5 New Ways to Revolutionize Population Health Management

Abhinav Shashank
Fri 29 Sep 2017
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Imagine a patient walks into her physician’s office, swiping off the notification on her smart-watch or phone reminding her of her appointment. The physician too, glances at her computer and with just one click, pulls up the patient’s records. The records have every information, right from her past immunizations to her family’s medical history and the physician bases her questions on the obtained patient history.

Once the physician inputs patient responses into the computer and designs a suitable care plan for the patient, the computer updates both their calendars with the next visit schedule. The patient leaves the office, assured that the automated notifications would remind her of the next visit and the details of her care plan. Similarly, the physician can relax, knowing that every visit will be documented and she would be able to monitor the patient’s health and responses, in person and as remotely as necessary.

What is missing to make it happen?

Every patient is different- from their medical conditions to social factors affecting their health to, at the very heart of it, their genes. The needs of the patients differ across the population and managing them needs precision. The precision that we can only have with relevant real-time data.

Why bring about a change in health IT?

When it comes to technology, changes in the healthcare industry are much more gradual and incremental. As of today, we are at a digital nexus in healthcare with mounds of data and smart technology. Providers have always made use of available data from EHRs, claims, and other clinical records, but to achieve true PHM, we cannot just limit ourselves to the traditional way of using healthcare data and trying to find the valuable, necessary insights to create a better healthcare world.

If we aim to usher healthcare into the future, it’s important to fix the core issues first. Health IT solutions should primarily focus on improving physician satisfaction and making the process efficient. Since effective population health management will lead us to value-based care, we have to redesign health IT to support PHM and deliver superior outcomes.

Here’s what health IT solutions should aim to be:

1.) Instrumental in improving care and adherence

The primary goal of PHM is to ensure patients are not just treated of their disease, but they should be made healthy. We have widespread adoption of EHRs, and the beauty of EHRs is how we have more information stored electronically than ever before. However, as effective PHM needs to counter the challenges of meaningful use and reporting on quality measures, we need to simplify how to first identify, then access, analyze and make the right data actionable. Only actionable data can drive custom-made care plans for patients, addressing all their needs.

Once the data is all sorted, PHM requires patients to follow their regimen. Health IT must be designed to make the treatment meaningful to patients. When it comes to care management, adherence is very critical. One thing to notice here is that in pain medication, adherence is high because the results are obvious. Imagine the difference in regimen adherence, if patients could have reminders or notifications that while talking about medications, also demonstrate an effect it could have – such as blood pressure or blood sugar level varying.

2.) Intuitive workflows

Despite their best efforts, providers know that there are some processes that may be redundant or some errors that may skip their eye. With a smart solution in place, these redundancies and errors can be cut down to manage population health better.

Consider the example of a health system based in New York. This practice grew from 16 physicians in 1996 to 250 physicians 20 years later and looks after 250,000 patients. To keep the number of errors to a minimum and improve the efficiency of the practices, the health system with its IT vendor looked closely at their over 2,200 procedures. They set about streamlining every workflow, provided an easy shifting of tasks from physicians to nurses, reduced unnecessary testing, and improved overall patient satisfaction- all by using smart analytics.

3.) More involvement with patients

Population health management is incomplete without patient engagement. Yet, almost 85% of patients find themselves dissatisfied with at least one aspect of their providers. Patient engagement is not just improving the experience of care, it’s also to ensure that patients make fully-informed decisions. And to make fully-informed decisions, we have to ensure that they can access credible sources of information.

Patients can be involved in their care delivery process by means of technology- be it communication-oriented or data-driven. Patients can be made aware of their vitals, the impact of their medicine intake, their upcoming tests, and visits, and provide a channel to connect with their providers on the go. In fact, 67% providers believe improved communication will improve care coordination and 56% agree that clinical guideline prompting faster lab results will also do the trick.

4.) Engage and empower physicians

Physicians play a critical role in the functioning of a healthcare organization- from providing care to making decisions, physicians are entrusted with 75%-85% of all quality and cost decisions. That said, population health management is not possible without physician engagement. One hospital observed a 26% increase in productivity from engaged physicians over disengaged ones. In terms of dollars, one engaged physician contributes an average of $460,000 inpatient revenue per year- not an insignificant source to ignore!

Speaking technology-wise, there are multiple channels for physician engagement that will help them be aware of the outcomes and performance of their practice, both manual and automated: Fax, Print-outs, EMR view, Third party tool, and Mobile apps. It’s important to analyze the particular healthcare setting and figure out what mechanism to pick, the scope of the channel, its adaptability, and the cost-effectiveness of each channel to get an increased return on investment- for example, coding gaps have 50% acceptability in printout format whereas EMR view has 80% acceptability, but its implementation of EMR is four times as high as printing data out.

5.) User-friendly disposition

More than anything, it’s the number of clicks and complexities that providers try to avoid. Health IT is designed to ease off the workload but, the complexities and time-taking processes reduce efficiency. Health IT solution has to be cut out for the organization, where the providers can build strong relationships with their population and leverage data from their systems in one click that intelligently improve their decision-making. Technology has to assist providers by delivering widespread connectivity and the ease to navigate through the system.

As we stand on a goldmine of data and look into the future of healthcare, we are looking for technology that fuses intelligence with simplicity. A renewed focus towards population health management needs actionable insights, seamless communication, and simple answers. Health IT has the potential to transform healthcare one datum at a time, and we just need to tap it well!


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Tags: Accountable Care, Healthcare, Integration
Abhinav Shashank
5 New Ways to Revolutionize Population Health Management

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