Presentation Transcript

1. Co-ordinated care using a comprehensive and fully integrated health information and communication system at Maccabi, Israel. Prof. Ehud Kokia Israel
2. Maccabi’s Vision Maccabi Israel's leading and most advanced healthcare organization aims to achieve Total Health for its members, providing integrative and personally- tailored health care to each and every member, and encourages excellence in the quality of medical care, knowledge and service.
3. The Geographical Concentration of Maccabi’s Members
4. Maccabi Overview Snapshot Over 2,000,000 members (24% Market Share). 9,000 employees. 3,660 physicians 4,500 health professionals 5 regions - 150 branches and clinics 1 Central fully automated medical laboratory with 239 collection centers 2.3 billion euro budget
5. Maccabi Healthcare Services Maccabi functions as a recognized health fund within the framework of the National Health insurance Law. Maccabi is responsible for providing insurance cover for all services included in the public basket of services Maccabi is permitted, by law, to offer supplementary services, as well as to offer health insurance to non-residents Maccabi supplies services to its members both via its own facilities and through outside providers.
6. Maccabi selectively contracts with providers according to its own standards and conditions Members are free to choose their physician and other service providers from a wide range of approved suppliers. They can go directly to specialist physicians without the referral of a family physician Co-payments exist for medications, visits to physician specialist clinics and some other services. Maccabi Healthcare Services
7. Maccabi Health Care Delivery System Emphasis on Prevention and Health Promotion New Structures and Processes of Chronic Illness Disease Management Integrated Care Increased Community Orientation; Less Hospital Care At the forefront of technological advance Medical Technology Assessment Early Adopter of new proven technologies Rapid advancement in adoption and development of innovations in information and communication technologies
8. Empowerment of the Consumer Increasing Transparency Reduced Bureaucracy Empowerment of the Physician Increased Decision Support Physician Portal EMR Participation in Policy Making and Implementation Empowerment of the Staff Performance Measurement (HVA) Knowledge Management
9. One of the major tools that facilitates the management of Maccabi is ourintegrated and comprehensiveHealth Management Information System
10. Developments & Reforms at Maccabi Adopting the Chronic Care Model Planned, pro-active intervention by team members based on EBM and ExBM Using integrated IT to manage [registries, reminders, CDSS, etc.] Empowering patients to take an active role in the management plan Monitoring a complex set of clinical quality measures
11. PHYSICIAN LEVEL
12. Physicians Concerns 1. Lack of trust in the system.(What’s the catch) 2. Computerization increases the administrative work. 3. We don’t need telemedicine. We are a small country. (not Alaska, nor Texas). 4. We will lose the human touch. 5. The technology is not good enough. 6. It is for the employers.
13. Physician’s Incentives WiiFM What’s In It For Me?
14. IT at the physicians’ services
15. Pharmacy
16. Prescription
17. Prescription CPOE
18. Drug to Drug Interaction Alert
19. Alerts for Allergies
20. Preauthorization

21. Telemedicine

22. Examples
23. Examples Zoom
24. Information and PhysicianProfile
25. Maccabi Medical Registries Types for patient’s tracing and follow-up ofcomputerizeddata available Medical History Family History Demographic parameters Lab Results Visits & Hospitalization Medications Imaging Treatments
26. Maccabi Medical Registries (Disease Management) * Data collected since 1998
27. Doctor’s Profile Use of Antibiotics Usage of Antibiotics
28. Usage of First and second line Antibiotics Usage of First and second line Antibiotics
29. Patients at Risk that did not get Influenza Shots diabetes Heart asthma Other Phone Phone Num. First Name Last Name ID # Pneumovax
30. Patients in Diabetes Registry Statistics: Diabetes Patients Average HbA1C % HbA1C Average LDL % Done LDL %Done Urine Done Creat % Done Eye Exam % Patients Aspirin % Patients Ace Inhibitors % Visit Dietician % Patients HbA1C over 9.5
31. PATIENT LEVEL
32. M HEALTH You can get every information on your smart phone.
33. Total Health and Telemedicine The Future Services will be provided to members, to the extent possible, at the most comfortable and convenient location for them (home, office) via use of the most advanced information and communication technology (web, e-mail, SMS) Servicesthat cannot be provided at home will be provided in the physician’s clinic which will be, to the extent possible, a “one stop shop” for most of the patient’s healthcare needs
34. The physician-patient relationship will remain the focal point of modern health care The primary care physician will be the patient’s “personal physician” and will provide holistic care The physician and the patient will be partners and share the responsibility for the patient’s health The primary care physician will work within a multidisciplinary team.
35. Telemedicine will not take the place of the patient physician relationship but will strengthen the relationship Telemedicine will not replace the need for face-to-face visits and physical examination when medically necessary Telemedicine will add numerous tools and options that will improve care, provide greater flexibility and comfort, and improve the efficiency, timeliness and effectiveness of health care
36. Lessons learned Tailor the system to the organization Each profession needs its own approach: Physician are very different from nurses. Physician hate stiff guidelines and pathways. Try to be flexible
37. Lessons learned Users should be part of the design. On going dissemination is the biggest challenge. Do it gradually…Not too many reminders… Reimbursement on time and money on hardware and software. Take care of legal aspects and medical confidentiality.
38. Why Telemedicine? The Teleradiology case Equal access all over the country. On-Line diagnosis. Extension of service hours. Reliable diagnosis due to advanced digital tools. Quality control and assurance. Archiving capabilities for future comparison & Medico legal reasons. Sharing information among physicians for treatment and consultation. Sharing Information with the patient and patient empowerment. Lower cost- maximization of medical personnel time utilization.
39. Thank you!