Unlocking the Potential in Modern Medicine

Presented by James L. Madara, MD, at the 2nd Annual CEO Roundtable on September 15, 2016

Technological innovation is rapidly changing the landscape of health care, breaking down new barriers and allowing physicians, for the first time, to provide care to almost anyone, anywhere, at any time. For physicians, the challenge in 21st Century medicine is keeping pace with these changes, and the opportunity is to unlock the potential in new technologies to better serve patients and their communities.

The American Medical Association (AMA) is at the forefront of modern medicine and has developed three strategic focus areas to help patrons and physicians thrive. AMA is focused on supporting physicians and the needs of their practices, improving outcomes for patients so that we may reduce the burden of chronic disease, and creating the medical school of the future. Dr. Madara's presentation shows how these bold initiatives are empowering physicians and helping deliver high-quality care and how physician-focused innovation will improve the delivery of care and the health of our nation.

Transcript

1. © 2016 American Medical Association. All rights reserved. James L. Madara, MD American Medical Association
2. © 2016 American Medical Association. All rights reserved. AMA and the Emerging Context of Health Care 2
3. © 2016 American Medical Association. All rights reserved. AMA Mission Statement ‘To Promote The ART and SCIENCE of Medicine and the Betterment of PUBLIC HEALTH’
4. © 2016 American Medical Association. All rights reserved. The “AMA Equation” House of Delegates Members Practice/ Business Tools Research & Education Advocacy AMA The AMA is the sum of multiple parts Newly developed innovation ecosystem
5. © 2016 American Medical Association. All rights reserved. Management Application of Board Criteria 1 2 3 4 1 2 3 4 Desirability (Mission, Urgency, Alignment, Credit) Feasibility (Impact, Leader, Capacity) 2011-2012: Global Redeployment of AMA Resources 110 Active Projects Were Clustered Into 27 Domains (Below) from Which Three Projects Emerged Core strengths to integrate/build upon Opportunities for reconfiguration/exit Exit 27 “PROGRAMS”
6. © 2016 American Medical Association. All rights reserved. Three Big Ideas Now Drive AMA Mission Strategy Bring medical education into the 21st century. Make the practice of medicine joyous again. Connect the clinic to the community to optimize health outcomes.
7. © 2016 American Medical Association. All rights reserved. 29 M The number of Americans with diabetes 86 M The number of Americans with pre-diabetes A Big Opportunity: The Case of Pre-Diabetes 7
8. © 2016 American Medical Association. All rights reserved. Improving Health Outcomes: Creating Connections to Community Pre-Diabetes AMA TARGET:
9. © 2016 American Medical Association. All rights reserved. Medicare Diabetes Prevention Act • Introduced by AMA-ADA-YMCA • Sponsored by Senators Franken and Collins and Reps Davis and King • AMA sponsored CBO-like scoring (Avelere) • CBO subsequently finds same positive score • Act put into law by Congress • Example of: – Strength through partnerships – Deploying AMA Advocacy as a means of memorializing progress in mission 9
10. © 2016 American Medical Association. All rights reserved. Ad Council: AMA-CDC-ADA 10 $16.9M in total donated media to date: • $5.2M in TV (broadcast + cable) • $5.5M in Radio • $4.1M in OOH TV support on relevant channels for target audience including CBS Sports, Golf Channel, and Fox News :30 spot continues to run in the campaign’s top priority markets
11. Next Generation Products Based on User Feedback *Will include printable page for physician to share 11
12. © 2016 American Medical Association. All rights reserved. • Activating state medical (specialty) societies to increase: • Physician engagement in diabetes prevention • Use of AMA/CDC tools and resources • Activating health care purchasers to increase: • Coverage of diabetes prevention programs • Use of AMA/CDC tools and resources Partnering with State Medical Societies AMA/IHO National Program Office (CDC funded) 12
13. © 2016 American Medical Association. All rights reserved. Plan for Scaling to More States (Phase 1) learning and best practices from MI and SC; setting readiness criteria for next state medical societies (2016-17) (Phase 2) CDC potentially issues RFP to support additional 5 state medical societies; evaluate (2017-18) (Phase 3) Model for sustainability; shovel- ready programs for 20 additional state medical societies (2018-19) 50 States 13
14. © 2016 American Medical Association. All rights reserved. Three Big Ideas Now Drive AMA Strategy Bring medical education into the 21st century. Make the practice of medicine joyous again. Connect the clinic to the community to optimize health outcomes.
15. © 2016 American Medical Association. All rights reserved. Beyond Flexner: Fundamental Flaws Currently Widespread in UME - “Time” Rather Than Competence - Not Individualized - Outdated Educational Methods - Limited Use of Technology - Restrictions Derivative of Separate Groups of Content Experts (i.e Faculties) - Physical Plant as a Restrictive Force - Playing to Past Site-of-Care - Playing to Past Poor Structural Decisions (Split Between Health Care and Public Health: Inattention to Matching Treatment Need With Cost Platform; Bad Math; Outdated Casting of Science Domains)
16. © 2016 American Medical Association. All rights reserved. CEO Large Private Payer: “Future Impact of Site-of-Care is Vastly Underappreciated”
17. © 2016 American Medical Association. All rights reserved. AMA Medical School Consortium (11 original schools) * * * * * * * * * * * Indiana Mayo NYU Oregon Penn State Brody – East Carolina* Brown* UC Davis* UCSF Michigan Vanderbilt * (Sub-consortium for underserved populations/disparities) Each a piece of the puzzle Supported by AMA Grants/Infrastructure AMA Investment of $11 million in consortium
18. © 2016 American Medical Association. All rights reserved. 18 Expanded to 32 schools
19. © 2016 American Medical Association. All rights reserved. Products Developed 19 • Teaching EMR: – 2 new schools in 2016 – 1 new school in 2017 (to date) • HSS Textbook: – 5 schools using chapters this fall – 14 schools for 2017 • NBME style HSS subject exam: – 7 schools testing students this fall • Academic publications: 14 to date – 7 AMA authored papers
20. Enhancing Chronic Disease Curricula in Undergraduate Medical Education ACE-IHO Collaboration 20
21. © 2016 American Medical Association. All rights reserved. ACE-IHO Co-hosted Meeting to Enhance Chronic Disease Curricula in Undergraduate Medical Education 21 22 medical schools (28 faculty) from ACE Consortium gathered in Chicago June 20-21
22. © 2016 American Medical Association. All rights reserved. Next Steps for ACE-IHO • 19 medical schools (22 faculty) form interest group on chronic disease prevention and management • Charge of interest group is to establish goals and prioritize areas of focus: 1. Develop a sample curriculum for teaching chronic disease prevention and management 2. Create "ABC’s" (i.e., basic fundamentals/principles) of chronic disease prevention and management 3. Develop competencies related to chronic disease prevention and management 4. Create rubric for conducting a chronic disease- focused history and physical examination (H&P) 5. Create a repository of best practices and resources for teaching chronic disease prevention and management 22 • Interest group will continue to meet to enhance and reinvent the larger teaching paradigm for chronic disease prevention and management
23. © 2016 American Medical Association. All rights reserved. Three Big Ideas Now Drive AMA Strategy Bring medical education into the 21st century. Make the practice of medicine joyous again. Connect the clinic to the community to optimize health outcomes.
24. © 2016 American Medical Association. All rights reserved. Internal to Physician Practices External to Physician Practices Practice Transformation (STEPSForward) Physician Payment Professional Satisfaction and Practice Sustainability Digital Health Public Policy/Advocacy Physician Organizational Relationships Physician Leadership Training Research 24 Creating Thriving Physician Practices
25. © 2016 American Medical Association. All rights reserved. Physician Practice Improvement Modules: Beta Site Released in October/Final in June, 2015 www.stepsforward.org Transformation Toolkits • Pre-visit planning • Expanded rooming • Prescription management • Team documentation
26. © 2016 American Medical Association. All rights reserved. Steps Forward Digital Recognition 26 + Recognized as MACRA practice improvement tool
27. © 2016 American Medical Association. All rights reserved. The International Conference on Physician Health 27 • Sponsored by • American Medical Association (AMA) • Canadian Medical Association (CMA) • British Medical Association (BMA) • September 18-20, 2016 at the Boston Renaissance Waterfront Hotel www.ama-assn.org/go/physicianhealth
28. © 2016 American Medical Association. All rights reserved. …..Another Element that Shapes the Context: 28 MACRA
29. © 2016 American Medical Association. All rights reserved. Critical Elements in the MACRA Strategy • Tools for physicians and practice managers to facilitate their transition/adoption of new payment models • Correcting problems with existing incentive programs (MU, PQRS, VBM) • Maximizing alignment (or minimizing disconnect) between public and private sector models • Comprehensive and well coordinated communication and education network including physicians and practice managers 29
30. © 2016 American Medical Association. All rights reserved. Building an Iterative and Comprehensive Set of Resources 30 Version 1: Release early August Dedicated AMA website pages/content New StepsForward content Version 1.0 of Payment Model Evaluator • Educational content does not require login • User registration for enhanced personalized experience and ability to save information • Series of questions to assess which MACRA path applies • Assessment of MACRA and high-level financial impact
31. © 2016 American Medical Association. All rights reserved. AMA’s Three Strategic Ideas: The Work Has Defined Specific Problems Bring medical education into the 21st century. Make the practice of medicine joyous again. Connect the clinic to the community to optimize health outcomes. Need to Produce Solutions: (Products and Services)
32. © 2016 American Medical Association. All rights reserved. Emerging AMA Innovation Ecosystem Strategic/capi tal affiliates Academia Tech Firms Health Care System Strategic Partners Strategic Partners Strategic/capi tal affiliates Strategic/ Capital Affiliates Focus Areas Portfolio Management Business Products Advocacy Examples: Health2047 An integrated innovation company
33. © 2016 American Medical Association. All rights reserved. Multiple Ways Toward New Content/Product 33 Example 1: crowd sourcing ideas for internal work
34. © 2016 American Medical Association. All rights reserved. Steps Forward: Practice Transformation Resources 34 Eight new modules/resource pages released in August 1. Quality Reporting and the importance of Qualified Clinical Data Registries (QCDRs) 2. Patient and family advisory councils 3. Physician suicide and distress 4. Project ECHO 5. Choosing Wisely 6. Empathy training 7. Appreciative inquiry 8. Clinical decision support
35. © 2016 American Medical Association. All rights reserved. AMA Interaction Studio at MATTER (~ 130 Healthcare Startups) 35 Feb 2015 Example 2: embed knowledge in accelerator
36. © 2016 American Medical Association. All rights reserved. Innovation Studio – Health 2047 • Critical Elements: – Governance Separation • Permissive of cultural differences – Location • Where needed talent/skill reside – Interface – Not specified to unique niche – Not THE innovation solution • Model: 36 Example 3: stand up an integrated innovation studio
37. © 2016 American Medical Association. All rights reserved. 521 7th Street San Francisco 37
38. © 2016 American Medical Association. All rights reserved. -Rapid Prototyping -Co-development -Mixed Functions Apply knowledge of AMA micro-verticals – link to tech center
39. © 2016 American Medical Association. All rights reserved. 39 Improving outcomes of chronic disease Defining Med School of future Creating thriving practices A key to systems engineering: “define the boundaries of the system” Prototyping Solutions workflow patient engagement physician tools and networks Segmentation for focused sector investment/ prototype development Post-product integration – toward systems solutions convergence Richard Larson Mitsui Professor of Engineering Systems, M.I.T. Problem Idea Prototype Sector Product Converge
40. © 2016 American Medical Association. All rights reserved. Health Solutions Snapshot A Comprehensive Product Portfolio of AMA IP • Masterfile The nation's largest repository of primary source physician data. • CPT® The United States standard for how medical professionals document and report medical, surgical, radiology, laboratory, anesthesiology, and evaluation and management (E/M) services. CPT® is the only medical code set in the world authored by practicing clinical experts representing the full House of Medicine. • AMA Guides® to the Evaluation of Permanent Impairment The standard in medical impairment rating, emphasizing the fundamental skills physicians need to evaluate and communicate patient impairments. Adopted in 43 states and seven countries. 40 Example 4: create dynamic new versions of business products internally
41. © 2016 American Medical Association. All rights reserved. Print and Digital Content Portfolio • More than 100 titles with concentration on serving the coding industry • Coding industry is experiencing explosive growth • Global Market: $33B and 88% digital Print will continue to decline but will not disappear Outsell, Inc.: Scientific, Technical & Medical Information: 2015 Market Size, Share, Forecast, and Trend Report • Strategic Direction: Advance portfolio to 50% digital in 3-5 years • Best Practice: JAMA transformation 41 97.5% 2.5% Revenue: current state Print Digital 50% 50% Revenue: future state (Dollars in millions) 2013 2014 2015 2016 2017 2018 2019 Revenue $ 39.2 $ 38.4 $ 41.3 $ 39.0 $ 39.5 $ 40.5 $ 42.0 Contribution Margin $ 23.6 $ 21.8 $ 24.4 $ 23.0 $ 23.5 $ 24.0 $ 25.0 Today 3-5 Years
42. Hosted by © 2016 Health Integrated. All rights reserved.