1. Health Authorities & Cost Drivers: the VCH perspective
Mary Ackenhusen
President & CEO
Vancouver Coastal Health

2. The Iron Triangle of Healthcare

3. Our Current State
Growing demand on the system with status quo models of care
Default into acute and residential care in the face of few viable alternatives
Uneven resource allocation with over-served and under-served populations

4. Our Current State
Lack of integration between services and providers reinforcing a provider centric approach
Cost and process pressures from advancements in clinical technology and procedures
Underinvestment in technology and data analytics

5. Technology/data investment
VCH
US Healthcare
Providers
University
Health Network
UK Healthcare
Calgary Regional Health Authority
Professional Services
US Banking/
Financial Services

6. Provincial health funding
$9 billion
Regional Health Authorities
$1 billion
Pharmacare
$2.5 billion Ministry of Health & PHSA
$4 billion
MSP/Physicians
Fiscal year 13/14

7. VCH Budget allocation Acute Care 60.5% Residential Care 13%
Population Health & Wellness 3%
Corp, Benefits, IT 7.5%
Acute Care 60.5%
Residential Care 13%
*2014/15 – 2016/17 Service Plan (includes Providence Health Care)

9. OECD Healthcare comparison

10. “The way our system is funded – predominantly with block transfers to hospitals and fee for service payments to physicians – encourages volume of procedures and status quo. It does not reward quality of care, or responsible stewardship. In fact, when an individual or a program goes out on a limb and makes changes to improve efficiency and cost effectiveness, the benefits often accrue to others; perverse incentives are commonplace and counterproductive.”
Andre Picard
July 28, 2015

12. Incremental
Change
Transformation

13. System Enablers Modern and open information management systems
Good analytics (big data)
Good supports for clinicians to learn/adapt to new IM systems
An open mindset to innovation and outside partners
A skunk works/test bed infrastructure tasked to introduce new technology and ideas.

14. Pacific Health Innovation eXchange (PHIX)

15. Attributes of innovation?
Largely funded outside the global health budget
Can be proven to save money or align with mandated quality improvement goals
True partnership, often with shared financial risk
Credible, influential champion

16. UV Disinfection Funded through philanthropy
Reduction of c-difficile was mandated
Championed by physician lead for Infection Control

17. Patient Safety System Funded through philanthropy
Majority of costs were paid by Masimo
Championed by the Senior Medical Director

18. Home Health Monitoring
Funded by vendor as a value add innovation fund in provincial contract
Proven to save money
Partnered to provide resources to develop, implement and evaluate
Championed by the Ministry of Health

19. Online Therapy Funded through philanthropy and CESEI Reduces costs
Championed by partnership between clinician & operations lead
Online Therapy

20. Remote Cardiac Monitoring
Funded by vendor
Reduced cost of patient surveillance
Championed by cardiac leadership

21. Renal Disease Management
Funded by vendor
Reduced costs
Shared financial risk
Championed by VP and physician partner

23. Email: mary.ackenhusen@vch.ca
Tel:
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