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Disrupting Cancer Care: Novel Ways to Bend Cancer Spending Trend Manali I. Patel, MD MSPH Instructor of Medicine, Hematology/Oncology Stanford University.

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Presentation on theme: "Disrupting Cancer Care: Novel Ways to Bend Cancer Spending Trend Manali I. Patel, MD MSPH Instructor of Medicine, Hematology/Oncology Stanford University."— Presentation transcript:

1 Disrupting Cancer Care: Novel Ways to Bend Cancer Spending Trend Manali I. Patel, MD MSPH Instructor of Medicine, Hematology/Oncology Stanford University School of Medicine

2 Overview Cancer Care Expenditures – Compared to Healthcare, Gross Domestic Product – Drivers of cancer expenditures Innovations in care delivery – Value Options and the “Triple Aim” – Clinical Excellence Research Center – Pilot test partners – Next steps

3 Annual Percent Increase GDP, Healthcare, Cancer costs National Cancer Institute 2012

4 Expenditures Borne by Society 1: 10 spend > $18,000.00 out of pocket on care 1/3 patients used up savings for cancer care 2.65x as likely to file bankruptcy Ramsey 2013; Bach P 2013; Garber 2012

5 Value Improvement Options Sum = + + Care Delivery Innovations Focused Improvement Bursts Manage for Daily Improvement Adapted from W.E. Deming Health Care Professionalism +

6 Value Improvement Options Sum = + + Care Delivery Innovations Focused Improvement Bursts Manage for Daily Improvement Adapted from W.E. Deming Health Care Professionalism +

7 Value Improvement Options Sum = + + Care Delivery Innovations Focused Improvement Bursts Manage for Daily Improvement Adapted from W.E. Deming Health Care Professionalism +

8 The “Triple Aim” Population Health Experience of Care Per Capita Cost Better CareBetter Health Lower Cost Berwick D Health Affairs 2008

9 Clinical Excellence Research Center Better Health, Less Spending

10 Clinical Excellence Research Center: A Care Model Accelerator

11 CERC Design Process Unreasonable value improvement targets Knowledgeable inventors, trans-disciplinary Diverse panel of subject matter experts Exposure – “Design disciplines” – Relevant emerging science/technology Partnerships – Target-set, test, demonstrate and spread PayerPilot Partners

12 Design-thinking in Cancer? Patel MI 2013 Transdisciplinary Approaches to Improving Cancer Care, JOP, In Press;

13 Design-Thinking: Through the Patient’s Journey

14 Design-Thinking: Un-Met Needs Patient CaregiverProviderStaffPayer Wait timesBurn-outTimelinessWait timesClaims RespectCommunicationQuality careSchedulingData ComfortDistractionsAdministrativeAuthorizationsCosts AnxietySpace CommunicationFollow-up plansSatisfaction Goals AnxietyFollow-up plansComfortScheduling

15 Design-Thinking: Opportunities Wait Times CommunicationSupport Inform, engage patients Improve workflow, Engage families and patient and caregiversfewer tasks, delegation, Websites and videos Comfortable environment“Lean” clinics Educational activities

16 Design-Thinking: Solution Validation

17 Design-Thinking: Concept

18 CERC Design Product: Advanced Cancer Care Respect patient and family goals – 1:1 Care Guides Immediately relieve symptoms – Protocol-driven symptom control Optimize care at and near home – Appointments, chemotherapy closer to home ~ 30% Net Reduction in Annual US Spending Patel MI 2014

19 Next Steps Other pilot test sites – Similar model of co-design – Demonstration/Evaluation – Spread Translate research into practice and policy

20 Summary Rapid growth of health expenditures Expenditures largely borne by society Addressing targets bends spending trends Satisfaction and clinical outcomes important Value improvement options are needed Can innovative care delivery models succeed?


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