Population Health Management is the Bridge to Quality in Care

Abhinav Shashank
Tue 01 Aug 2017
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I can easily, hands down, say that no one is a stranger to the ‘quality-versus-quantity of care’ debate. A while ago, I read about a patient with terminal cancer and the choices she made following her diagnosis. The patient, a 51-year old female was diagnosed with stage IV metastatic breast cancer. Following the example of several other women, she too contacted her physician, had a mammography followed by a biopsy, which confirmed her doubts and the diagnosis of breast cancer.

The thing that I couldn’t get out of my mind was that despite knowing that a stage IV diagnosis is a terminal one and has a high probability of cancer bouncing back, the woman chose to find the treatment with the least possible amount of side effects. Why? Because she didn’t want a negative impact on her life. She wanted to have a quality life and chose a good life over a long one.

The first step towards making an informed choice

I have come across several physicians who recount me the tales of their patients- some battle with Alzheimer’s, some suffer from cancer- cases with massively aggressive treatments are recommended and in most cases, there is little guarantee of improvement, or even sustaining it. Only in a few instances do patients tell the medical staff that they wish to focus on the quality of life.

Needless to say, with so many groundbreaking developments in the field of medicine as well as health IT, the options are ever expanding. People have more treatment options; they can easily connect with their physicians, there can be better health evaluations- the possibilities have just increased exponentially and taken healthcare out of the ‘black-and-white.’ It’s no more about a right-or-wrong decision; it’s about well-informed ones.

How does an informed decision affect quality of life? The logic is simple. The thought of living a quality life and having a better sense of well-being motivates people and in turn, is instrumental in reducing hospitalizations, emergency room visits, and lesser use of medications.

With motivation comes quality

Perhaps preliminary focus on health seems like a fundamental idea and on paper, improving well-being looks simple, but it is miles away from the traditional approach health care usually takes. Between conventional medicine, clinical procedures and alternative medicines, the treatment options are ever-increasing, especially for chronic conditions. Apart from this, many get themselves checked a few times in a year, follow general prescriptions. In my opinion, it’s the joint responsibility of the patient as well as the providers to think about the situation, ask themselves questions about what they want and then find out how exactly will the treatment proceed. Some questions like:

  • How critical is the condition and how likely is it that the patient will benefit from a particular treatment?
  • What treatment options are available and feasible?
  • How will the patient’s life change during and after the procedure?
  • What are the opinions of the friends and family members and what effect will they have?

Apart from this, a major question that looms before providers is how to make sure the patients stick to their care plans. Once a patient leaves the physician’s office, there’s little they can do to ensure their compliance or address the barriers that won’t let them stay on the wagon. That’s why, the answer has to be more holistic than patient-provider interaction.

The key: Population Health Management

Despite the lack of a definition, most people in the healthcare industry would agree that population health management begins with collecting key demographics and clinical data of patient population, segment them into different categories based on their clinical history and then address these issues.

However, the main aim of population health management often gets overlooked- it’s not delivering better care outcomes, it’s not containing costs. It’s about creating an environment where every patient gets safe, standardized and high-quality care based on their personalized data. A care plan cut out just for them.  

Population health management doesn’t just require a new way of thinking. It needs a new way of executing care plans combined with innovative skills. A seamless method of data exchange, on-hand data analytics, data-driven care coordination, distributed workloads and a thorough, ever-growing focus on quality of care.

How do I believe PHM can improve quality of life?

It’s not about the continued tale of ‘if you can’t measure something, you can’t improve’ or ‘quantifying quality’ through quality measures. Simplification of the term ‘quality’ is not the key.

Healthcare is a bit more complex than its counterparts, and that’s why quality of life can’t be quantified or determined in real-time. PHM is the pipeline between medicine and patients and it’s all about making data useful and transforming these raw sets depicting demographics, medicine intake, lab tests- into useful and actionable information.

Once providers have access to this information- either through past records or by asking questions- they can have an understanding of how every little factor contributes to overall health. And once they have the information, the high-risk patients can get better attention, frequent follow-up, enhanced social support and care coordination. For patients with lower risk, they can benefit from automated notifications about their vitals, regular screenings, communicating with their physicians and picking up a healthy lifestyle.

The ultimate focus would be on creating a plan tailor-made for a patient- complete with personalized notifications, a dedicated care team and outcome-based care. Telling them what would work best for them. Listening to their concerns. Understanding what they want and what they don’t want. That, in true sense, would be the key to improving the quality of life.

The road ahead

Healthcare is different. The approach we follow in other spheres can’t be applied to healthcare without a few alterations. Improving the quality of life is much bigger and much more important than just adding meaningless, painful years to someone’s life. Redundant procedures, poorly acquired data and increasing cost of care make people cautious about undergoing months of treatments just to add a couple more weeks at the end of life. And yet, people end up putting quantity over quality. It’s about time providers understood how quality triumphs over longevity and helps patients comprehend the same because healthcare is about maintaining what people have and not losing it.


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Tags: Accountable Care, Healthcare
Abhinav Shashank
Population Health Management is the Bridge to Quality in Care

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