1. The Disruptive Potential of Virtual Care Trevor Jamieson May 8, 2015 Bmath(CS/Soft Eng), MD, MBI(soon), FRCPC Virtual Care Lead, WIHV Women’s College Hospital

2. A story….

3. The need….

5. Boiling the ocean!

6. Virtual Care (noun): any interaction between patients and/or members of their circle of care, occurring remotely, using any forms of communication or information technologies, with the aim of facilitating or maximizing the quality and effectiveness of patient care. What I’ve just described is the essence of “Virtual Care”

7. Virtual Care is the first disruption in health in a long time where we can finally forsee the patient actually moving back to the center of their care Parceling complex patients by disease doesn’t work, and neither will parceling them along geographic or institutional lines – and, in 2015, there’s no good need to. NOT an intervention for Hospital X’s patients But a tool for Patient X who receives care in the following settings…

8. Many of the most dangerous elements of our system are also properties of the system; they exist by the system’s very design… We need to build and incentivize systems that virtually eliminate the “transition” – not that perpetuate it Always risky – no matter how much you spend on it Risk minimized through task delegation, communication, accountability, contingency planning

9. A precondition for Virtual Care is the inevitable convergence of the consumer and health IT spaces

10. The key to this disruption is innovation and new post-institutional ways of thinking about data/people ~90 Apps BUT!!! Data is the same….how can one be BETTER???

11. ??? Apps My question is why we think healthcare has to be all that different

12. Promoting significant innovation, however, is hampered by significant infrastructural problems Identity management Privacy/Security Terminology Incentives Etc, etc, etc, etc… Data availability

13. At WIHV, our focus is to look at any problem from 3 main perspectives… Maximally Empowered Patient Cross-Silo Provider Team Innovator

14. …and to try to figure out how it can possibly work in this amazingly complex ecosystem Free-for-All Innovation Security, Effectiveness, Systemic Benefit, Etc… There is no innovation without some risk.

15. My challenge to all of you is this…for any product you’re creating, ask yourself the following questions: 1)To what extent can your product be used directly in real patient or provider decisions about health? (**Put the patient truly at the center**) 2)To what extent does your product represent a patient’s entire journey across the continuum of care? (** Think outside the silo**) 3)To what extent are you tackling the small percentage of patients in our system who generate dramatically out of proportion systemic costs? (**The complex are a rule, not an exception**) Together we can shake up the system and produce the tools the system needs for the patients who need them most! If not….WHY NOT???