[Applause] as a physician and the leader of a large
as a physician and the leader of a large
as a physician and the leader of a large health system there’s something I want
health system there’s something I want
health system there’s something I want to share with you in the United States
to share with you in the United States
to share with you in the United States we are really good at sickness care in
we are really good at sickness care in
we are really good at sickness care in fact we may be the best in the world
fact we may be the best in the world
fact we may be the best in the world sickness care is the care that you get
sickness care is the care that you get
sickness care is the care that you get when you come to the hospital come to
when you come to the hospital come to
when you come to the hospital come to the emergency department sickness care
the emergency department sickness care
the emergency department sickness care is often about doing things doing tests
is often about doing things doing tests
is often about doing things doing tests and doing procedures but I want to tell
and doing procedures but I want to tell
and doing procedures but I want to tell you something else we’re not getting the
you something else we’re not getting the
you something else we’re not getting the care that we need I know this as a
care that we need I know this as a
care that we need I know this as a physician as a healthcare executive and
physician as a healthcare executive and
physician as a healthcare executive and as a daughter in 2005 my father was
as a daughter in 2005 my father was
as a daughter in 2005 my father was diagnosed with a rapidly progressive
diagnosed with a rapidly progressive
diagnosed with a rapidly progressive dementia he died in 2009 and in between
dementia he died in 2009 and in between
dementia he died in 2009 and in between we struggled as soon as I heard the
we struggled as soon as I heard the
we struggled as soon as I heard the diagnosis I knew I knew that he would
diagnosis I knew I knew that he would
diagnosis I knew I knew that he would continue to decline and soon become
continue to decline and soon become
continue to decline and soon become unrecognizable as the husband and father
unrecognizable as the husband and father
unrecognizable as the husband and father that we knew but I thought we’ve got
that we knew but I thought we’ve got
that we knew but I thought we’ve got this I’m a doctor my middle sister is a
this I’m a doctor my middle sister is a
this I’m a doctor my middle sister is a nurse and an Episcopal priest my
nurse and an Episcopal priest my
nurse and an Episcopal priest my youngest sister’s a social worker and my
youngest sister’s a social worker and my
youngest sister’s a social worker and my mother was the world’s best Executive
mother was the world’s best Executive
mother was the world’s best Executive Assistant we were the perfect team but
Assistant we were the perfect team but
Assistant we were the perfect team but it soon became clear that being the
it soon became clear that being the
it soon became clear that being the perfect team simply wasn’t enough we
perfect team simply wasn’t enough we
perfect team simply wasn’t enough we were challenged we went from crisis to
were challenged we went from crisis to
were challenged we went from crisis to crisis and the care was there when the
crisis and the care was there when the
crisis and the care was there when the crisis happened but it was what occurred
crisis happened but it was what occurred
crisis happened but it was what occurred in between that was so difficult he had
in between that was so difficult he had
in between that was so difficult he had multiple hospitalizations multiple
multiple hospitalizations multiple
multiple hospitalizations multiple visits to the emergency department in
visits to the emergency department in
visits to the emergency department in one very poignant moment when we were in
one very poignant moment when we were in
one very poignant moment when we were in a
a
a I ki a trick crisis center where he was
I ki a trick crisis center where he was
I ki a trick crisis center where he was absolutely convinced that his doctor was
absolutely convinced that his doctor was
absolutely convinced that his doctor was dr. Sanjay Gupta from CNN I thought this
dr. Sanjay Gupta from CNN I thought this
dr. Sanjay Gupta from CNN I thought this just isn’t right he shouldn’t be here he
just isn’t right he shouldn’t be here he
just isn’t right he shouldn’t be here he should be at home the resources that we
should be at home the resources that we
should be at home the resources that we thought were available to care for him
thought were available to care for him
thought were available to care for him either weren’t accessible weren’t
either weren’t accessible weren’t
either weren’t accessible weren’t affordable or simply didn’t exist now I
affordable or simply didn’t exist now I
affordable or simply didn’t exist now I know that many of you have had a similar
know that many of you have had a similar
know that many of you have had a similar experience caring for a loved one with a
experience caring for a loved one with a
experience caring for a loved one with a complicated illness and certainly if
complicated illness and certainly if
complicated illness and certainly if it’s dementia the worries about safety
it’s dementia the worries about safety
it’s dementia the worries about safety and wandering are all part of that
and wandering are all part of that
and wandering are all part of that concern and I don’t have to tell you the
concern and I don’t have to tell you the
concern and I don’t have to tell you the coordinating appointments managing
coordinating appointments managing
coordinating appointments managing medication schedules arranging
medication schedules arranging
medication schedules arranging transportation getting information from
transportation getting information from
transportation getting information from one doctor to another doctor it easily
one doctor to another doctor it easily
one doctor to another doctor it easily becomes a full-time job and I also don’t
becomes a full-time job and I also don’t
becomes a full-time job and I also don’t have to tell you that doing that job may
have to tell you that doing that job may
have to tell you that doing that job may mean the difference between your loved
mean the difference between your loved
mean the difference between your loved ones staying at home or going back to
ones staying at home or going back to
ones staying at home or going back to the hospital we need a different system
the hospital we need a different system
the hospital we need a different system of care we need a system that provides
of care we need a system that provides
of care we need a system that provides care between those moments of crisis a
care between those moments of crisis a
care between those moments of crisis a system that prevents those moments of
system that prevents those moments of
system that prevents those moments of crisis so here’s something else that’s
crisis so here’s something else that’s
crisis so here’s something else that’s really important to know five percent of
really important to know five percent of
really important to know five percent of the population accounts for fifty
the population accounts for fifty
the population accounts for fifty percent of what we spend on healthcare
percent of what we spend on healthcare
percent of what we spend on healthcare think about that half of what we spend
think about that half of what we spend
think about that half of what we spend in healthcare goes to five percent of
in healthcare goes to five percent of
in healthcare goes to five percent of the population now some of those people
the population now some of those people
the population now some of those people have a devastating illness but most of
have a devastating illness but most of
have a devastating illness but most of those people have chronic disease often
those people have chronic disease often
those people have chronic disease often multiple chronic too
multiple chronic too
multiple chronic too Jesus it turns out that forty-five
Jesus it turns out that forty-five
Jesus it turns out that forty-five percent of Americans have a chronic
percent of Americans have a chronic
percent of Americans have a chronic disease diseases like diabetes
disease diseases like diabetes
disease diseases like diabetes hypertension heart failure chronic lung
hypertension heart failure chronic lung
hypertension heart failure chronic lung disease depression eighty-one percent of
disease depression eighty-one percent of
disease depression eighty-one percent of our hospital beds are filled with people
our hospital beds are filled with people
our hospital beds are filled with people who have complications from from chronic
who have complications from from chronic
who have complications from from chronic disease people with chronic disease
disease people with chronic disease
disease people with chronic disease particularly people with multiple
particularly people with multiple
particularly people with multiple chronic diseases are most at risk when
chronic diseases are most at risk when
chronic diseases are most at risk when it comes to care that’s not well
it comes to care that’s not well
it comes to care that’s not well coordinated and as you know there’s a
coordinated and as you know there’s a
coordinated and as you know there’s a human cost there’s a human cost but
human cost there’s a human cost but
human cost there’s a human cost but there’s also a financial cost we spend
there’s also a financial cost we spend
there’s also a financial cost we spend over three trillion dollars on
over three trillion dollars on
over three trillion dollars on healthcare in the United States and it’s
healthcare in the United States and it’s
healthcare in the United States and it’s going up the costs are rising people are
going up the costs are rising people are
going up the costs are rising people are paying more out-of-pocket state
paying more out-of-pocket state
paying more out-of-pocket state government federal government are
government federal government are
government federal government are stretched private employers are
stretched private employers are
stretched private employers are concerned about rising costs we have to
concerned about rising costs we have to
concerned about rising costs we have to do something different part of our
do something different part of our
do something different part of our challenge is that the current payment
challenge is that the current payment
challenge is that the current payment system rewards sickness care it’s
system rewards sickness care it’s
system rewards sickness care it’s fee-for-service people get paid for
fee-for-service people get paid for
fee-for-service people get paid for doing things for the volume of care
doing things for the volume of care
doing things for the volume of care rather than the value of care so if
rather than the value of care so if
rather than the value of care so if we’re going to help achieve better
we’re going to help achieve better
we’re going to help achieve better health and do it at a lower cost we need
health and do it at a lower cost we need
health and do it at a lower cost we need to make a fundamental change in how we
to make a fundamental change in how we
to make a fundamental change in how we deliver care we need a system of care
deliver care we need a system of care
deliver care we need a system of care that supports people who have chronic
that supports people who have chronic
that supports people who have chronic disease that doesn’t let people bounce
disease that doesn’t let people bounce
disease that doesn’t let people bounce from crisis to crisis but is a system
from crisis to crisis but is a system
from crisis to crisis but is a system that’s proactive meets people where they
that’s proactive meets people where they
that’s proactive meets people where they are and gives them the opportunity to
are and gives them the opportunity to
are and gives them the opportunity to lead a quality of life that’s meaningful
lead a quality of life that’s meaningful
lead a quality of life that’s meaningful to them
to them
to them keeps them keeps them at home keeps them
keeps them keeps them at home keeps them
keeps them keeps them at home keeps them in the community and provides care
in the community and provides care
in the community and provides care that’s affordable so there are a lot of
that’s affordable so there are a lot of
that’s affordable so there are a lot of creative ways that people are thinking
creative ways that people are thinking
creative ways that people are thinking about solving this issue and at
about solving this issue and at
about solving this issue and at christiana care health system in
christiana care health system in
christiana care health system in Wilmington Delaware we’ve developed an
Wilmington Delaware we’ve developed an
Wilmington Delaware we’ve developed an approach to caring for people with
approach to caring for people with
approach to caring for people with chronic disease we call it Christiana
chronic disease we call it Christiana
chronic disease we call it Christiana Care carelink and it’s why I’m so
Care carelink and it’s why I’m so
Care carelink and it’s why I’m so optimistic about the future of health
optimistic about the future of health
optimistic about the future of health care so let me tell you a story let me
care so let me tell you a story let me
care so let me tell you a story let me tell you about Denise Denise is 68 years
tell you about Denise Denise is 68 years
tell you about Denise Denise is 68 years old and she has diabetes she recently
old and she has diabetes she recently
old and she has diabetes she recently became the guardian of four
became the guardian of four
became the guardian of four grandchildren she stressed and her
grandchildren she stressed and her
grandchildren she stressed and her finances are stretched she stops going
finances are stretched she stops going
finances are stretched she stops going to her primary care physician she
to her primary care physician she
to her primary care physician she stopped seeing her therapist she starts
stopped seeing her therapist she starts
stopped seeing her therapist she starts cutting corners with her medication so
cutting corners with her medication so
cutting corners with her medication so not surprisingly soon Denise doesn’t
not surprisingly soon Denise doesn’t
not surprisingly soon Denise doesn’t feel very well most of the time so she
feel very well most of the time so she
feel very well most of the time so she does what most people do when they don’t
does what most people do when they don’t
does what most people do when they don’t feel well she goes to the emergency
feel well she goes to the emergency
feel well she goes to the emergency department in fact she goes seven times
department in fact she goes seven times
department in fact she goes seven times in three months and on several of those
in three months and on several of those
in three months and on several of those occasions she’s admitted to the hospital
so what does caroling do that’s
so what does caroling do that’s different so caroling starts with a
different so caroling starts with a
different so caroling starts with a unique innovative data platform so think
unique innovative data platform so think
unique innovative data platform so think of it this way all of Denise’s
of it this way all of Denise’s
of it this way all of Denise’s healthcare information regardless of
healthcare information regardless of
healthcare information regardless of where she gets care regardless of which
where she gets care regardless of which
where she gets care regardless of which hospital which physicians office which
hospital which physicians office which
hospital which physicians office which lab testing center all of that
lab testing center all of that
lab testing center all of that information goes into a data bucket and
information goes into a data bucket and
information goes into a data bucket and it’s Denise’s own data bucket and better
it’s Denise’s own data bucket and better
it’s Denise’s own data bucket and better yet it goes there in real time and then
yet it goes there in real time and then
yet it goes there in real time and then carelink uses artificial intelligence
carelink uses artificial intelligence
carelink uses artificial intelligence machine learning to help us understand
machine learning to help us understand
machine learning to help us understand what is it that’s putting Denise at risk
what is it that’s putting Denise at risk
what is it that’s putting Denise at risk and then it uses that learning to create
and then it uses that learning to create
and then it uses that learning to create a tool that relies on predictive
a tool that relies on predictive
a tool that relies on predictive analytics to help determine exactly what
analytics to help determine exactly what
analytics to help determine exactly what Denise’s risk is in real time and most
Denise’s risk is in real time and most
Denise’s risk is in real time and most importantly it then informs the carelink
importantly it then informs the carelink
importantly it then informs the carelink team it alerts the caroling team a team
team it alerts the caroling team a team
team it alerts the caroling team a team of wonderful compassionate caring
of wonderful compassionate caring
of wonderful compassionate caring professionals nurses physicians social
professionals nurses physicians social
professionals nurses physicians social workers therapists nutritionists it
workers therapists nutritionists it
workers therapists nutritionists it gives the caroling team the opportunity
gives the caroling team the opportunity
gives the caroling team the opportunity to be proactive to reach out to make a
to be proactive to reach out to make a
to be proactive to reach out to make a difference for Denise and others like
difference for Denise and others like
difference for Denise and others like Denise before the crisis occurs so this
Denise before the crisis occurs so this
Denise before the crisis occurs so this is what the carelink team did for Denise
is what the carelink team did for Denise
is what the carelink team did for Denise the nurse called her and learned about
the nurse called her and learned about
the nurse called her and learned about the four grandchildren and understood
the four grandchildren and understood
the four grandchildren and understood the kind of stress that Denise was under
the kind of stress that Denise was under
the kind of stress that Denise was under so the caroling nurse got the caroling
so the caroling nurse got the caroling
so the caroling nurse got the caroling social worker involved the caroling
social worker involved the caroling
social worker involved the caroling social worker linked Denise and her
social worker linked Denise and her
social worker linked Denise and her family to community resources that would
family to community resources that would
family to community resources that would help support her in caring for her
help support her in caring for her
help support her in caring for her grandchildren the caroling nurse also
grandchildren the caroling nurse also
grandchildren the caroling nurse also engaged the carelink pharmacist the
engaged the carelink pharmacist the
engaged the carelink pharmacist the caroling pharmacist reviewed her
caroling pharmacist reviewed her
caroling pharmacist reviewed her medications was able to make some
medications was able to make some
medications was able to make some changes trim the list find more
changes trim the list find more
changes trim the list find more affordable medications and then also
affordable medications and then also
affordable medications and then also enroll her in a financial assistance
enroll her in a financial assistance
enroll her in a financial assistance program the carelink nurse did something
program the carelink nurse did something
program the carelink nurse did something else she connected Denise back to her
else she connected Denise back to her
else she connected Denise back to her primary care physician who said I was
primary care physician who said I was
primary care physician who said I was wondering what happened to Denise
wondering what happened to Denise
wondering what happened to Denise haven’t seen her for a while and the
haven’t seen her for a while and the
haven’t seen her for a while and the nurse also connected didn’t connected
nurse also connected didn’t connected
nurse also connected didn’t connected Denise back to her therapist a whole
Denise back to her therapist a whole
Denise back to her therapist a whole team not only addressing Denise’s
team not only addressing Denise’s
team not only addressing Denise’s medical needs but also thinking
medical needs but also thinking
medical needs but also thinking holistically about her social needs and
holistically about her social needs and
holistically about her social needs and what it would take
what it would take
what it would take to help Denise stay healthy but along
to help Denise stay healthy but along
to help Denise stay healthy but along the way the social worker found
the way the social worker found
the way the social worker found something that nobody expected Denise
something that nobody expected Denise
something that nobody expected Denise couldn’t read denise couldn’t write and
couldn’t read denise couldn’t write and
couldn’t read denise couldn’t write and denise couldn’t understand numbers so
denise couldn’t understand numbers so
denise couldn’t understand numbers so every time Denise had been given a piece
every time Denise had been given a piece
every time Denise had been given a piece of paper your follow-up appointment is
of paper your follow-up appointment is
of paper your follow-up appointment is on such-and-such a date call this number
on such-and-such a date call this number
on such-and-such a date call this number it was useless for Denise so the social
it was useless for Denise so the social
it was useless for Denise so the social worker did one more thing the social
worker did one more thing the social
worker did one more thing the social worker got Denise to a literacy support
worker got Denise to a literacy support
worker got Denise to a literacy support group to help her learn some new skills
group to help her learn some new skills
group to help her learn some new skills the caroling team gave Denise the
the caroling team gave Denise the
the caroling team gave Denise the opportunity to access care that met all
opportunity to access care that met all
opportunity to access care that met all of her needs they made sure the Denise
of her needs they made sure the Denise
of her needs they made sure the Denise went to her apartments they made sure
went to her apartments they made sure
went to her apartments they made sure she took her medications they connected
she took her medications they connected
she took her medications they connected her to community resources they made
her to community resources they made
her to community resources they made sure that Denise didn’t fall through the
sure that Denise didn’t fall through the
sure that Denise didn’t fall through the cracks so what were the results in the
cracks so what were the results in the
cracks so what were the results in the next three months no emergency
next three months no emergency
next three months no emergency department visits no hospitalizations
department visits no hospitalizations
department visits no hospitalizations probably saving the system maybe fifty
probably saving the system maybe fifty
probably saving the system maybe fifty thousand dollars in a voided health care
thousand dollars in a voided health care
thousand dollars in a voided health care costs but more importantly Denise felt
costs but more importantly Denise felt
costs but more importantly Denise felt great Denise was healthier her diabetes
great Denise was healthier her diabetes
great Denise was healthier her diabetes was under control and she had the
was under control and she had the
was under control and she had the resources that she needed to lead the
resources that she needed to lead the
resources that she needed to lead the quality of life that was important to
quality of life that was important to
quality of life that was important to her she had energy to run after those
her she had energy to run after those
her she had energy to run after those grandchildren in the first few months of
grandchildren in the first few months of
grandchildren in the first few months of carelink we know we’re making a
carelink we know we’re making a
carelink we know we’re making a difference not just for Denise but for
difference not just for Denise but for
difference not just for Denise but for thousands of others we’re reducing
thousands of others we’re reducing
thousands of others we’re reducing readmissions to the hospital we’re
readmissions to the hospital we’re
readmissions to the hospital we’re reducing emergency department visits
reducing emergency department visits
reducing emergency department visits most importantly we’re improving health
most importantly we’re improving health
most importantly we’re improving health outcomes people are getting back on
outcomes people are getting back on
outcomes people are getting back on their feet sooner
their feet sooner
their feet sooner after they’ve had surgery people with
after they’ve had surgery people with
after they’ve had surgery people with chronic disease are able to stay at home
chronic disease are able to stay at home
chronic disease are able to stay at home more and lead the lives that are
more and lead the lives that are
more and lead the lives that are important to them in terms of quality
important to them in terms of quality
important to them in terms of quality and in a few short months we know that
and in a few short months we know that
and in a few short months we know that Carol Inc has saved millions of dollars
Carol Inc has saved millions of dollars
Carol Inc has saved millions of dollars by creating a system that delivers the
by creating a system that delivers the
by creating a system that delivers the care that people need in the way that
care that people need in the way that
care that people need in the way that they need it caroling is making a
they need it caroling is making a
they need it caroling is making a difference and I don’t think we’re
difference and I don’t think we’re
difference and I don’t think we’re finished yet I think there’s much more
finished yet I think there’s much more
finished yet I think there’s much more to come I can envision a time when all
to come I can envision a time when all
to come I can envision a time when all of us have a nap on that little computer
of us have a nap on that little computer
of us have a nap on that little computer that lives in our pocket or in our purse
that lives in our pocket or in our purse
that lives in our pocket or in our purse and that app is our data bucket and no
and that app is our data bucket and no
and that app is our data bucket and no matter where we are whether we’re in
matter where we are whether we’re in
matter where we are whether we’re in Delaware in the United States or
Delaware in the United States or
Delaware in the United States or anywhere in the world where ever we get
anywhere in the world where ever we get
anywhere in the world where ever we get care that all of that data comes into
care that all of that data comes into
care that all of that data comes into that app into that databook it and
that app into that databook it and
that app into that databook it and better yet all of that data is connected
better yet all of that data is connected
better yet all of that data is connected to a care team so that wherever we are
to a care team so that wherever we are
to a care team so that wherever we are if we have an issue we can reach out to
if we have an issue we can reach out to
if we have an issue we can reach out to that care team and get care but more
that care team and get care but more
that care team and get care but more importantly that care team can tell us
importantly that care team can tell us
importantly that care team can tell us that we’re at risk for experiencing a
that we’re at risk for experiencing a
that we’re at risk for experiencing a crisis and by reaching out to us
crisis and by reaching out to us
crisis and by reaching out to us wherever we are can prevent that crisis
wherever we are can prevent that crisis
wherever we are can prevent that crisis from happening can change the trajectory
from happening can change the trajectory
from happening can change the trajectory of care simply put it’s about getting
of care simply put it’s about getting
of care simply put it’s about getting the right care in the right place at the
the right care in the right place at the
the right care in the right place at the right time and it is the right thing to
right time and it is the right thing to
right time and it is the right thing to do so I often think I wonder what it
do so I often think I wonder what it
do so I often think I wonder what it would have been like for my family
would have been like for my family
would have been like for my family particularly my mother if carelink had
particularly my mother if carelink had
particularly my mother if carelink had been around when my father was ill I
been around when my father was ill I
been around when my father was ill I truly believe that if we had had access
truly believe that if we had had access
truly believe that if we had had access to Carolyn
to Carolyn
to Carolyn it would have made all the difference in
it would have made all the difference in
it would have made all the difference in the world it would have meant that my
the world it would have meant that my
the world it would have meant that my father could have been at home more and
father could have been at home more and
father could have been at home more and it would have meant that my mother could
it would have meant that my mother could
it would have meant that my mother could be that have been that effective
be that have been that effective
be that have been that effective caregiver she so desperately wanted to
caregiver she so desperately wanted to
caregiver she so desperately wanted to be so important for her so as a daughter
be so important for her so as a daughter
be so important for her so as a daughter as a healthcare executive and as a
as a healthcare executive and as a
as a healthcare executive and as a physician I know that we can create a
physician I know that we can create a
physician I know that we can create a system of care that addresses the needs
system of care that addresses the needs
system of care that addresses the needs that we have provides us with the health
that we have provides us with the health
that we have provides us with the health that we deserve and do it in a way
that we deserve and do it in a way
that we deserve and do it in a way that’s affordable and that is
that’s affordable and that is
that’s affordable and that is sustainable value
sustainable value
sustainable value [Applause]
”
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