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How can you combat cardiovascular disease - the world's top killer?

You can’t do it alone. It’s only through partnerships, where we combine the forces of data, device technology and medical expertise.

By Didier Deltort, Vice President and General Manager for Global Healthcare Solutions and Partnerships, Boston Scientific

Digital technologies are enabling breakthrough research to be carried out at an astounding pace in healthcare – research that’s leading to a more precise understanding of patient needs across a wide spectrum of disease states, and enabling more effective therapies and more comprehensive, tailored care. As a result, new forms of digitally enabled services and solutions are improving, becoming more functionally effective and more cost-effective to deploy at scale.

What’s more, governments, providers, payers and pharmaceutical and medical device companies are leveraging these developments, exploring new approaches, strategies and business models to spark a major improvement in health and healthcare. At the same time, however, this increasing array of treatment paths can be overwhelming for healthcare providers and their patients, particularly for the growing number of people who are suffering from complex and enduring conditions, such as chronic heart failure.

Partnership is needed among and across the various healthcare stakeholders to use real-world data and evidence to determine which patients gain the most benefit from which interventions, and how those decisions might change with new forms of post-acute and post-discharge care coordination. 

Digital technologies are enabling breakthrough research to be carried out at an astounding pace in healthcare – research that’s leading to a more precise understanding of patient needs across a wide spectrum of disease states, and enabling more effective therapies and more comprehensive, tailored care. As a result, new forms of digitally enabled services and solutions are improving, becoming more functionally effective and more cost-effective to deploy at scale.

What’s more, governments, providers, payers and pharmaceutical and medical device companies are leveraging these developments, exploring new approaches, strategies and business models to spark a major improvement in health and healthcare. At the same time, however, this increasing array of treatment paths can be overwhelming for healthcare providers and their patients, particularly for the growing number of people who are suffering from complex and enduring conditions, such as chronic heart failure.

Partnership is needed among and across the various healthcare stakeholders to use real-world data and evidence to determine which patients gain the most benefit from which interventions, and how those decisions might change with new forms of post-acute and post-discharge care coordination. 

Collaborative approach

Boston Scientific has had the good fortune to work with some of the world’s leading institutions toward the goal of defining what best practices for the next generation of healthcare might look like. A good example is the care of patients with chronic heart failure, which has been identified as one of the costliest disease states to manage. In Europe, heart failure accounts for about 2% of healthcare spending, and results in average hospital stays of 11 days. Many of these costly stays are readmissions, which raises the question: Is there a way to help patients stay out of the hospital after receiving treatment for heart failure? To answer, we embarked on a research project in collaboration with global life sciences service provider Accenture, and some of the leading institutions in Scandinavia and the UK, to assess the current state of care delivery for heart failure patients and to identify opportunities for improvement at each hospital.

The work resulted in the development of a cloud-based, data-driven digital solution that will become part of our growing ADVANTICS™ portfolio of innovative healthcare solutions. Essentially, the solution gives providers more robust and timely insights into their patient populations, so they can make better and more proactive decisions designed to improve the care patients receive, both while they are in the hospital and after they are discharged. To do this, it relies on Accenture’s analytics insights platform to monitor three key measurements: patient engagement (the content and tools to support patients as they self-manage their condition); care coordination (the technology platform to enroll and consistently follow up with patients post discharge); and pathway analytics (the dashboards to track heart failure patient outcomes and financial impact).

Partnership is needed among and across the various healthcare stakeholders to use real-world data and evidence to determine which patients gain the most benefit from which interventions. Maria Stewart, Vice President for Health Economics and Medical Affairs at Boston Scientific, said of the project: “We know it isn’t good enough for innovative technologies to only improve clinical scenarios; they have to be sustainable in the real world as well. They have to improve patient outcomes and offer economic value to healthcare systems.”

This fundamental outlook drove the project, particularly at Tampere Heart Hospital, a full-service center with multidisciplinary heart teams providing services throughout Finland and beyond. Dr Kari Niemelä, CEO, noted: “The collaboration with Boston Scientific identified significant opportunities to increase provider collaboration and improve the quality of care that patients experience when coming to our hospital. For example, we found a 25% unnecessary heart failure readmission rate, and therefore a definite need for better care coordination, supported by modern technology and processes that can decrease overall costs.”

Dr. Jeff Elton, Managing Director of Accenture Strategy and global lead for the predictive health intelligence and patient health practices at Accenture, shares this view: “Realizing value is a function of recognizing early what is best for a patient, preparing the institution and the patient for what needs to be done and better equipping and partnering with the patient for self-care and self-management once they are discharged. That’s extremely difficult – if not impossible – for any single organization to do on its own, especially in this day and age. And so it really has to be a journey undertaken with partners that brings their own capabilities and distinctive talents to the table, and shares the relentless perseverance it takes to succeed.”

At Boston Scientific, this initiative has helped advance a patient-care-services approach to our work, in addition to our focus on developing medical devices. We know we can contribute to achieving the best possible clinical and economic outcomes in a variety of ways, with our medical device innovation and with digitally fuelled solutions. This collaboration was less about developing a particular product and more about figuring out how to enable a hospital to treat many more patients in a better way, while being extremely conscious of the current cost structure and the need to reduce costs where possible.

photo healthcare professionals reviewing patient chart photo healthcare professionals reviewing patient chart

Collaborative approach
 

Boston Scientific has had the good fortune to work with some of the world’s leading institutions toward the goal of defining what best practices for the next generation of healthcare might look like. A good example is the care of patients with chronic heart failure, which has been identified as one of the costliest disease states to manage. In Europe, heart failure accounts for about 2% of healthcare spending, and results in average hospital stays of 11 days. Many of these costly stays are readmissions, which raises the question: Is there a way to help patients stay out of the hospital after receiving treatment for heart failure? To answer, we embarked on a research project in collaboration with global life sciences service provider Accenture, and some of the leading institutions in Scandinavia and the UK, to assess the current state of care delivery for heart failure patients and to identify opportunities for improvement at each hospital. 

The work resulted in the development of a cloud-based, data-driven digital solution that will become part of our growing ADVANTICS™ portfolio of innovative healthcare solutions. Essentially, the solution gives providers more robust and timely insights into their patient populations, so they can make better and more proactive decisions designed to improve the care patients receive, both while they are in the hospital and after they are discharged. To do this, it relies on Accenture’s analytics insights platform to monitor three key measurements: patient engagement (the content and tools to support patients as they self-manage their condition); care coordination (the technology platform to enroll and consistently follow up with patients post discharge); and pathway analytics (the dashboards to track heart failure patient outcomes and financial impact). 

Partnership is needed among and across the various healthcare stakeholders to use real-world data and evidence to determine which patients gain the most benefit from which interventions. Maria Stewart, Vice President for Health Economics and Market Access at Boston Scientific, said of the project: “We know it isn’t good enough for innovative technologies to only improve clinical scenarios; they have to be sustainable in the real world as well. They have to improve patient outcomes and offer economic value to healthcare systems.”

photo of physicians in lab under headlight photo of physicians in lab under headlight

This fundamental outlook drove the project, particularly at Tampere Heart Hospital, a full-service center with multidisciplinary heart teams providing services throughout Finland and beyond. Dr Kari Niemelä, CEO, noted: “The collaboration with Boston Scientific identified significant opportunities to increase provider collaboration and improve the quality of care that patients experience when coming to our hospital. For example, we found a 25% unnecessary heart failure readmission rate, and therefore a definite need for better care coordination, supported by modern technology and processes that can decrease overall costs.” 

Dr. Jeff Elton, Managing Director of Accenture Strategy and global lead for the predictive health intelligence and patient health practices at Accenture, shares this view: “Realizing value is a function of recognizing early what is best for a patient, preparing the institution and the patient for what needs to be done and better equipping and partnering with the patient for self-care and self-management once they are discharged. That’s extremely difficult – if not impossible – for any single organization to do on its own, especially in this day and age. And so it really has to be a journey undertaken with partners that brings their own capabilities and distinctive talents to the table, and shares the relentless perseverance it takes to succeed.”

At Boston Scientific, this initiative has helped advance a patient-care-services approach to our work, in addition to our focus on developing medical devices. We know we can contribute to achieving the best possible clinical and economic outcomes in a variety of ways, with our medical device innovation and with digitally fueled solutions. This collaboration was less about developing a particular product and more about figuring out how to enable a hospital to treat many more patients in a better way, while being extremely conscious of the current cost structure and the need to reduce costs where possible. 

At Boston Scientific, this initiative has helped advance a patient-care-services approach to our work, in addition to our focus on developing medical devices. We know we can contribute to achieving the best possible clinical and economic outcomes in a variety of ways, with our medical device innovation and with digitally fuelled solutions. This collaboration was less about developing a particular product and more about figuring out how to enable a hospital to treat many more patients in a better way, while being extremely conscious of the current cost structure and the need to reduce costs where possible. 

Catheterization lab innovation
 

Tampere Heart Hospital has been pursuing other ways to improve patient services, for example through the continuous improvement program it has implemented in its catheterization lab for cardiac rhythm management patients.

Tampere has limited resources, a constrained budget, and limited experience with change management initiatives. In 2013, its leaders committed to finding a way to build continuous improvement into its operations. Focusing on the lab, they wanted to be able to treat more patients while improving its outcome/cost ratio at the same time. If their efforts were successful, they could extend this work across other areas over time. 

The project began with a complete analysis of the lab’s infrastructure and processes. Here, Boston Scientific was again able to contribute. Working alongside Tampere senior staff as part of a team called Tahti (the Finnish word for ‘pacing’), we began with a workshop to identify opportunities to optimise patient flow.

The workshop generated 29 improvement ideas that Tampere has since pursued, including: redesigning the elective patient process to create a more efficient patient flow (targeted improvements included rigorous on-time procedure starts, preparation of the lab and procedure details the day before, and clearer processes for scheduling elective activity and managing the emergency caseload); improving patient treatment plans (in particular, ensuring named staff are allocated to each treatment, preventing any gaps or uncertainties); and using whiteboards to track employee satisfaction (staff members logged their mood at the end of each day, and started each new day with a ‘huddle’ to review status and discuss improvement ideas). 

Tampere also articulated its strategic goals in terms of actionable, measureable activities. Specifically, over a seven-year period, the Heart Hospital determined to: increase the number of pacemaker patients treated by 30 percent; reduce the number of patient follow-up appointments required by 50 percent; and improve procedure process flow, reducing the total time patients spend in the lab by 20 percent.

After six months, the lab had a robust process in place to measure and share performance data. Staff satisfaction levels had also improved, largely as a result of clearer objectives, roles and responsibilities. And, after a year, the number of pacemaker patients treated had increased by nine percent, while those requiring follow-up appointments had decreased by 14 percent. 

Looking ahead, Tampere plans to broaden responsibility for improvement activity. Teams of doctors and nurses will begin working on various initiatives, guided by experienced Tahti project coaches, who will also pursue training in lean Six Sigma tools and principles. 

 

1. Boston Scientific case study, Performance Optimization, Tampere University Hospital, Cardio Rhythm Lab Continuous Improvement Program, Boston Scientific, 

2015 A longer version of this article was published in The New Economy May 17, 2017

Read a story about Watchman left atrial appendage (LAA) closure device, an implanted heart device designed to reduce the risk of strokes in certain patients, and other Boston Scientific technologies designed to improve outcomes and the patient experience. 

At Boston Scientific, this initiative has helped advance a patient-care-services approach to our work, in addition to our focus on developing medical devices. We know we can contribute to achieving the best possible clinical and economic outcomes in a variety of ways, with our medical device innovation and with digitally fuelled solutions. This collaboration was less about developing a particular product and more about figuring out how to enable a hospital to treat many more patients in a better way, while being extremely conscious of the current cost structure and the need to reduce costs where possible. 

Catheterization lab innovation
 

Tampere Heart Hospital has been pursuing other ways to improve patient services, for example through the continuous improvement program it has implemented in its catheterization lab for cardiac rhythm management patients.

Tampere has limited resources, a constrained budget, and limited experience with change management initiatives. In 2013, its leaders committed to finding a way to build continuous improvement into its operations. Focusing on the lab, they wanted to be able to treat more patients while improving its outcome/cost ratio at the same time. If their efforts were successful, they could extend this work across other areas over time. 

The project began with a complete analysis of the lab’s infrastructure and processes. Here, Boston Scientific was again able to contribute. Working alongside Tampere senior staff as part of a team called Tahti (the Finnish word for ‘pacing’), we began with a workshop to identify opportunities to optimise patient flow.

The workshop generated 29 improvement ideas that Tampere has since pursued, including: redesigning the elective patient process to create a more efficient patient flow (targeted improvements included rigorous on-time procedure starts, preparation of the lab and procedure details the day before, and clearer processes for scheduling elective activity and managing the emergency caseload); improving patient treatment plans (in particular, ensuring named staff are allocated to each treatment, preventing any gaps or uncertainties); and using whiteboards to track employee satisfaction (staff members logged their mood at the end of each day, and started each new day with a ‘huddle’ to review status and discuss improvement ideas). 

Tampere also articulated its strategic goals in terms of actionable, measureable activities. Specifically, over a seven-year period, the Heart Hospital determined to: increase the number of pacemaker patients treated by 30 percent; reduce the number of patient follow-up appointments required by 50 percent; and improve procedure process flow, reducing the total time patients spend in the lab by 20 percent.

After six months, the lab had a robust process in place to measure and share performance data. Staff satisfaction levels had also improved, largely as a result of clearer objectives, roles and responsibilities. And, after a year, the number of pacemaker patients treated had increased by nine percent, while those requiring follow-up appointments had decreased by 14 percent. 

Looking ahead, Tampere plans to broaden responsibility for improvement activity. Teams of doctors and nurses will begin working on various initiatives, guided by experienced Tahti project coaches, who will also pursue training in lean Six Sigma tools and principles. 

 

1. Boston Scientific case study, Performance Optimization, Tampere University Hospital, Cardio Rhythm Lab Continuous Improvement Program, Boston Scientific, 

2015 A longer version of this article was published in The New Economy May 17, 2017

Read a story about Watchman left atrial appendage (LAA) closure device, an implanted heart device designed to reduce the risk of strokes in certain patients, and other Boston Scientific technologies designed to improve outcomes and the patient experience. 


Catheterization Lab Innovation

Photo of exterior of hospital Photo of exterior of hospital


 

Tampere Heart Hospital has been pursuing other ways to improve patient services, for example through the continuous improvement program it has implemented in its catheterization lab for cardiac rhythm management patients.

Tampere has limited resources, a constrained budget, and limited experience with change management initiatives. In 2013, its leaders committed to finding a way to build continuous improvement into its operations. Focusing on the lab, they wanted to be able to treat more patients while improving its outcome/cost ratio at the same time. If their efforts were successful, they could extend this work across other areas over time.

The project began with a complete analysis of the lab’s infrastructure and processes.Here, Boston Scientific was again able to contribute. Working alongside Tampere senior staff as part of a team called Tahti (the Finnish word for ‘pacing’), we began with a workshop to identify opportunities to optimise patient flow.

The workshop generated 29 improvement ideas that Tampere has since pursued, including: redesigning the elective patient process to create a more efficient patient flow (targeted improvements included rigorous on-time procedure starts, preparation of the lab and procedure details the day before, and clearer processes for scheduling elective activity and managing the emergency caseload); improving patient treatment plans (in particular, ensuring named staff are allocated to each treatment, preventing any gaps or uncertainties); and using whiteboards to track employee satisfaction (staff members logged their mood at the end of each day, and started each new day with a ‘huddle’ to review status and discuss improvement ideas). 

Tampere also articulated its strategic goals in terms of actionable, measureable activities. Specifically, over a seven-year period, the Heart Hospital determined to: increase the number of pacemaker patients treated by 30 percent; reduce the number of patient follow-up appointments required by 50 percent; and improve procedure process flow, reducing the total time patients spend in the lab by 20 percent. After six months, the lab had a robust process in place to measure and share performance data. Staff satisfaction levels had also improved, largely as a result of clearer objectives, roles and responsibilities. And, after a year, the number of pacemaker patients treated had increased by nine percent, while those requiring follow-up appointments had decreased by 14 percent. 

Looking ahead, Tampere plans to broaden responsibility for improvement activity. Teams of doctors and nurses will begin working on various initiatives, guided by experienced Tahti project coaches, who will also pursue training in lean Six Sigma tools and principles. 

The project began with a complete analysis of the lab’s infrastructure and processes. Here, Boston Scientific was again able to contribute. Working alongside Tampere senior staff as part of a team called Tahti (the Finnish word for ‘pacing’), we began with a workshop to identify opportunities to optimise patient flow.
The project began with a complete analysis of the lab’s infrastructure and processes. Here, Boston Scientific was again able to contribute. Working alongside Tampere senior staff as part of a team called Tahti (the Finnish word for ‘pacing’), we began with a workshop to identify opportunities to optimise patient flow.

Image of exterior of hospital Image of exterior of hospital

Sources

1. Boston Scientific case study, Performance Optimization, Tampere University Hospital, Cardio Rhythm Lab Continuous Improvement Program, Boston Scientific, 2015. A longer version of this article was publish in The New Economy May 17, 2017

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