With the increasing emphasis on value-based care, population health will continue as a driving force for American health systems. Our success lies in better information management because data is the DNA of any effective population health effort.
In 2018, health care organizations are well-aware of data’s importance to population health, but they still have a long way to go in their ability to manage data and leverage it. This challenge is more difficult than it may seem, especially since digital data–once so difficult to obtain–is now inundating health care providers. With our own EHRs, insurance and vendor information, government records and more, we are on the verge of drowning in the data we once worked so hard to acquire. Further, we must address issues of variability and compatibility across all data sets, and find ways to combine the information received from multiple sources.
"“Whole person” mindset includes the social determinants of health– access to care, reliable transportation, housing, education, and nutrition as well"
Getting a grip on data and managing it well will require us to act differently. Here is our checklist for being better at data management and succeeding in population health in 2018:
Establish clarity in population health goals– Many organizations approach infrastructure-building as an end in itself while addressing population health and value-based transformation initiatives in parallel. Instead, the primary drivers for investing in and building IT infrastructure should be establishing objective population health goals and developing a pragmatic roadmap for achieving targeted outcomes. This approach ensures our information infrastructure investments meet short-term business needs and build capacity for long-term success in value-based care.
Build data management capabilities–Old-school methods of managing data with an enterprise data warehouse are falling short. The sheer volume of data, variability in formats and structure, and time lag (often ranging from weeks to months) between when data is received and when it can be used effectively dilute these methods’ effectiveness. A new approach is harnessing the power of “big data” and cloud technologies to meet health care’s security, compliance and data needs. It is critical to build capability within a big data infrastructure to process and correlate clinical, claims, financial and administrative data across multiple sources, essentially converting raw data into meaningful, holistic information that aligns with population health goals.
Prioritize information sources and the end-user experience–The mere existence of data doesn’t automatically trigger meaningful usage. Because there are significant costs to collecting, storing, processing and disseminating information, we must prioritize information sources which align with business goals. By collaborating with stakeholders, we can build information frameworks that share truly relevant information and insights with end-users- -pragmatically and cost-effectively. The secret? Minimize disruption to the end-user workflow, and always make accessing the data easier. As we’ve all learned over the years, make processes easier for end-users (caregivers in this case) and you’ll vastly improve the probability that information will be used effectively to achieve business goals.
Deepak Sadagopan, VP of Population Health informatics and government programs, Providence St. Joseph Health
Get a whole-person mindset–Traditionally, clinical and IT departments have taken a narrow focus, each solving one problem at a time. But today’s providers are challenged to think differently about many factors that are important to our patients. It’s a “whole person” mindset that includes the social determinants of health–access to care, reliable transportation, housing, education, and nutrition. At Providence St. Joseph Health, we are building capabilities that combine clinical and financial data with social determinant risk scores to empower providers in addressing our patients’ holistic needs. These capabilities allow caregivers to access non-clinical factors such as homelessness or inadequate access to transportation that can impact a patient’s health. Having this information readily accessible helps the care team refer the patient to community resources that address underlying problems, ultimately leading to health improvement and lower costs.
Embrace new technology– There is intense interest in the use of new technology such as artificial intelligence, machine learning and wearables. In light of the excitement, we must ensure new technologies fit into our broader population health strategies. As an example, wearables can track a patients mobility after a hip/ knee replacement procedure, helping the care team follow the patient’s progress and identify follow-up care needs. Similarly, advanced machine learning algorithms can predict a short-list of patients that are at a higher health risk, or are likely to become high-utilizers, again saving caregivers considerable time in analyzing patient needs. The key is to assign new technologies specific roles in meeting business objectives.
Keep an eye on the big picture–Over the past few years, IT departments have weathered the big storms like ICD-10 and other mandates, and health systems have been occupied with reimbursement rates and ongoing legislative changes. But we need to re-prioritize and remind ourselves that we are here to be of service to patients and communities. Population health puts us on this pathway, and we believe both clinical and IT departments will need to step up efforts when they commit to helping communities enjoy the benefits of good health.