1. Possible increased staff to call patients
2. Technology for Continuity of Care
2.1. Continuity of patient care is broken many times when the patient goes to the emergency department, urgent care, or specialist.
2.1.1. Vision Statement
2.1.1.1. We will change healthcare and create a seamless continuity of care between all physicians attending to the same patient utilizing the changing technological landscape to create the ultimate patient experience.
2.1.2. How can the patient's primary care physician (PCP) be notified when the patient goes to these places?
2.1.2.1. Technology Application to Notify PCP
2.1.2.1.1. PCP receives text or email
2.1.2.1.2. PCP can receive information
2.1.3. PCP is out of the "loop".
2.1.3.1. Not aware patient sought service
2.1.3.1.1. Does not know to follow up
2.1.3.2. Access to labs may be limited
2.1.4. Continuity of care is broken
2.1.4.1. Patient does not follow up with PCP
2.1.4.1.1. Revisit may not get paid
3. Stakeholders
3.1. Internal
3.1.1. Departments
3.1.1.1. Software Development
3.1.1.1.1. Makes the actual application
3.1.1.2. Marketing
3.1.1.2.1. Packages the application to appeal to both hospitals and PCP
3.1.1.3. Sales
3.1.1.3.1. Cultivates customer acquisition
3.1.1.4. General Operations
3.1.1.4.1. Day to day business operations
3.1.1.5. Legal
3.1.1.5.1. Licensing option potential with current Hospital Information Systems
3.1.2. People
3.1.2.1. Adaptors & Innovators
3.1.2.1.1. Adapters to keep the project on track
3.1.2.1.2. Innovators to challenge the status quo
3.1.2.2. Group Idea Roles
3.1.2.2.1. Decision Maker
3.1.2.2.2. Facilitator
3.1.2.2.3. Participators
3.1.2.3. Personalities
3.1.2.3.1. Variety of VAT participants
3.1.2.3.2. DiSC
3.2. External
3.2.1. Hospital CFO
3.2.1.1. Sending information to PCP
3.2.1.2. Allows the technology to send to PCP
3.2.2. PCP Providers
3.2.2.1. Customers receiving the information
3.2.2.2. Follows up with clients for patient continuity of care.
3.2.2.2.1. Increases overall patient satisfaction
4. References
5. Questions
5.1. Proof of Concept
5.1.1. Would PCP utilize this?
5.1.2. Would hospitals see the value in this?
5.1.2.1. How do we prove the value?
5.1.2.2. How would we measure decreased admissions?
5.1.2.2.1. Due to the technology?
5.2. Measuring success
5.2.1. How would we measure patient satisfaction?
5.2.2. How would we measure PCP satisfaction?
5.2.3. How would we determine PCP increase in patient follow-up after discharge?
5.2.4. How would we measure increased pay-for-performance due to new technology?
5.2.5. How do we prove increased continuity of care?
5.3. Technology
5.3.1. How do we get the application in the first hospital/PCP?
5.3.1.1. Approach a full system including both hospitals & PCPs.
5.3.1.1.1. Banner?
5.3.1.1.2. St. Mary's Reno?
5.3.2. How do we integrate into current HIS?
5.3.2.1. Call Cerner or Meditech?
5.3.2.2. Charge the HIS or offer it for free?
5.3.2.3. How do we update the HIS with physician information if not already there?
5.4. Payment structure
5.4.1. PCP
5.4.1.1. Subscription service?
5.4.1.2. One time fee?
5.4.2. HIS
5.4.2.1. License?
5.4.2.2. Free?
5.4.2.3. Offer as a Module?
5.5. Team Members
5.5.1. How do we put together the right team?
5.5.1.1. Find people passionate about patient care.
5.5.1.2. How does the concept get further developed?
5.5.1.2.1. Brainstorming
5.5.1.2.2. Beta testing feedback
5.5.1.2.3. Programmer input
5.5.2. How do we continue forward without stalling out?
6. Creating Success
6.1. Organizational forces that impact the success of the project
6.1.1. Acceptance of PCP to subscribe to service
6.1.2. Acceptance of hospitals to integrate the module in there registration.
6.1.3. Getting the data to prove the concept
6.1.4. Leader of the innovation
6.1.4.1. "Leaders' strength in analytical intelligence can contribute to their weakness in accessing their innovative intelligence" (Weiss & Legrand, 2011, p.53).
6.1.4.2. Leaders focus on facilitating the process
6.1.4.2.1. Not the innovative person
6.1.4.2.2. Make the complex issue clear
6.1.4.2.3. Available for team to ask questions
6.2. Barriers to Success
6.2.1. HIPAA laws
6.2.1.1. Follow HITECH rules
6.2.1.2. Use secured platforms
6.2.1.3. Look at EMR security
6.2.2. Changing thinking of PCP
6.2.2.1. Show the advantages
6.2.2.1.1. Ability to address patient issues proactively
6.2.2.1.2. Increased income due to more patient visits
6.2.2.1.3. Continuity of patient care
6.2.2.1.4. Not always addressing emergencies
6.2.2.2. Address issues
6.2.2.2.1. Accessibility of information
6.2.3. Changing thinking of hospitals
6.2.3.1. Decrease readmissions to ED
6.2.3.2. Decrease non-emergent visits to ED
6.2.4. Technology itself
6.2.4.1. Constantly changing
6.2.4.2. Offering more options to access patient information
7. Evaluation & Outcomes
7.1. Outcomes
7.1.1. Increased PCP visits after ED
7.1.1.1. SMART goal
7.1.1.1.1. S:PCP visits after ED as directed
7.1.1.1.2. M: Increased %
7.1.1.1.3. A: Work with one medical system to begin with
7.1.1.1.4. R: This may be hard with HIPAA. It just takes one system.
7.1.1.1.5. T: Start with a 12 month window.
7.1.2. Baseline Measure
7.1.2.1. Current # of discharges that visit PCP as directed
7.1.2.1.1. PCP visits currently 50 patients from ED
7.1.3. Improved Outcome Measure
7.1.3.1. 12 months after program initiation
7.1.3.1.1. PCP increase 10% = 5 additional patients from ED visits
7.2. 6 steps to evaluating the impact of healthcare innovations
7.2.1. 1. Determine how the product or service generates value
7.2.1.1. $$
7.2.1.2. Reduce ED readmissions
7.2.1.3. Higher quality of patient care
7.2.2. 2. List all the key assumptions behind the value generated and the costs incurred
7.2.2.1. Patients will go to PCP after ED visit
7.2.2.1.1. Increase PCP $$
7.2.2.1.2. Higher % will go to the appointments if initiated by PCP
7.2.3. 3. Research baseline values for each of the assumptions where possible.
7.2.3.1. Determine % of patients that call PCP and make an appointment after ED visit
7.2.4. 4. Create potential ranges of values for each assumption.
7.2.4.1. Increased % of patient visit will show success of the product
7.2.5. 5. Integrate the assumptions to estimate key performance indicators.
7.2.5.1. ROI
7.2.5.2. Profitability
7.2.6. 6. Perform a sensitivity analysis by seeing how much the key performance indicators change in response to changes in the values for the assumptions
7.3. Diffusing the Technology
7.3.1. Trialability
7.3.1.1. Low risk trials
7.3.2. Advantage
7.3.2.1. Needs to be better than the old ways
7.3.3. Compatibility
7.3.3.1. Does it work with the current sytem
7.3.4. Observability
7.3.4.1. The program can be successful
7.3.4.2. Relationship with innovator
7.3.4.2.1. Important knowledge can be passed on
7.3.5. Simplicity
7.3.5.1. Simple - easy to implement
7.3.5.2. Complicated - difficult to implement
7.4. The Four-Step Innovative Thinking Process
7.4.1. Step 1: Framework
7.4.1.1. understand the business issue
7.4.2. Step 2: Issue Redefinition
7.4.2.1. surface the underlying issues
7.4.3. Step 3: Idea Generation
7.4.3.1. discover one or more innovative solutions to the problem
7.4.4. Step 4: Implementation Planning
7.4.4.1. Four Stages in Step 4
7.4.4.1.1. Stage 1: Confirm the preferred ideas.
7.4.4.1.2. Stage 2: Engage in risk analysis and develop mitigation strategies.
7.4.4.1.3. Stage 3: Present the innovation solution for approval.
7.4.4.1.4. Stage 4: Ensure an effective handoff to the team that focuses on change implementation.
8. Timeline
8.1. 2015
8.1.1. 1st Quarter
8.1.1.1. Idea Generation
8.1.2. 2nd Quarter
8.1.2.1. Create vision statement
8.1.2.2. Research
8.1.2.2.1. Does this idea exist currently in healthcare?
8.1.2.2.2. Is there value in this idea
8.1.3. 3rd Quarter
8.1.3.1. Research finance for healthcare and innovation
8.1.4. 4th Quarter
8.1.4.1. Develop Project Plan for Technology Innovation
8.1.4.1.1. Ask questions
8.1.4.1.2. Consider options
8.1.4.1.3. Identify barriers
8.1.4.1.4. Create SMART goal
8.1.4.1.5. Define success
8.1.4.2. Technology Development
8.1.4.2.1. Meet with programmer
8.1.4.2.2. Start to define the scope of the project
8.2. 2016
8.2.1. 1st Quarter
8.2.1.1. Technology Development
8.2.1.1.1. Review initial application
8.2.1.1.2. Talk to PCPs
8.2.2. 2nd Quarter
8.2.2.1. Technology Development
8.2.2.1.1. Incorporate PCP suggestions
8.2.2.1.2. Create a hospital application that works with registration, initial version
8.2.3. 3rd Quarter
8.2.3.1. Technology Integration
8.2.3.1.1. Identify hospital/hospital system to beta test.
8.2.3.2. Technology Development
8.2.3.2.1. Continue to tweak both programs to work together
8.2.4. 4th Quarter
8.2.4.1. Launch product?