Sailing Unfamiliar Waters of PHM: Leveraging the Power of Healthcare Analytics
By Tariq Dastagir, MD, medical director
If there’s a take-home message for healthcare systems testing the waters of population health management (PHM), it’s that the old ways of doing things are no longer good enough.
“For medical practices, which are structured around individual, face-to-face encounters, pursuing a population-based approach means considering what happens between visits,” notes a 2015 article in The New England Journal of Medicine. In addition, the authors write, PHM requires improving preventive care services; “addressing health disparities” between segments of the population and “referring patients to a wider range of community services” equipped to facilitate their ongoing care.
The Centers for Medicare and Medicaid Services (CMS), which is driving the shift toward PHM by tying Medicare reimbursement to quality and value, describes this budding model of healthcare delivery as “better, smarter, and healthier.” It’s a system, the agency reports in its 2016 Quality Strategy, that is meant to make healthcare more “person-centered, reliable, accessible, and safe,” as well as more affordable and more effective.
Real-Time, Actionable Data at Your Fingertips
The question, then, is how can healthcare systems transitioning to PHM get up to speed as quickly as possible? And to that, the experts also have an answer: Leverage the power of healthcare analytics. “Population health analytics is now a strategic imperative,” reads one opinion piece in Healthcare IT News. Analytics solutions, the author explains, aggregate data across the continuum of care to give care teams and executives alike actionable information “when and where they need it.” They employ “risk stratification algorithms” that help organizations tailor health management programs to specific segments of a given population. In addition, they allow healthcare systems to examine clinical outcomes to “enhance quality, cost and efficiency of care delivered at both an individual and population level.”
Indeed, another report on how PHM might lead to success in the “new age of accountable care” describes information technology in general—and “robust business analytics and data management” specifically—as a “catalyst” for PHM. A PHM approach utilizing healthcare analytics provides clinicians, health partners and other relevant stakeholders access to the same information “in real time,” the authors note, “enabling virtual collaboration and data-driven, patient-centered, well-coordinated care.” And then there’s the power of “predictive” modeling, or using healthcare analytics to anticipate certain outcomes related to patient care, like the risk that an individual with a chronic condition will be readmitted within a specific period of time. When healthcare systems and clinicians have real-time, actionable data like this at their fingertips, they can then focus their resources where they can make the biggest impact, whether it’s coordinating services among specialty physicians, implementing measures that reduce gaps in care or improving patient outreach and education.
In fact, it’s the “proactive” capabilities of healthcare analytics that make the technology so attractive to the industry. As healthcare moves away from episodic models of care and toward one that revolves around better health and wellness, it’s become increasingly clear to frontline care teams that they must play an active role in the lives of their patients—and not just when they roll through the emergency room doors. These physicians, their care teams and the executives that back them, have all seen what is possible when there’s a single system in place where patient information can be viewed quickly on the go. They’ve seen what they can do when they use this data to make informed decisions at the point of care. And they’ve seen how better and more timely decisions powered by this technology can lead to improving care efficiency, reducing care costs and ultimately helping them achieve better patient outcomes.
A familiar quote by Mark Twain may be applicable here:
The transition to PHM may not be easy and it may require swimming in unfamiliar waters, but healthcare organizations that leverage data analytics will certainly have the right tools to help ensure their success.
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