The population health approach aims to improve clinical outcomes and lower the total cost of care for a designated group of patients. Healthcare has been known as being disconnected between locations and providers, from an IT and process perspective, which makes it challenging to achieve coordinated care.
“If systems can come together it will have a big impact on the health of the population,” Jitrenda Barmecha, CIO of Saint Barnabas said. “It’s a huge culture change because we’ve been siloed. There has been a huge change away from episodic toward longitudinal care. It wasn’t there 7 years ago.”
Despite the challenge, the population health approach is necessary for the shift we’re beginning to experience from volume-based care (fee for service) to a value-based reimbursement system (fee for value), and it’s quickly becoming a priority for health systems and providers. In a KPMG survey, 44% of respondents said that they have a population health platform in place that is being “utilized efficiently and effectively.” Another 24% are in the process of implementing a population health program within the next three years. Only 10% said they have no plans to implement a population health platform.
While electronic health records are the most common tool used by health systems to implement and enable population health management programs, there are other technologies that are becoming critical too. “A wide swath of technologies are being used,” HIMSS Analytics research director Brendan FitzGerald said at the Pop Health Forum in Boston. As EHR vendors are adding features and functionality for value-based and patient-centric care, hospitals will increasingly turn to those platforms for population health management initiatives instead of implementing standalone products. BlackBook Managing Partner Doug Brown predicted a coming wave of consolidation as hospitals move from best-of-breed to integrated platforms for population health management and leading EHR vendors acquire PHM companies and technologies.
David Chou, CIO and CDO, Children’s Mercy Hospital, said that IT is the center of a health system’s entire ecosystem and knows how the data flows, which is a key component of population health programs. But it’s not solely about the systems in place. Chou recommended not focusing too much on cutting-edge technologies at the expense of user training. That focus shouldn’t all be on doctors and hospitals either. Barmecha says that population health programs should include anyone with a touch-point on the system, that includes social workers, community care providers, those people helping find food of shelter for patients.
Having accepted that these PHM systems are critically necessary, many have been quick to begin implementing them and may have subjected the initial investments to less scrutiny than usual. Now some of these organizations are trying to figure out what kind of return on investment they can expect, and in the process are finding that figuring out what to measure if more difficult than expected.
Michael Beaty, a principal at KPMG’s Healthcare & Life Sciences practice said, “Providers are taking on more financial risk from these programs, but they have a greater opportunity to share from savings. Payers gain from administrative efficiencies and letting providers take on that risk.” Dennis Weaver, MD, a senior consultant with the Advisory Board, recommends that health organizations start the investment analysis with broad strategic questions like “Does this investment help us grow?” and “Are we balancing risk and reward?” She also proposes that health leaders create a matrix which compares the cost/benefit ratio for individual components of the planned pop health program, such as remote monitoring and care management.
“Over time, it seems likely that healthcare leaders will probably come to a consensus on what elements to measure when sizing up their pop health investments, as with virtually every other major HIT expense. But in the interim, it seems that figuring out where to look for ROI is going to take more work.” Anne Zieger via Hospital EMR & EHR
Whether such population health programs will be widespread five years from now, however, comes down to finding innovative business cases, Shahid Shah, a healthcare consultant, said. “We need a different business model than the sick care model. I don’t see the idea of pop health if we don’t drive it through business models. All we’re going to say five from now is ‘oh pop health didn’t work.’ We need to reorient for pop health.”
So where do we stand with Population Health? Only time will tell.
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