Concerto Health Model Methodology behind efficiency gains, results and projection Presentation at the MOHLTC Toronto, May 28 2013

Presentation Content Basis of efficiency gains North-America experience Evaluation of potential efficiency gains Measurement of efficiency gains Results in Sud-de-Lanaudière experience Projection on a 6 years period

Basis of efficiency gains Impact of chronic disease People with 3+ chronic diseases represents 71% of all hospital admissions Shortell, Stephen 3% ot the population uses 50% of bed days-of-care Frequent flyers: 3+ hospitalizations over a 3 year period Quebec province April 1st 2006 to March 31st 2009 224,128 patients has been hospitalized 3+ times 2,9% of the population and 47% of bed days-of-care

North-America experiences Veteran’s health administration High risk patients Decrease ER visits: 40% Decrease hospital admission: 63% Decrease bed-days-of-care: 60% Decrease long term care admissions: 64% Decrease long term bed-days-of-care: 88% Increase patient satisfaction: 90%

North-America experiences PacifiCare Behavorial Health Cardiac hearth failure patients (case management) Decrease hospital admission: 50% Decrease ER visit: 73% Maine Health Asthma patients (case management) Decrease hospital admission: 85% Decrease ER visit: 71%

North-America experiences Maisonneuve-Rosemont hospital, Quebec Chronic obstructive pulmonary disease patients (Tele-Health) Decrease hospital admission: 88% Decrease bed-days-of-care: 80% Decrease ER visit: 73% Decrease home care visit: 59%

North-America experiences Des Sommets, Health and social service center, Quebec Frequent flyers (case management) Decrease hospital admission: 83% Decrease bed-days-of-care: 80% Decrease ER visit: 72%

Evaluation of potential Identify patients with chronic disease in FHT Match list with IT system in local hospital Admission IT system Emergency IT system (where it applies) Archive IT system Calculating, on a 3 years period, the number of: Beds days-of-care Stretchers days-of-care at the ER Calculating the retention rate in the local hospital

Evaluation of potential Apply a 50% reduction on a year base Apply the direct cost of: One bed day-of-care to the calculated number of beds day-of-care reduce by 50% One stretcher day-of-care to the calculated number of stretcher reduce by 50% On the Sud-de-Lanaudiere experience, based on the financial year 2008-2009: One bed day-of-care: 300$ One stretcher day-of-care: 500$

Measurement Every 6 months Match the list of patients with chronic disease in the Concerto health program with: Admission IT system Emergency IT system (where it applies) Calculating for a six month period Beds day-of-care Stretchers day-of-care Comparison with the 3 year result Establish the efficiency gains on a one year basis

Expérience Sud-de-Lanaudière Experience 2 Family Health Team Population: 30 000 Family doctor: 25 Interdisciplinary team: 6 FT nurses (additionnal), 1 FT nutritionnist, 1 FT respiratory therapist, 1 FT pharmacist, 2 FT social workers, 1 FT physiotherapist, 1 FT occupationnal therapist, 1 FT kinesiologist, 2 FT secretary, 1 FT administrative technician. Recurrent costs Interdisciplinary team Lease IT support cost Other cost (stationery and medical supplies) Non recurrent costs Hardware and software Office furniture Medical equipment

Expérience Sud-de-Lanaudière Experience Recurrent costs Year 1 Year 2 Year 3 Interdisciplinary team 824 374$ 1 114 290$ 1 162 755$ Lease 60 000$ 120 000$ IT support 5 000$ 10 000$ Stationary and medical supplies IT system ? Non recurrent costs PC and software 30 000$ 0$ Office furniture 20 000$ Medical equipment Total 959 374$ 1 314 290$ 1 302 755$

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Expérience Sud-de-Lanaudière Experience

Thank you for your attention Questions ? Concerto Health Model Thank you for your attention Questions ?