Transforming Healthcare Through Connected Health
Technology - A Story from the United States
Robert L. Jesse, MD, PhD
Professor, Internal Medicine – Cardiology
Virginia Commonwealth University Health System
and
Chief, Office of Academic Affiliations
Veterans Health Administration
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Disclosures
Robert L. Jesse, M.D., Ph.D.
Has no financial interest or relationships to disclose
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Healthcare Will Transform
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Why Healthcare Must Transform
• Priorities are changing:
– People will embrace health as a personal attribute
– Cost to the individual will be an important driver
– Commoditization will occur at multiple levels
– Quality will be a given – Efficiency will be the rule
– Individuals will own and manage all of their data
– Trusted health information will be the new currency
– Access will be defined through engagement
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Re-Envisioning Healthcare
• Health care becomes personalized according to an
individual’s needs and values – “Precision Health”
– Still evidence-based care… but individualized for me
– Quality for an ‘n of 1’ + safety and prevention of harm
• Control shifts from health systems to the individual
– Individuals own the entirety of their health information
• That record is agnostic to the source and inclusive of all
data generated by providers and by the individual
– Access is defined by whom patients choose to help:
• Support health promotion, prevention and well being
• Navigate complex healthcare decisions
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Innovations Driving Healthcare Change
• Team-based care - PCMH (VA calls it PACT)
– Moving from encounters to sustained relationships
• Transactional coherent health information
• Health Management Platforms vs EMRs
• Data big and small
• Relationship-based care is Connected health
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Connected Health
Connected Health is about sustaining the relationship
between patient and healthcare system beyond the
traditional bricks and mortar walls and thus
empowering patients to manage their own health
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VA Connected Health Technologies
Proudly Serving Veterans since 1984
Telehealth Services
• Clinical Video Telehealth
• Home Telehealth
• Store and Forward
Telehealth
VA Mobile Health
• Patient Mobile Apps
• Provider Mobile Apps/ Devices
• Annie – Text Messaging
My HealtheVet Patient
Portal
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VA Secure Messaging
VA Blue Button
Veterans Health Library
Rx Refill/Tracking
The Phone
The Smart Phone
The Dumb Phone !
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Telehealth Services
Services Provided in 2014:
 2.1 million episodes of care to 717,000 VA patients
 45% of these patients live in rural areas
– 150,000 patients case-managed by home telehealth
– 250,000 patients used clinical video telehealth between
VA clinics
– 4,000+ received clinical video telehealth visits directly
into their homes
– 380,000 used store and forward telehealth technology
– 75,000 implanted devices monitored remotely
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Connected Health Technologies - FY14
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VA Mobile: There’s an App for That
VA App Store http://mobile.va.gov/appstore
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Telehealth Services - Impact
Home Telehealth
 54% reduction in bed days of
care
 32% reduction in hospital
admissions
 $2,000 savings per annum
per patient
Travel Reduction Savings:
 Clinical Video Telehealth
$34.45 per consultation
 Store and Forward Telehealth
$38.81 per consultation
Video Tele-Mental Health
 35% reduction in acute
psychiatric bed days of care
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VA TeleMental Health Services
FY 2003-2014
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The Health Care Reality
Health care is an information business
• It’s increasing - and increasingly complicated
• Most of which patients can’t access
…or understand
The current Healthcare industry
thrives on information asymmetry
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Changing Dynamics of Healthcare
• Patients engage (us) as partners in their care
– We focus on preventive health
– We focus on chronic disease management
– We focus on patient outcomes
– They demand convenient, local and timely care
– They demand complementary/alternative care
– They demand readily available information
• including the ability to contribute to that data set
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What Will Healthcare of the Future Be?
Healthcare is an information business
Coherent and transactional - Logistics and scale
Data big and small – not just in the EMR
As information asymmetry is reduced then
Commoditization accelerates - the role of AI
Managing data and information exchange is the
new value proposition in healthcare
Connected Health is the platform for this
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Better Information
Better Decisions
Better Health
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END
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