetized

11

Value based health care is key and will

be paid for

22

Health care starts to converge towards a

provider-payor-life science continuum

33

New technology will be fully exploited44

55

McKinsey & Company | 15

160.000 Terabyteglobal medical imaging scan

data volume p.a.

8,000,000 millionMRT scans in Germany

2 Terabyteraw reads from sequencing

1 human genome

19,000,000,000claims data sets collected

by German payors p.a.

Full exploitation of new technology

SOURCE: McKinsey Hospital Institute

McKinsey & Company | 16SOURCE: McKinsey Hospital Institute

Five predictions for digitalization of health care

▪ Patients start to assume more responsibility for

their own data

▪ Real world will become the norm

▪ Sensor data as “new source of data” surpass

digital imaging as biggest data asset

▪ Personalized care plans will be faster in the

market than personalized medicine

▪ Analytical capabilities are necessary to keep up

with the champions

McKinsey & Company | 17

Embracing IT solutions creates value

SOURCE: Press; company websites

Innovative documentation, database search, consulting, training

Timely data collection from multiple sources across the health care

value chain

Handheld apps for transmission of stethoscope sounds, ultrasound,

otoscopy, etc.

Mobile telehealth platform - medical consultations and triage via any

device anywhere globally

Wireless sensors allows patient monitoring at ICU-level

McKinsey & Company | 18

Five major trends for value creation in hospitals

SOURCE: McKinsey Hospital Institute

Patient experience matters and will

be monetized

11

Value based health care is key and will

be paid for

22

Health care converges towards a

provider-payor-life science continuum

33

New technology will be fully exploited44

Disruptive changes and innovative

hospital concepts will appear

55

McKinsey & Company | 19

Principles

ParkinsonNet is an example for a regional initiative driving quality andsaving cost

SOURCE: ParkinsonNet; Prof. B. R. Bloem, Nijmegen Medical center

11 Define catchment area or regional

hospital

Select dedicated therapists22

Track these therapists using guidelines

and tell them what to STOP doing33

Promote communication among them44

Establish 24/7 communication between

professionals and patients66

Make them visible55

McKinsey & Company | 20

How could the hospital of the future look like?

Today Tomorrow

Innovative hospital concepts

Balanced doctor-patient relation-ships

Up-to-date means of communication

SOURCE: McKinsey Hospital Institute

McKinsey & Company | 21

Value creation opportunities for hospitals

Value

Maximizing value in existing systems

Embracing benefits of new technology

Redefining health care

Time

SOURCE: McKinsey Hospital Institute


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