Steve Hester, MD, MBA Senior SVP, Chief Medical Officer

Norton Healthcare

Effective Care Delivery Across the Continuum

2013 Total encounters 2,214,079

Per Day Statistics:• Average Daily Census…………………………………….…….875• Admissions………………………………………………………….168• Surgeries (IP & OP)………………………………………………134• Outpatient visits (excluding ER)…………………………1,080• ER visits……………………………………………………………….570• Freestanding Diagnostic visits………………………………..69• Practice visits (primary care & specialists)…………4,045• Total encounters per day…………………………………..6,066

Norton Healthcare

Norton Medical Group

Norton Medical Group Profile 2013Total Visits 1,465,657 Primary Care, ICC, and Pediatrics 674,334 Specialist Visits 791,323Total Locations 128Total Visits per day 4,015Total Primary Care Visits per day 1,847Total Specialist Visits per day 2,168Total ICC Visits 161,805

Healthcare – A System in Chaos

• The health care system is under duress

• Irresistible drivers of change include:– Medical progress – Aging population– Global economy

• Challenges for providers and patients:

– Too many people involved, too much to do, no one with all the information, no one with full accountability

– Result: Chaos gaps in quality and safety, inefficiency

Specialty Physician

Home ICC

Diagnostic Center

Skilled Nursing; LTAC;

Rehab

Patient HomeHome Health

Hospital - ER services, OP services, IP stays

Value in the Future = Patient Care Continuum

Care Team Center Wellness

Center

Changing Care Delivery

• Hospital Practices: Improved management of complex patients

– Complex Care Management

– Multidisciplinary Plans of Care through electronic health record

– Increased emphasis to social barriers

• Physician Practices: Patient-centered care

– Patient Centered Medical Home (PCMH)

– Practice redesign

– Payor collaboration

– Wellness – increased screening & lifestyle coaching

Why now?Physician Centered Care Patient Centered Care

Physician

Patient

Nurse

PharmacistSocial Worker

Physical Therapist

Patient

Physician

Pharmacist

Physican TherapistNurse

Social Worker

Required Support for Patient Success

Overcoming health system barriers

Education where knowledge deficits exist

Communication between patient, care provider, and the community

The Future Patient Experience

• Patient Navigation: Result of Fragmented Healthcare• Patients will truly be in control of their care. • Never have to traverse the complicated health system

alone.• Be informed of the care they are provided and be better

able to make knowledgeable decisions.

Navigation Results

• Cancer patient rates as an example:– The screening rate improved 10.8 - 17.1%– Adherence to diagnostic services after an

abnormality was detected improved 21 - 29.2%.

This information provided by: a patient navigation intervention. Cancer. 2007;109(2 suppl):359-367.

Next Steps in Patient Navigation

Commitment from all stakeholders for sustainability

Standardization of the methodology and certification process

Defined standards and metrics for billing

Norton Healthcare’s Patient Navigator Program

NHC Patient Navigators

Discuss Medications

Schedule Follow-ups

Go over discharge instructions

Provide additional information

Answers all questions

Assists the patient in overcoming barriers

Questions?