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FCW : July 30, 2014
SQL Server, business intelligence tools, Windows Server and System Center management tools. Much of the warehouse’s holdings stem from the VA’s EHR system, called the Veterans Health Information Systems and Technology Architecture. But other sources contribute as well. Sean Murphy, chief technology officer for federal health care at Microsoft, said the VA’s strategy is to “bring together many disparate data sources...to enable reporting and analytics across many differing and complementary domains of data.” The VA’s data store contains more than 500 billion rows of data, he added. Other population health efforts include the Healthy Peo- ple program managed by the Department of Health and Human Services. Healthy People provides a set of national 10-year objectives for boosting the health of Americans. An HHS spokesperson said the objectives serve as a framework for public health activities nationwide. The current iteration of the program, Healthy People 2020, covers 42 health topics, including one labeled “health communication and health IT.” That topic area seeks to use communication strategies and health IT “to improve population health outcomes and health care quality, and to achieve health equity,” the spokesperson said. AHRQ, part of HHS, also pursues population health man- agement with an emphasis on data. The agency works with a group of patient safety organizations to collect data on safety events in hospitals and other health care settings, White said. Researchers aggregate and analyze the data to identify concerns related to devices and medications. In one case, AHRQ’s analysis found a problem with bloodstream infections caused by bacteria traveling down the catheter used to administer drugs and nutrients to patients — so - called central line infections. “With the data we collected, we were able to recognize that was a big problem and figure out an intervention,” White said. As a result of the research, the AHRQ-funded Keystone ICU project advanced procedures for the safe handling of central lines, and the infection rate plummeted, he added. The fundamentals The Population Health Alliance has created a conceptual framework that breaks the population health management process into four stages: health assessment, risk stratifica- tion, patient-centered interventions and impact evaluation. The assessment phase looks at the health risks and disease status of a population. Based on the assessment, the popula- tion is categorized as low, moderate or high risk, Goldstein said. Interventions are then designed for individuals based on their risk category. The final step measures the clinical and financial impact of those interventions. Market watchers are already seeing an increase in IT spending triggered by the push for population health man- agement. The IDC Health Insights report describes the field as an emerging and active technology market. “The requirement for managing a population is really driving the technology investment,” Burghard said. Population health management technology offers three levels of functionality. First is an analytics capability that lets organizations identify patients who would benefit from July 30, 2014 FCW.COM 29 Next steps for improving population health • Boosting data quality. On the horizon is a drive toward better population health data, said Dr. Jon White, director of the health IT portfolio at the Agency for Healthcare Research and Quality. When combating outbreaks as varied as severe acute respiratory syndrome and salmonella poisoning, data must be pulled from a number of locations in a timely fashion. Maintaining data on the nature of health care data is also important, White added. Researchers need to know where the data originat- ed and when and why it was generated. • Developing communication standards. Fred Goldstein, interim executive director of the Popula- tion Health Alliance, said he looks forward to the development of standards for the communication and exchange of health data. Such standards will become more important as health care organiza- tions attempt to pull data from multiple electronic health record systems, personal health records and other datasets. • Providing simpler access. Neil Jordan, general manager of worldwide health at Microsoft, said he believes one of the biggest breakthroughs in population health management will happen when people can query data using natural language. That approach will make data even more accessible. — John Moore
July 15, 2014
August 15, 2014