Population Health Management: A Technology Perspective

The shift away from volume or episodic care delivery, and a focus on a comprehensive standards-driven approach that results in lower costs and improves healthcare outcomes, requires a re-thinking of the health information technology platform. As much as any organization might try to standardize around a single health information technology or electronic health record platform, the complete picture of a managed population of patients will require integration and system interoperability.

Technology evolution
Previous regulatory mandates, specifically the Health Information Technology for Economic and Clinical Health Act and the Medicare and Medicaid EHR incentive programs, have laid the foundation for technological innovation by digitizing patient health records across the country. In fact, there has been a nine-fold increase in the number of providers utilizing EHRs since 2008, according to the Office of the National Coordinator for Health Information Technology.

New regulations, like the Medicare Access and Children’s Health Insurance Program Reauthorization Act, have created an environment where providers are further incentivized to change the approach to care delivery. This is a seismic shift from the model of care where incentives were to increase volume and throughput within a fee-for-service framework, to one that challenges the provider organizations to approach care with the results in mind–in a fee-for-performance framework–be it qualitative patient outcomes or reduced healthcare expenditure, in comparison to established peer and contractual benchmarks.

The technology evolution over the last decade has provided a treasure trove of information to create a data-rich knowledge base about a patient population, which is hosted and curated within the provider domains. The advancement of the health information technology platform enables providers to build actionable insights that will contribute to understanding the patient population better, predicting care demands, and suggesting care processes geared toward improving patient health outcomes while reducing costs.

The result will enable the triple aim of better care, smarter spending, and healthier people as healthcare dollars are spent toward prevention, and care models are geared toward collaborative, targeted, and return-on-investment-driven care management with a focus on outcomes. Ultimately, this will lead to a healthier population.

Population health and technology’s impact
Fundamentally, one can define population health as an effort to provide the most informed care for a patient population through a comprehensive care delivery approach with a goal of improving overall healthcare outcomes in a cost-efficient manner. Technology will be critical in the successful achievement of these goals.

As healthcare moves away from volume, care venues will become less relevant than actual management of care. Innovation in technology is driving this change with telemedicine and mobile and web-based applications that can bridge the gap between physicians and patients. Thus, it has become critical that healthcare information is safely and meaningfully shared between disparate systems and solutions. Interoperability is more critical today than ever, and it will continue to be the biggest lever in healthcare innovation in the future. It is essential to managing the health of a population and it is a key element to the overall transformation of healthcare.

The ONC released a nationwide interoperability road map in 2014 to promote appropriate health information exchange as it pertains to improving health and care. Furthermore, interoperability is an essential component of the learning health system framework. According to the ONC, the intent of the learning health system is to function in an interoperable environment of healthcare IT solutions to enable lower costs, improve health, drive innovation, and empower the consumers.

A successful population health management platform cannot be achieved without a focus on system interoperability. The intelligence within clinical insights to drive data-driven decision support needs access to contextual data. The artificial silos of data need to be broken and with the proliferation of health information technology, this data may reside in a combination of several different systems.

A mechanism to seek, identify, and reconcile this data for the benefit of clinicians and patients requires intention and commitment of healthcare organizations, plus the necessary tools and strategy to enable an interoperable environment.

Christina Churchill, principal at RSM, leads the Dallas-based consulting group. Her primary focus is working with clients to align their strategic objectives and practical solutions to develop and implement financial, organizational, and technological improvements in profitability, process efficiency, and operational effectiveness.

Posted in Expert Opinions.