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

2. 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

3. 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 to March 31st 2009
224,128 patients has been hospitalized 3+ times
2,9% of the population and 47% of bed days-of-care

4. 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%

5. 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%

6. 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%

7. 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%

8. 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

9. 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 :
One bed day-of-care: 300$
One stretcher day-of-care: 500$

10. 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

11. Expérience Sud-de-Lanaudière Experience
2 Family Health Team
Population:
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, 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

12. Expérience Sud-de-Lanaudière Experience
Recurrent costs
Year 1
Year 2
Year 3
Interdisciplinary team $ $ $
Lease
60 000$ $
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 $ $ $

13. Expérience Sud-de-Lanaudière Experience

14. Expérience Sud-de-Lanaudière Experience

15. Expérience Sud-de-Lanaudière Experience

16. Expérience Sud-de-Lanaudière Experience

17. Expérience Sud-de-Lanaudière Experience

18. Expérience Sud-de-Lanaudière Experience

19. Expérience Sud-de-Lanaudière Experience

20. Expérience Sud-de-Lanaudière Experience

21. Expérience Sud-de-Lanaudière Experience

22. Expérience Sud-de-Lanaudière Experience

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