At HIMSS10, Dr. Fishman had the opportunity to speak with Dan Pelino, General Manager of Healthcare and Life Sciences at IBM. Mr. Pelino explains that IBM is involved in several aspects of Health Information Technology. First, the company has partnered with many EHR vendors to help small practices identify which EHR solution is best for their specific needs, and it can also offer various hosting solutions. Second, IBM has the ability to help practices integrate their EHR system with referral networks. Third, IBM has embarked on a collaborative effort with the American Academy of Family Physicians and the American College of Physicians to implement pilot projects based on the Patient-Centered Medical Home (PCMH) approach. Mr. Pelino provides an a example of this pilot with the Community Care of North Carolina, which applied the PCMH approach to successfully prevent hospitalizations among asthmatics and saved 150 million dollars in the process. Dr. Fishman and Mr. Pelino close by discussing IBM’s involvement in international healthcare systems, specifically the development of an Electronic Health Record system in Denmark.
Dr. Eric Fishman: This is Dr. Eric Fishman for EHRtv. We're at HIMSS10 and today, we're speaking with Dan Pelino, General Manager of Healthcare and Life Sciences at IBM. Dan, I thank you very much for taking your time today to speak with us.
Dan Pelino: Thank you.
Dr. Eric Fishman: Tell us about IBM and how it interfaces most particularly with the small medical practice. The majority of physicians are in small practices, 1 to 5 or 1 to 10 doctors and obviously, IBM has a very, very, large footprint in hospitals and in patients but our concentration will be the 1 to 10, 1 to 50 doctor practices. So tell us how a physician might be able to utilize your services.
Dan Pelino: Yes, thank you. One of three ways. One is with the small primary care, the small office working on their own looking for maybe an operational model versus a capital model, to have an EMR included within their work flow and process. They might turn to IBM to say what are my available options. These could be hosted solutions working with partners that are out there, usually very affordable, on a per month basis. On potentially a per member basis, very affordable, looks at the entire work flow and process, integrates the work flow that's associated with that office. That's one way. That way is relatively inexpensive and creates an option by which you can pay on a per month basis.
Dr. Eric Fishman: Just to be clear, IBM does not sell the EMR but you know a lot about the industry and can point the small practice in the right direction.
Dan Pelino: Right. We do not sell an EMR. We actually bring EMR partners together and work very closely with them looking not only at the EMR itself but also scheduling, the ability to do adjudication, eligibility. We think there's roughly 32 applications that are within a doctor's office. As we can integrate these better into a monthly type of subscription on a cloud type offering, we think that's a way that's very affordable for the doctor. It works as with their work flow and process they have today and it's very affordable.
Dr. Eric Fishman: For a small practice completely integrated. Now, you said three different methods and I think we've covered the first.
Dan Pelino: Right, we talked about the first one. The second is a small doctor office may decide to integrate in a clinic, into a larger organization. Maybe they want to scale the scheduling, maybe they want to scale the EMR, maybe they want to scale insurance and claims.
Dr. Eric Fishman: Not to misuse a current word these days, but there's a tidal wave of that happening these days.
Dan Pelino: There's absolutely a tidal wave of that and the reason is because you see benefit and you'd like to maybe still keep your ability to perform --
Dr. Eric Fishman: Independence.
Dan Pelino: -- independently from any of these hospital systems but yet be able to have a referral network. So you join into a clinic. There's many of these that are expanding. The third of course is the affiliation. We're seeing significant growth.
Dr. Eric Fishman: I understand you have an affiliation for instance with the AFP. They're 90 some thousand members and tell us about that.
Dan Pelino: The American Academy of Family Physicians as they start to look and make recommendations, they're supporting of course the medical home.
Dr. Eric Fishman: Right.
Dan Pelino: What they're looking for is solution sets that address the medical home, allow you to be NCQA Level-3 certified. There's some funding mechanisms that are appropriate there. Also, the health plans are looking for doctors that are certified within medical home. They know that if they put members into those systems, they have better quality metrics coming out based on the initial peer reviews that we've done. You have many people that are looking for those types of IT infrastructures that allow you to be NCQA Level 3 certified, perform at the medical home. The American Academy of Family Physicians and the ACP will be able to help guide and direct you.
Dr. Eric Fishman: I think there are a lot of our viewers who probably are not that familiar with the term medical home and if you could spend a few moments discussing that.
Dan Pelino: The medical home is the thought around continuum of care with a team care model. This allows doctors, caregivers, nurses, et cetera to perform at their highest level of their license looking at the patient in totality. Within this, then you start to think about the client and the patient as an extension of how your system works. Instead of that acute or episodic condition, what you're looking for then is how do I treat that patient from a continual experience, ensuring that they're taking the right kind of medications, that they're adhering to whatever you've asked them to do. We could in fact maybe address even behavior. So it's not just an episodic or acute 15 minute discussion that you have but you're actually thinking about that patient on an extended view.
Dr. Eric Fishman: I think there are a lot of people here in Atlanta today who are very happy that American health care is taking this direction. Maybe even some in Washington believe that this is an appropriate direction.
Dan Pelino: Absolutely. The work that we've done so far and the pilots that are out there show just tremendous benefit. I'll use just one example. Community Care of North Carolina, one disease condition - asthmatics. Population base is 750,000 people. Their goal: keep asthmatics out of the emergency room.
Dr. Eric Fishman: Emergency room. Of course.
Dan Pelino: What it showed was they were able to save $150 million out of 750,000 people population base, one condition, asthmatic, and be able to keep them out of the hospital. If you can do that in eastern Carolina, and that was the population base, just think what we could do across the state. That's the benefits of a medical home.
Dr. Eric Fishman: That's clearly a direction we are and need to be going. I commend IBM for doing that. I understand that the United States is one small part of your market and I've been told that there have been 3,000 transformational product checks that have been done by IBM such as the entire country of Denmark.
Dan Pelino: Yes.
Dr. Eric Fishman: Can you, and we've been speaking about the small scale load, just for a few moments talk about some of the larger scale projects that you’ve done.
Dan Pelino: Sure, and thank you for mentioning that to us. We do run the health care system for Denmark. Denmark is actually 5.5 million people. When you look across 5.5 million people, believe it or not, that looks like a region in the U.S. In Denmark, we've been able to focus on primary care, chronic conditions. They have a different mix than we do of specialty versus primary care. As a matter of fact, they're just the opposite of what we are. They're 75 percent primary care, 25 percent specialty. Also, in Denmark, they went from 155 hospitals to 25 hospitals. So you can actually see the compression, and as you know, Denmark is the best performing country when you look at all the metrics for health care. If we were to look to them, the ability to be able to put an integrated delivery system with primary care at the front end, allows you to have a better health care delivery system and it actually is less expensive.
Dr. Eric Fishman: The International Bar Association, the IBA, is having a health care IT meeting in Denmark this May and I'm now understanding why in fact it may be in Denmark.
Dan Pelino: Yes. As a matter of fact, in talking with Dr. Blumenthal, he actually sent a delegation over to Denmark to study what's been happening there. The very fact that if we can do it in 5.5 million people what's to stop us from doing it in the major regions within the U.S. and potentially expanding it in a broader level?
Dr. Eric Fishman: I think the answer is not very much and I think it may be happening.
Dan Pelino: I think it is and that's the exciting part.
Dr. Eric Fishman: Thank you very much. I thank you for your time.
Dan Pelino: My pleasure.
Dr. Eric Fishman: I appreciate it. This is Dr. Eric Fishman. We've been speaking with Dan Pelino, General Manager of Healthcare and Life Sciences at IBM. Thank you.