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Clinical Transformation

The U.S. healthcare system is in the midst of an unprecedented transformation. We continue to draw upon our deep capabilities and spirit of innovation to lead the field in creating a model of healthcare for the future. Clinical transformation is more than a concept – it’s about driving change. Leaders across our health system are asking patients and front-line caregivers how best to deliver healthcare that is convenient, accessible, coordinated and meets patients’ desired outcomes. While we work to improve the patient and provider experience and make care more affordable, we are relentlessly focused on quality and safety. 

Integrated Care Model

Integrated Care Model

The Cleveland Clinic Integrated Care Model is a value-based model of care, which means it is designed to optimize outcomes while reducing costs. The patient remains at the heart of the Cleveland Clinic Integrated Care Model. The blue band represents the care system, which is a seamless pathway that patients move along as they receive care in the different settings listed. The care system represents integration of care across the continuum. Focus areas of the new model include elimination of unnecessary practice variation through the development of care paths and seamless care coordination across the continuum.

Population Health

Population Health

Population health describes when a healthcare provider is responsible for delivering care to a predefined group of people – either with the same disease or condition, or within the same geography. Population health is affected by many factors including socio-economic status, environmental health, access to quality healthcare, and health behaviors. Population health management has the potential to reduce waste in healthcare delivery and help patients remain healthier and out of the hospital.

In 2016, Cleveland Clinic announced a five-year agreement with IBM to expand our health information technology to better capture the value of data and establish a model for health system transition to population health. The new technology implementation is designed to enable efficient analysis of data from electronic health records (EHR), information from administrative claims, and social determinants of health, allowing for both personalized clinical care and broader population-focused management. For example, data analysis could help predict if diabetes patients are resistant to certain treatments and whether similarities exist within a group of diabetes patients that could help medical providers better tailor patient engagement to address specific needs, such as notifying of recommended treatments or actions to take.

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Research & Innovation

Research

Cleveland Clinic researchers focus on an array of conditions, including breast and liver cancer, coronary artery disease, heart failure, epilepsy, Parkinson’s disease, chronic obstructive pulmonary disease, asthma, high blood pressure, diabetes, depression and eating disorders. The Lerner Research Institute is one of the largest private research facilities in the United States, with hundreds of principal investigators, project scientists, research associates and postdoctoral fellows, with total annual research expenditures exceeding $150 million from federal agencies, non-federal societies and associations and endowment funds. 

For the past 14 years, Cleveland Clinic has held a Medical Innovation Summit each fall as a way to bring together all stakeholders in healthcare to build the relationships and ignite the technologies that will advance patient care. The Summit is part of Cleveland Clinic’s commitment to drive healthcare innovation and quality.  The Summit offers a slate of premier speakers, the hottest topics, and an unmatched network of professionals that help health systems prepare for the ever-changing healthcare market.

Data at Cleveland Clinic has been a gold mine for Michael Kattan, PhD, winner of 2016’s Sones Innovation Award. Out of millions of available patient records, he and his team are finding patterns and algorithms that they are using to develop predictive models. To date, they have developed predictive analytics for 32 diseases, free for physician use. Dr. Kattan’s group has published more than 550 articles in peer-reviewed journals, including a 2016 article in CA: A Cancer Journal for Clinicians that has triggered efforts to replace cancer staging with statistical prediction models.

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Carepaths

Care Paths

A key component of value-based care, care paths are multidisciplinary plans of care that limit variation in care and optimize outcomes. By following a care path, providers base treatment on documented evidence or shared experience to deliver consistent value for a patient or population of patients. Cleveland Clinic caregivers across the enterprise are creating care paths for delivering care during particular clinical procedures, such as total hip replacement or treatment of cancer.

The care path initiative focuses on three main objectives:

  • Standardizing physician clinical management with a focus on value-based, patient-centered care
  • Integrating work flows and algorithms into the electronic medical record when appropriate
  • Tracking patient-reported outcomes to improve care quality

As of 2016, 131 care paths have been developed, with 35 piloted and 17 fully embedded in the electronic health record. Our Complete Care Program is a team approach that includes the patient, the surgeon and a Specialty Care Coordinator. This bundled treatment plan along with a bundled payment plan provides efficient care for the patient.

Distance Health

Distance Health

Technology is transforming where and how we practice medicine. Through distance health, Cleveland Clinic is improving quality and bringing our care to more patients in more locations. Leveraging technology in innovative ways, we are expanding the reach of our world class service and reducing costs. Patient entered data, apps, partnerships and data interrogation tools are revolutionizing the practice of medicine, and Cleveland Clinic is at the forefront in bringing these capabilities to life. In 2016, we increased our telemedicine presence and opened more urgent care walk-in clinics throughout our community.

Among the examples of successful use of health enabling technologies are our Mobile Stroke Unit and telestroke services, eHospital inpatient critical care monitoring, concussion app, MyChart, MyCare online virtual visits, Express Care online, remote image upload, and remote monitoring for chronic disease management.

Patient-Centered Medical Home

Patient Center Medical Home

A patient-centered medical home might sound like a place or somewhere you would go, but it is not. It is a long-term, team-based approach for your primary healthcare. Patients are engaged with their care team across the continuum and have a direct relationship with their provider who coordinates a team of caregivers and arranges appropriate treatment as needed.

In 2013, the Joint Commission’s surveyors evaluated us on how effectively primary care clinicians and interdisciplinary teams work in partnership with patients to provide comprehensive, coordinated and patient-centered care. The Primary Care Medical Home certification was launched for hospitals in February 2013 to help improve outcomes, reduce healthcare costs and ensure patients receive timely and appropriate treatment. As an outcome of The Joint Commission’s survey, 39 Medicine Institute practices at 29 sites — involving 230 primary care physicians and advanced practice nurses — received Primary Care Medical Home certification at Cleveland Clinic.

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Shared Medical Appointments

Shared Medical Appointments

Shared medical appointments (SMAs) offer an innovative, interactive approach to healthcare that brings patients with common needs together with one or more healthcare providers. While an individual appointment typically lasts 15 to 30 minutes, a shared appointment is 90 minutes long, allowing participants to spend more time with the healthcare team.

We piloted SMAs more than 10 years ago and now offer them at several Cleveland Clinic hospitals and family health centers. They are quickly evolving as a key component of transforming healthcare. Patients enjoy the opportunity to relate to other patients who are dealing with similar health issues. They share stories, learn from one another, and create a kindred bond, especially for those dealing with chronic conditions like asthma, diabetes and hypertension.

Express Care

Save resources and bring the healthcare provider to you. No appointment needed. Just an internet connection.

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Mobile Stroke Treatment Unit

“Yesterday our founders innovated for today. Today we must innovate for tomorrow.”

—Dr. Toby Cosgrove, Cleveland Clinic President and CEO