1. Moving from Health Care to Life Care
May 13, 2019
Judy Murphy, RN, FACMI, LFHIMSS, FAAN
Chief Nursing Officer, IBM Global Healthcare

2. What we will cover:
Industry
Prevention
Engagement
Consumerism AI

3. 1. INDUSTRY Old Healthcare New Healthcare
Fee for service Pay for performance
Acute care, episodic focus Continuum of care, life focus
Volume Value
Process & delivery Quality & outcome
Employer-centric Consumer-centric
Prices unknown Cost transparency
One way dialogue Engaged & mobile
Transactional Brand loyal
Data poor & disconnected Integrated rich “big” data
Reactive Predictive & prescriptive
Standards Personalized & optimized

4. PAST FUTURE The New Model of “Care” Fee for Service Value-Based Care
Compete on Volume
Individual Patients
Focus on Illness, Episodic Encounters
Acute Care centric
Compete on Outcomes
Population Health Management
Focus on Health/Wellness, Prevention & Disease Management
Continuum of Care, all venues 4

5. Digital Healthcare Progression
Pop Health Management AI
Personalization
Precision Medicine
EHR Optimization
Analytics
Mobile Apps
Portals
Telehealth
Digital Reinvention
Digital Reinvention incorporates digital technologies like never before to create revenues and results via innovative strategies, products and experiences.
EHR Implementation
Digital transformation
Digital transformation digitizes whole aspects of a business producing customer experiences that support what individuals need or want.
Digitization
Digitization improves efficiency by applying technology to individual resources or processes. 5

6. 2. PREVENTION
Source: Bipartisan Policy Center,
TFAH/RWJF, Aug. 2013

7. Population Health Management Model
ENTIRE POPULATION
40-60%
20-25%
5-15%
2-3%
POPULATION
HEALTHY / LOW RISK
AT RISK
60+
CHRONIC
ACTIVE DISEASE
RISK STRATIFICATION
5-10%
15-20%
30-40%
40-50%
RELATIVE COST
No or very-low touch
Low touch
Medium to high touch
High touch
ENGAGEMENT
Fully automated
Validate from data
Mostly automated with , call, text, mobile app
Blended -retail outlet, care mgt, automated
Active Case Mgmt
OUTREACH
~20% of population drives ~80% of cost

8. Population Health Management
Health, Wellness and Prevention is the Goal
With Population Health Management,
we help move people from right to left –
and work to keep them there
Health care spending
Health Status
Healthy/
Low Risk
At-Risk
High
Risk
Active
Disease
Chronic 8

9. 3. ENGAGEMENT “Know me” “Engage me” “Empower me”
Capture and incorporate preferences
“Engage me”
What’s my history?
What are my preferences?
How will I respond?
What will motivate me?
Respect my privacy
Personalize offerings and services
Engage in the preferred dialog
Be relevant (“right information”)
Be consistent across touch points
Show sincerity -- “you care”
Give me the information I need
Shared Decision Making
Collaborative Care Planning
“Empower me”
Innovate to deliver quality, convenience and total experience
Connect me with relevant communities and chronic care networks
Demystify; simplify control and access
Enable action and convenience
Provide transparency in both clinical and financial
Promote home care and telehealth 9

10. Why Engagement Matters
Marketing
Clinical
Target & Attract Consumers
Optimize Care
Utilization
Build Loyalty & Prevent Leakage
Empower and Enable
Health & Wellness
Optimize Engagement Opportunities
Prevent & Manage
Chronic Conditions 10

11. 4. CONSUMERISM
Healthcare consumer expectations are changing.
Consumer experience is increasingly important.
Self service, digital interaction and online engagement is expanding and expected in all industries – including healthcare
Consumers are experiencing more “out of pocket” healthcare expenses than ever before
Healthcare consumers are beginning to demonstrate more “retail-like” behaviors
Seamless, frictionless experiences are now anticipated
New business models, mergers and acquisitions are delivering healthcare services with more options and choice
Slide 11

12. Consumer experiences have forever changed customer’s expectations …
Set the “better
customer
experience”
stage
Redefined
convenience
& service
Practically
“magic” 12

13. 5. AI 13 Medical Literature Exogenous data – 60% Guidelines
Clinical data – 10 %
Genomics data – 30%
Exogenous data – 60%
Medical Literature
Guidelines
Institutional Knowledge 13

14. Social determinants of health converge with traditional care

15. Use of telehealth, remote monitoring, IoT, and allowing aging in place
“Life Care” Management: the Future
Everyone has an AI-supported care plan with clinical decision support and analytics that help determine the most effective mix of interventions:
high-touch / low-touch
remote / in person
including wellness / prevention / disease management / illness
Use of telehealth, remote monitoring, IoT, and allowing aging in place

16. SUMMARY Better health, managed costs, and best patient and provider experience (Quadruple Aim) enabled through AI insights
A comprehensive view of the individual and population - using clinical, social and other key determinants of health
Personalized care at scale - engaging patients as individuals without compromising efficiency
Population Health Management - providing insights to manage health/wellness and care for an individual and across a population

17. What we covered:
Industry
Prevention
Engagement
Consumerism AI

18. 18

19. Thanks!
Judy Murphy
@JudyMurphyHIT