Our view on remote / telehealth and data

1. M-health for cost savings
and care management
Andy Arends
Managing Principal
Health Plan Innovation & Consulting, Dell
Phil Patterson
Executive Vice President
HealthNetConnect

2. 2
Agenda
Introductions
M-health – what are we really talking about?
What are we trying to accomplish?
What is keeping us from being successful?
A case study of success.
What is the path forward?

3. 3
What does Dell
know about
healthcare?
Services

4. 4
Dell health plan strength and numbers
Working with Top Health Plan Organizations
ACO Strategy
A marketplace where
provider and Payer can
communicate through our
secure hosting of provider
records and payer claims –
improving transparency for
ACO adoption
Dell Private Exchange:
Leveraging our learning's
from the countries first
exchange that is run by us
at Massachusetts
Consumerism
Assess and spread your reach
to consumers through digital
experience and mobility. Use
Social Media to reach
individuals for both sales and
improving a payer’s brand
image.
Everest Group
Positioned as Leader and
Star Performer in Payer
ITO Service Provider
Landscape (2013)
Strength and FocusDell Health Plan Facts and Figures:
More than 500
technology partners
14,000+ Healthcare associates
globally. 6,000+ Healthcare
Payer associates globally
Serving 100+ insurance
organizations, Support for
100+ million policy holders
1.3M enrollments per annum,
98% of changes processed
within 48hrs
11M+ calls handled annually,
310k items audited
approximately each year
96M+ claims processed
annually, 99% of claims
processed within SLA
• Kaiser Permanente
• WellPoint
• Aetna
• CIGNA
• Humana
• Harvard Pilgrim Healthcare
• IEHP
• Emblem Health
• Blue Cross Blue Shield of Rhode Island
• UnitedHealthGroup
• Massachusetts Connector
• Community Health Plan of Washington
• Physicians Plus Insurance Corporation
• WellCare
• CareSource
• NAMM California
• WPS
• Delta Health
• Kern Health
• Blue Cross Blue Shield of Michigan
Horses for Sources (HfS)
High Performer in the 2013
Blueprint Healthcare Payer
Report

5. 5
Dell remote & tele-health

6. 6
Sources of innovation @Dell
Our customers’ most
important challenges:
clarity of strategy and
sequencing of solutions
New offerings
Leveraged across multiple platforms
and models
Hardware, infrastructure,
and cloud computing
Software and integration Services
Dell’s domain expertise
Our work in
other
industries
External inputs
and ideation
Our work with our
healthcare clients

7. 7
M-health—what
are we really
talking about?
Services

8. “(T)he use of medical information exchanged from one
site to another via electronic communications to
improve a patient’s clinical health status. Telemedicine
includes a growing variety of applications and services
using two-way video, email, smart phones, wireless
tools and other forms of telecommunications
technology.”
~American Telemedicine Association

9. 9
Intel global innovation survey

10. 10
Commercial Clinical
PersonalProfessional
Personal
activity
tracking Blood testing
Mobile
diagnosis
Retail clinic
Retail weight / BP High-risk
pregnancy
Web
appointment
Home fetal
monitor
CHF
readmission
Weight /
sleep monitor
Where m-health is deployed today
Web coaching

11. 11
Commercial Clinical
PersonalProfessional
Apple

12. 12
How are you
using m-health
today?
Remote visits2
Wellness
support
3
Retail visits4
Remote
monitoring1
Incentive
programs
5
Not using at
all
6
Poll the audience

13. 13
Goals of
m-health
Services

14. 14
Goals of m-health
Economics
• Readmission
reduction
• Reimbursement
maximization
Quality
• More accurate /
appropriate
monitoring
• More proactive
interventions
• More successful
interventions
Engagement
• HEDIS / CAHPS
score improvement
• Member churn
reduction
• Health / wellness
engagement
Access
• Rural / provider
constrained areas
• Efficient specialist
access
• Timeliness /
persistence of access

15. 15
Poll the audience
What are the
barriers
m-health
usage?
Technology
platforms
2
Cost3
Interoperability/
integration
4
Provider
engagement1
Lack of proven
outcomes
5

16. 16
Case study
Services

17. 17
Deliver easy to use
technology that empowers
patients and healthcare
professionals to collaborate
on the management of the
their health…while lowering
costs and increasing the
availability of healthcare.
Our VideoDoc solution
provides an innovative virtual
clinic that goes beyond video
conferencing and consumer
devices. VideoDoc is HIPAA
and HITECH compliant and
FDA and CE registered.
Healthcare Delivery, Reimagined
Our Mission / Our Solution

18. 18
CMS 2015
COVERAGE FOR
REMOTE
MONITORING
PENALTIES FOR
READMIT 2-3%
HEALTH PLAN
AND PROVIDERS
ROLE IS
BLURRED
# OF PATIENTS
INCREASING, #
OF FACILITIES
INFLECTION
POINT IN THE
INDUSTRY
Why telemedicine?
The time is now

19. 19
Use Cases
Remote Medicine
• HC professional to HC
professional
• Triage and/or Urgent
Care
Remote Medicine
• HC professional to HC
professional
• Triage and/or Urgent
Care
Remote Patient
Monitoring
• Patient to Healthcare
Professional
• Uses: Chronic Disease
Management
Remote Patient
Monitoring
• Patient to Healthcare
Professional
• Uses: Chronic Disease
Management

20. 20
• 11” Tablet given to patients
for home use
• HIPAA and HITECH
compliant
videoconferencing solution
11” Venue VideoDocTM
VideoDocTM
• All-in-One Medical PC
• Touchscreen
• Perfect for physician
offices and hospital
settings
23” VideoDocTM Cart

21. 21
Handheld ECG

22. A Pilot Study of Integrated
Tele-monitoring and Virtual
Provider Appointments
Department of Internal Medicine, Section of
Cardiology, Providence Hospital and Medical
Centers, Southfield, Michigan

23. 23
Heart failure in the United States
*Centers for
Disease
Control &
Prevention
Point 4
About half of
people who
develop heart
failure die within 5
years of
diagnosis.
Point 1
About 5.1 million people in
the United States have
heart failure.
Point 2
One in 9 deaths
in 2009
included heart
failure as
contributing
cause.
Heart failure costs the nation an
estimated $32 billion each year.3 This
total includes the cost of health care
services, medications to treat heart
failure, and missed days of work.

24. 24
CHF study
Group 2
14 received standard care
but added:
• Daily remote monitoring of
blood pressure, heart rate,
oxygen saturation, and weight
via the Health Net Connect
telemonitoring system for 3
months
• Received weekly video calls to
discuss care issues, answer
questions, and monitor
compliance with medication
regimens and office visits
Group 1
14 received standard care
28 patients
enrolled in study,
randomized 2
groups
There were no statistical differences in
baseline clinical characteristics, laboratory characteristics or
heart failure medications between both groups

25. 25
CHF study results

26. 26
Addressing the barriers
• Collaborate in developing and rolling out the program
• Provide additional support (e.g., clinical and member welcome
outreach / help desk)
• Link to pay for quality
Provider
Engagement
• Focus on clinical grade equipment and “light” platform that integrates
• Simple reporting / registries that align with existing efforts
• Create API / web service integration points for connectivity to health
plan and provider care management / EMRs
Technology
Platforms /
Integration
• Shared economic model integrated with other pay for quality efforts
• Sufficient scale to spread costs across volumes
• Integration with existing care management efforts
• Outsource low value-add support
Cost
• Rewards & gamification
• Clinician encouragement
• “Out of Box” experience
Member /
Patient
Engagement
• Pilot and fail fast
• Focus on the simple measures and programs
Proven
Outcomes

27. 27
Where to next?
Services

28. 28
Where we’re investing
Care Management
Anywhere
delivery
Licensed and
credentialed MDs
and Nurses to
provide care
Remote monitoring and
care delivery
Cutting edge remote monitoring
and telemedicine solutions to
ensure quality of care
Coordination
of care
HIE solutions to
provide
comprehensive
view of patient
care
Wellness and
disease
management
Patients take action
on their own health
through online
tools

29. What about
you?

30. Thank you
Contact information:
• Andy Arends: andrew_arends@dell.com
• Phil Patterson: ppatterson@healthnetconnect.com