Patients and Physicians Team to Build Personal Health Record and Manage Chronic Diseases
Innovation: The innovation is VisionTree Optimal Care(tm) or VTOC, web-based personal health record and chronic disease management portal system interoperable within a given community and accessible globally. VTOC is introduced to patients at time of disease management by their physicians or hospital, who purchase it as an affordable subscription model to be their first EMR or extension to an existing EMR. VTOC is web-based for patients, as well as their physicians to securely access vital health information anywhere, anytime and delivers interoperability of patient-centere data exchange within a community by pulling/pushing ADT information between disparate EMR and practice management systems, and standardizing the patient's personal health record.
Primary Beneficiaries: The patient is the primary beneficiary as he/she has access to their vital health information from any computer with internet access and can provide a physician or family member access through a guest account to have a clear understanding of their health history and store critical data for immediate management of an existing or new health condition.
How it is different from the current market: Currently, the marketplace is made of paper and electronic record systems in provider, payer and consumer-based models. Providers have both paper records, HIS, RIS, EMR and Practice Management Systems and are disparate between departments, surgery/cancer centers and physcian offices. Payers have web-based portals to deliver EOB and update contact information. Consumer models deliver web-based portals for self-management of health. VTOC is different in that it links all three deliver models by providing a benefit to the provider (registration, health record), payer (update of information and outcomes data), and the consumer (access to vital data anywhere, chronic disease management and online communication with their physician.
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tu idea
Focus of activity
Technology
Year the initiative began (yyyy)
2002
Posicionamiento de tu iniciativa en el diagrama del mosaico
Which of these barriers is the primary focus of your work?
Health care not consumer friendly
Which of the principles is the primary focus of your work?
Push work down the chain of command
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
Satisfying the Implementers of Change - The problem we are solving is making healthcare more consumer friendly, however, having been implementing a patient empowered personal health record and electronic clipboard for nearly 5 years, we found the greatest barrier within the healthcare system is the staff implementing change. Patients, physicians and administrators are extremely supportive and are embracing new, empowering technologies, but staff who have an existing process in place have no motivation to promote new patient empowerment and improved communication process, until it benefits their own workflow. Therefore breaking the primary barrier of making healthcare more consumer friendly, is closely followed by overcoming the barrier of satisfying the implementers of change.
Name Your Project
Patients and Physicians Team to Build Personal Health Record and Manage Chronic Diseases
Describe Your Idea
Innovation: The innovation is VisionTree Optimal Care(tm) or VTOC, web-based personal health record and chronic disease management portal system interoperable within a given community and accessible globally. VTOC is introduced to patients at time of disease management by their physicians or hospital, who purchase it as an affordable subscription model to be their first EMR or extension to an existing EMR. VTOC is web-based for patients, as well as their physicians to securely access vital health information anywhere, anytime and delivers interoperability of patient-centere data exchange within a community by pulling/pushing ADT information between disparate EMR and practice management systems, and standardizing the patient's personal health record.
Primary Beneficiaries: The patient is the primary beneficiary as he/she has access to their vital health information from any computer with internet access and can provide a physician or family member access through a guest account to have a clear understanding of their health history and store critical data for immediate management of an existing or new health condition.
How it is different from the current market: Currently, the marketplace is made of paper and electronic record systems in provider, payer and consumer-based models. Providers have both paper records, HIS, RIS, EMR and Practice Management Systems and are disparate between departments, surgery/cancer centers and physcian offices. Payers have web-based portals to deliver EOB and update contact information. Consumer models deliver web-based portals for self-management of health. VTOC is different in that it links all three deliver models by providing a benefit to the provider (registration, health record), payer (update of information and outcomes data), and the consumer (access to vital data anywhere, chronic disease management and online communication with their physician.
Innovación
Define the innovation
Innovation: The innovation is VisionTree Optimal Care(tm) or VTOC, web-based personal health record and chronic disease management portal system interoperable within a given community and accessible globally. VTOC is introduced to patients at time of disease management by their physicians or hospital, who purchase it as an affordable subscription model to be their first EMR or extension to an existing EMR. VTOC is web-based for patients, as well as their physicians to securely access vital health information anywhere, anytime and delivers interoperability of patient-centere data exchange within a community by pulling/pushing ADT information between disparate EMR and practice management systems, and standardizing the patient's personal health record.
Primary Beneficiaries: The patient is the primary beneficiary as he/she has access to their vital health information from any computer with internet access and can provide a physician or family member access through a guest account to have a clear understanding of their health history and store critical data for immediate management of an existing or new health condition.
How it is different from the current market: Currently, the marketplace is made of paper and electronic record systems in provider, payer and consumer-based models. Providers have both paper records, HIS, RIS, EMR and Practice Management Systems and are disparate between departments, surgery/cancer centers and physcian offices. Payers have web-based portals to deliver EOB and update contact information. Consumer models deliver web-based portals for self-management of health. VTOC is different in that it links all three deliver models by providing a benefit to the provider (registration, health record), payer (update of information and outcomes data), and the consumer (access to vital data anywhere, chronic disease management and online communication with their physician.
Context for Disruption:
VisionTree is transforming the healthcare system by empowering patients for their own wellness, chronic disease management and access to building their personal health record, by supporting the factors that drive transformation: consumer demand, the adoption of specific quality measures by payers and providers - and the overarching need to deliver the best quality of care, along with affordably for optimal, long-term quality of life. Based on these factors, VisionTree is working closely with patients, providers, medical societies and payers to collect outcomes data, foster patient responsibility and aggregate quality measures for transparency on physician, hospital and specialty levels. This strategy will support both short term adoption and long-term transformation into a patient-centered healthcare system.
Delivery Model
VTOC is reaching patients through adoption at high profile centers such as UCLA, Stanford, University of Pennsylvania and Henry Ford hospital, as well as by having patients create their own accounts and take their VTOC information to physicians within a community for their comprehensive and long-term care. VisionTree is reaching the providers taking an a version of its web-based data collection system and using it to run paperless CME conferences. This has brought the concept of web-based data collection and communication on PDAs, Smartphones and laptops to key decision makers such as department heads, administrators, payers and policy makers. VisionTree has also applied its web-based outcomes data collection to societies MOC and PQRI programs to lead the way in capturing and measuring P4P measures that have been approved and are being developed. There are 52 sites using VTOC with over 100,000 patients. There are over 100,000 healthcare professionals who have used the VisionTree Conference system, as well as over 20,000 physician members connected with the VisionTree Outcomes Online system.
Key Operational Partnerships
Partnerships have been an essential component to adoption, as well as quickly gaining a strong customer base. VisionTree partnership include:
1) Societies - VTOC as an endorsed portal by ASTRO (Radiation Oncology) and VisionTree Conference being used by CNS (Neurosurgery), ASCRS (Cataract and Refractive Eye Surgery), NASS (Spine), ACMP (Physics). VTOC's adoption has been driven by society support and exposure, as physicians recognize an immediate value to improving the quality and efficiency of care in their pratice and are introducing it to their patients.
2) Academia - VTOC is in numerous teaching institutions as the web-based system for collection quality of life outcomes data.
3) Healthcare System - VisionTree has had ongoing meetings at CMS with ORDI and is entering discussions regarding the personal health record. VisinoTree has been used in conferences with thought leaders at AHIP (Blue Cross/Blue Shield, Cigna), World Congress (David Brailer, Steve Case, Newt Gingrich) and
4) Industry - VisonTree is a Microsoft Certified Partner and its web-based data collection system has been used to run the mobility sessions at the MSFT Worldwide Partners Conference for the last two years. Palm has provided VisionTree with Treos to promote mobility in healthcare and VisoinTree is used by leading healthcare organizations as the web-based data collection system for internal and customer meetings including McKesson, Abbott Labs and J&J.
Impacto
Financial Model
As VisionTree is an on-going entity with plans to scale up existing conditions, our financial needs result in hiring more Clinical Application Managers in all regions with the hopes of developing teams in the 6 regions throughout the US.
What is your annual operating budget?
1,659,430
What are your current sources of revenue? (please list any sources that are foundation grants)
Our current source of revenue is the sale of our VTOC and Conference Live! products. This is used to fund our current expenses. We have not received any foundation grants. We are also receiving investment from private parties.
Effectiveness
VTOC has significantly impacted the patient/physician communication process and workflow efficiency of accessing and managing documentation. There were three (3) peer reviewed posters presented in 2006 at the AANS, CNS and ISRS documenting a 30% improvement in patient satisfaction and 20% improvement in post treatment welfare by patients using VTOC compared with a control group of patients that did not have the VTOC system. A 20% improved in workflow efficiency (misdirected phone calls) and 30% improvement in reducing missed/cancelled appointments has also been realized at VTOC sites, such as UCLA Medical Center. VTOC as driven communities of physicians, such as Radiation Oncologists in Philadelphia practicing at the University of Pennsylvania to standardize their history forms. Prior to VTOC they had 12 different forms the patient was completing; now there is one standard, which is also becoming the patient’s personal health record. Of 500+ patients surveyed, 90%+ have rated VTOC easy to use, 80%+ want to continue using it for their long-term care with an average patient user age of 61 years old.
Which element of the program proved itself most effective?
The most effective aspect of VTOC has been the delivery of relevant information to the patient at the right time during their disease management. VTOC templatizes disease management, delivering custom interactive forms, consents, education material, reminders and internet links to a patient’s portal at each stage of their treatment pathway. This is driving patients to be active participants in their treatment and provides them a resource to view documents and media, when they are ready to do so in the privacy of their home, while also being able to take their health record to a physician within their community for comprehensive, long-term care. While staff at sites who are implementing VTOC might have skepticism in patients having internet access or being ‘computer savvy’, we have found that 40% of patients take their login card immediately with 80%+ compliance in completing forms and viewing relevant information. 50% of patients are participating in their portal on their own, while the other half is doing so with the support of a spouse or family member.
Number of clients in the last year?
VTOC is been on a rapid adoption rate with a high comfort level being reached for ASP models, as well as the comprehensive patient portal features VTOC delivers representing a best of breed addition to existing EMR systems. VTOC is in 52 sites around the country and in the last year, VTOC has had new clients including: Partners Telemedicine/Center for Connected Health, Henry Ford Hospital, University of Pennsylvania, ASTRO (6 licenses for key Radiation Oncology sites), UCSF (orthopedics), UCLA (new departments including Urology), Greater Baltimore Neurosurgical Associates and Scripps Health System (San Diego, CA).
What is the potential demand?
A web-based patient-centered health record that delivers interoperability within communities would meet the need of over 330 million patients annually in the U.S. alone and impact chronic disease management, with 7%+ of that population managing diabetes and 20%+ managing hypertension.
Scaling up Strategy
Over the next three (3) years, VisionTree will expand its support for the adoption and implementation of VTOC in four (4) regions of the country to a team of Clinical Application Managers, Support Services and Regional Managers totaling a team of 3-5 in each region.
Stage of the initiative:
1
Expansion plan:
VisionTree’s expansion plan is a highly focused effort on the provider market for the disease management by specialty and the primary care physician for the personal health record, as well as the payer market for chronic disease management. VTOC’s consumer adoption will continue to be viral by allowing patients to request their physician to be on the VTOC network. Consumers can also acquire their own VTOC account subscription to store their own personal health record, as well as for their family. VisionTree’s provider expansion will continue through the current distribution channel of 40+ managers, as well as new payer channels and a consumer channel introduced to patients through their provider and reinforced through strategic marketing efforts.
Origin of the Initiative
The company was founded by Martin Pellinat who has a background in marketing and product development in the healthcare industry. Having committed his career to launching new technologies in the fields of general surgery, urology, neurosurgery and radiation therapy, as well as taking a new reimbursement code to fruition with CMS, Martin began working with existing relationships at key academic sites throughtout the country to address the common need of improving the patient communication and documentation process. The design of VTOC began in 2002 to be a patient-centered tool for collecting and disseminating the right information at the right time for making more informed treatment option decisions and evolved into a comprehensive patient portal system with a database designed for interoperability within a given community. VisionTree’s patient and customer feedback has been the driving force behind the companies passion for improving the healthcare system. Countless personal stories from patient about how VisionTree has helped them make better decisions, communicate with their physicians, have access to vital data when they need it, continues to validate the companies direction and development. VisionTree is highly committed for the long-term to bridge the gap between access to patient health information and empower the patient to access it when they need it to improve the quality of their care and the efficiency of the healthcare system.
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What are your two main challenges to finance the growth of your initiative
The two main challenges is 1) The resources to pioneer the messaging of the concept that it can the personal health record and interoperability can become reality within a given community and 2) The resources for implementation of this web-based technology within a community. The good news is that by being web-based, there is no hardware to install or maintain and no IT resources required by a hospital or physician’s office. Training is minimal with videos and a clinical applications team already in place that has successfully been implementing the VTOC system at existing sites to date. We are now simply in the stage of scaling adoption within each region of the country VTOC is installed and building RHIOs to have patient’s be able to access their health information and self-manage their chronic diseases from home.
How did you hear about this contest and what is your main incentive to participate?
The VTOC site - CEI Stanford / Let Them Hear Foundation based in Palto Alto, CA (Rob McClelland, Executive Director) shared the link to this grant with us and thought VisionTree would be a very good fit for what we have successfully accomplished to date and the long-term direction we are headed.
La historia
Do you have an annual financial statement?
Yes - See attached copy.
Do you currently have an annual financial statement that tracks profit/loss?
Yes - We have a computerized accounting system which we use to track our profit and loss on a monthly basis. We also are able to compare to our budget year to date.
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
We would need in year one $1,659,430 for the implementation. After that, we estimate the projected income from VTOC will offset the projected expenses in year 2-5.
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