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FCW : July 30, 2014
Population health management is a multifaceted, many- layered endeavor that nevertheless has a common theme: the need for data and the ability to mine it for actionable information. A broad spectrum of health care players — individual providers, hospital systems, payers, local public health departments and federal agencies — are all in some way addressing population health management. The approach involves identifying populations, assessing their disease sta- tus and developing appropriate responses, such as man- agement programs for chronic diseases. Those activities require access to data — and plenty of it. “You can’t do population health management without data,” said Fred Goldstein, interim executive director of the Population Health Alliance. Dr. Jon White, director of the health IT portfolio at the Agency for Healthcare Research and Quality, said data — or the lack thereof — influenced his decision to leave his medical practice and join the government. AHRQ’s work in population health includes evaluating hospital safety via data analysis. “It became painfully obvious that having the right infor- mation at the right time is really important for delivering great care,” White said. “I didn’t have the information where I needed it when I was in practice.” The good news for organizations pursuing population health is that they have more data than ever. The Centers for Medicare and Medicaid Services have provided financial incentives for the adoption of certified electronic health record (EHR) systems by physicians and hospitals through its meaningful-use initiative. Furthermore, information formerly confined to paper charts is now in electronic form, and a new generation of wearable health-oriented devices promises to generate another stream of data. Why it matters Population health management is a key element of the Obama administration’s efforts to reform health care. The Medicare shared-savings component of the Affordable Care Act (ACA), for example, focuses on Medicare beneficiaries as a population. Under the law, accountable care organizations — groups of providers who coordinate the care of Medicare patients — receive a portion of the savings that result from better quality and lower costs. According to the law, the program “promotes accountability for a patient population.” In general, population health management dovetails with the ongoing shift from reimbursing providers for the num- ber of procedures they perform to paying them based on the value they deliver. “Part of that value is measuring your ability to manage the health of the population that has been assigned to you,” said Cynthia Burghard, research director for accountable care IT strategies at IDC Health Insights. More than 75 percent of health care costs can be attribut- ed to chronic conditions such as diabetes and heart disease, according to the Centers for Disease Control and Prevention. White called chronic diseases the foundational problem in health care and said chronic disease management and population health programs share a common IT remedy. “The tools we need to more effectively attack it are the same ones we need for population health,” he added. The Department of Veterans Affairs is among the fed- eral agencies building IT systems for population health management. Last year, VA’s Business Intelligence Service Line consolidated regional data warehouses into a central Corporate Data Warehouse. VA uses the data to identify high-risk populations that need extra care and examine readmission rates, among other activities, said a spokes- woman for Microsoft, which is working with the VA on the project. The Corporate Data Warehouse uses Microsoft’s Turning big data into better health outcomes BY JOHN MOORE Federal entities are playing a number of roles in population health management as the practice continues to unfold 28 July 30, 2014 FCW.COM ExecTe c h
July 15, 2014
August 15, 2014