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Choosing a PHM Platform: 7 Key Questions to Consider
As U.S. healthcare moves to a value-based model, a growing number of physicians want tools that will offer insights into different patient groups. As many have painfully learned, most electronic health record (EHR) systems, alone, will not be enough to develop effective preventive health programs, or satisfy the outcomes-based quality goals and terms spelled out by the Merit-based Incentive Payment System (MIPS) and the Medicare Access and CHIP Reauthorization Act (MACRA).
However, Population Health Management (PHM) software does allow physicians and care teams to segment groups of patients and their treatment and transactional data. By applying advanced analytics, population health technologies can help physicians and care teams establish risk levels, view trends and anticipate surprises, customize treatment efforts for specific patient groups and optimize preventive care.
According to an October 2016 survey of 95 healthcare IT executives conducted by Healthcare IT News, 44% plan to invest in PHM software in 2017. Larger care providers with access to more advanced EHR systems typically have more of the infrastructure required for PHM software, although a 2016 study by the Public Health Informatics Institute shows that smaller providers can also obtain PHM functionality.
Before even considering possible platforms and vendors, experts suggest answering some broad, open-ended and difficult questions about your organization, its priorities and its approach to data management:
1. What are your organization’s broad strategic goals in studying patient groups?
2. How skilled is the staff that would be working, day to day, with the system?
3. Is your EHR and healthcare IT foundation ready for PHM?
- How easily can your EHR database connect with other databases?
- How easily can you access your systems claims records?
- How open and vendor-agnostic are your IT systems?
- How clean and complete is your data, and is the data normalized and systematically maintained?
4. How are your partners approaching their IT development?
- Are your systems aligned, and what are your mechanisms for receiving and sharing data with public health organizations?
Answering these questions will frame and help focus discussions within your organization, allowing you to examine solutions with an open mind when the time comes. Once you answer these questions, you can move on to consider individual platforms and vendors. KLAS Research recently published a short list of crucial competencies for PHM vendors that can serve as a useful checklist. These include:
- Care coordination and health improvement
- Administrative and financial
- Patient engagement
- Clinician engagement
Therefore, when assessing different PHM platforms and vendors, consider asking some of these basic questions:
5. How well can the platform retrieve, aggregate and normalize data from different sources, and how easily and securely does it allow data to be shared with external partners?
- Does the system use open, vendor-neutral interfaces to work with data from IT platforms that were developed by competitors and other companies?
6. How soon can the platform demonstrate value and offer some return on investment? Is it capable of solving limited problems in the short term?
- The Cumberland Consulting Group suggests that the metric “Time to Value ratio” be a selection criterion.
7. How flexible is the vendor to understanding and accommodating your real-world data and workflow issues?
- As you evaluate prospective vendors, find out how willing they are to invest time in understanding your organization’s workflows and unique challenges.
As interest in PHM solutions grows and the number of vendors and platforms explodes, many healthcare organizations may be jumping into PHM investments before they fully understand their own goals and priorities. In the end, taking the time to understand your own operations and goals is crucial to select and leverage a platform that will improve clinical results and patient experience, and reduce costs.
Interested in learning more? Read our white paper for a deeper dive.