1 Building Transformation | April 21, 2018 | CCPL Vancouver
VALUE-BASED HEALTHCARE IN CANADAAN INDUSTRY PERSPECTIVE
NEIL FRASERPRESIDENT, MEDTRONIC CANADA
November 8, 2018
MEDICAL TECHNLOLOGY IS WHAT WE DO. IT’S WHAT WE’VE ALWAYS DONE.
And although you may know us as the pacemaker company, the diabetes pump maker, or deep-brain stimulation experts
we do so much more.
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Last year, Medtronic technology improved the lives of more than 70 million people.
That’s 2 people every second.
Value-based Healthcare in Canada | November 8, 2018 | CCCF
VALUE DEFINED
HARVARD
“The health outcomes achieved that matter to patients relative to the cost of achieving these outcomes.”
VALUE =OUTCOMES
COSTSClinical, Functional, PRO/Satisfaction, Surrogate
People, Equipment, Space, Consumables
HEALTHCARE PROVIDERS
Right Treatment Right Patient Right Time Provider Well-being
PATIENTS*
Affordable (for out-of-pocket) Timely appointment Confidence in the provider's
expertise Conveniently located
**https://patientengagementhit.com/news/how-do-healthcare-consumers-define-value-in-patient-centered-care
4 Building Transformation | April 21, 2018 | CCPL Vancouver
VALUE: AN INDUSTRY PERSPECTIVE
Co-founder, Earl Bakken, 1924-2018Seen here in his garage
EVALUATING VALUE VANCOUVER GENERAL HOSPITAL REVIEW OF COMPUTER ASSISTED SPINE SURGERY
Canadian Health Policy Institute:
HIGHER LEVEL OF ACCURACY WITH SCREW PLACEMENT: 95% VS 87%
LOWER RE-OPERATION RATE: 2 VS 15
FAVOURABLE ECONOMICSCOST SAVING AFTER 255 PROCEDURES/YR
PORTER’S 5 STRATEGIES FOR SHIFTING TO VBHC
1. Organize into integrated practice units
2. Measure outcomes and costs for every patient
3. Move to bundled payments for care cycles
4. Integrate care delivery across separate facilities
5. Expand excellent services across geography
6. Build an enabling IT platform
October 2013
6 Value-based Healthcare in Canada | November 8, 2018 | CCCF
LESSONS LEARNED FROM THE NETHERLANDS TO ACCELERATE VBHCMAY 2017
BIGGEST CHALLENGES
1. Measuring outcomes
2. Move to bundled payments (and away from fee-for-service)
3. Change culture + stimulate leadership
Published May 2017
GOALS100% patient access to digital EMR by 202050% of outcomes measured by 2021
©Medtronic plc 2016 All Rights Reserved.No further copying or dissemination without permission of Medtronic.
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THE PATH TO VALUE-BASED HEALTHCARE
Better experience (outcomes) + maximize resources (cost)
SYSTEM OPTIMIZATION
Better outcomes with guarantee
THERAPY OPTIMIZATION
Focus on population health & improved care models, including prevention
CHRONIC CARE MANAGEMENT
More integrated care across the continuum
EPISODIC CARE MGMT
44% reduction in mean wait time
14% increase inOR capacity
80 – 100% reduction in infections
38% reduction in readmissions
28% fewer post-surgery ED visits
82% more patients in glucose control
51% decrease in hospital readmissions
Value-based Healthcare in Canada | November 8, 2018 | CCCF
LESSONS WE HAVE LEARNED ALONG THE WAYCHALLENGES TO IMPLEMENTING VBHC
1Lack of
standardization
of outcomes
measurement
2Data (outcomes
& cost)
collection and
analysis are
challenging
4VBHC
procurement
process is in its
early stages; needs
development &
refinement
3Physician buy-in
and partnership
is critical for
success
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Implementing VBHC is hard work – it requires a new way of thinking, dedication, and heavy lifting
5Incentives
should be
aligned for all
parties
Value-based Healthcare in Canada | November 8, 2018 | CCCF
LESSONS FROM VBHC DESIGN DAY
Stop pursuing perfect
cost/outcomes data (repurpose existing)
Stop pursuing conceptual perfection
Decrease funding of pilots and consider
path to scale
Seek lessons learned from other industries
Work together earlier, particularly
with patients
Strengthen value-based procurement
capacity
Identify priority problems to solve
HOW YOU CAN HELP SUPPORT THE SHIFT TO VBHC
Be a agent of change
Focus on outcomes & costs, with data
Lead & collaborate
11 Value-based Healthcare in Canada | November 8, 2018 | CCCF
Q A
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