Building Health 2.0 into the Delivery System

Scott Shreeve, MDChief Executive Officer

April 14, 2009

Agenda

/ Intro/ Panelist/ Discussion/ Presenters/ Discussion

Integrated/GH Academic/BIDMC Group/DHCM Independent/RenH

Integrated/Kaiser Interdependent/Myca Independent/Google

The Cathedral and the Bazaar

vs

Cathedral CareVertical

HospitalServices

Ancillary Services

PhysicianServices

PatientServices

Characteristics:• Kaiser, Group Health, Geisinger, etc• Optimization at the system level• Full coordination of care• Information technology supports• Incentives aligned for outcomes• Reward for results• Patient consumer for life• Consumer is guided through process

Bazaar CareNon - Integrated

PhysicianServices

Characteristcs:• Fee for Service• Optimization at the component level • Disease Care• Lack of coordination• No Accountability• Consumer left to navigate• Incented for volume not value

Ancillary Services

ConsumerServices(None)

HospitalServices

Transformation

Current System

H2.0

Future System

The BazedralVirtual Health 2.0 Opportunity:

• Software/services integration layer• Coordinates patients, providers, and payment• Dramatic increase in health care value

Key points of “Virtualization”• Financing (payment / business models)• Delivery (new types of arrangements)• Incentives (increased $ for increased value)

Org

aniz

ing

Entit

y

PhysicianServices

Ancillary Services

ConsumerServices(None)

HospitalServices

Perspectives

James Hereford• VP Quality, Group Health• Integrated Delivery System

John Halamka, MD• CIO, BIDMC• Academic Medical Center

Dan Caruso, MD• Med Director, Dartmouth• Community Group Practice

Rushika Fernadouplle, MD• Founder, Renaissance Health• Individual Medical Clinics

Integrated Academic Group Independent

Cathedral or Bazaar?

vs

Ferrari Medicine

Ferrari Medicine

vs

Independent or Systemic?

Virtual

Org

aniz

ing

Entit

y

PhysicianServices

Ancillary Services

ConsumerServices(None)

HospitalServices

Vertical

HospitalServices

Ancillary Services

PhysicianServices

PatientServices

vs

Vertical or Virtual?

vs

On or Off the Grid?

PresentersRoni Zieger, MD• Project Manager, Google Health

Sean Khoizon, MD• Medical Director, Hello Health

Ted Eytan, MD• Clinical Innovation, Kaiser Permanente

Integrated/KaiserInterdependent/Myca Independent/Google

Free Flow or Gated Stream?

vs

“Almost always, disruptive innovations such as these have been ignored or opposed by the leading institutions in their industries for perfectly rational reasons”

- Clayton Christensen

Per

form

ance

Sustaining or Disruptive?N

ew M

easu

re o

fP

erfo

rman

ce Time

Time

Incumbents win

New Entrants win

1. Enabling technology2. New Business Model3. Value Based Network

EHR

PHR

PHR

PHR

PHR

Phrm Provider

vs

Payor Patient

Tethered or Untethered?

Takeaway Memes

1.Health 2.0 from just Promise to the Practical

2.Innovation from Inside as well as Outside

3.Relationships from Paternalistic to Participatory

The enabling tools and technology of H2.0 arecreating the next Generation Health System NOW

Join In!