For healthcare providers and payers, population health management is rapidly becoming a core strategy in the effort to reduce costs and improve health outcomes. And that strategy is increasingly relying on a range of IT tools. EHRs, telemedicine programs, mobile tools and analytics are being enlisted across the healthcare sector, and a recent article in HealthcareIT News surveys some of the latest results.
For example, Meridian Health, a “six-hospital health system in Neptune, New Jersey started a full-fledged, IT-supported population health management program early in 2015 with the three aims of improving the health of its 1.1 million patients, improving the quality of their care and reducing healthcare costs.” Among other things, it integrated healthcare data from 15 different sources into a data warehouse with a disease registry system, and “the number of data sources will increase to 20 by the end of March and include systems for hospitals, clinics, long-term care facilities, home health, labs, payers with which Meridian has accountable care organization agreements and Jersey Health Connection, the local health information exchange.”
According to Meridian vice president of IT Steve Sakovits, “a core focus for Meridian has been creating a platform that allows us to gather clinical, claims and other data, and aggregate the data into one database, upon which we can do sophisticated analytics, allowing us to create a comprehensive view of everything going on with the consumer.”
And the results so far? Among other things, Sakovits notes, ”Our latest data from the Centers for Medicare and Medicaid Services shows a marked decrease in emergency department visits and hospital admissions for high-risk Medicare Shared Savings Program patients.”
As John Moore, founder and managing partner at Chilmark Research, a healthcare IT research and consulting firm, sees it there are three types of technology that are pivotal to population health management.
"First, a system of records, a place where you can create and manage a longitudinal patient record that includes not just clinical data but patient-generated health data and claims data so caregivers can understand patients within a network of providers," he said.
"Second, analytics, where you understand the cost of care delivery, who is most efficient at delivering care, compliance of patients, which patients can be influenced and understanding transitions in care.”
Third is what Moore called systems of engagement: "How you structure all of this information, beyond the traditional health information exchange, which just moves information around, but something that provides insights to those on a given care team," Moore said. "Then that leads to guidelines, clinical pathways and more."