In the world of healthcare reform, population health management (PHM) must increasingly be a core competency of healthcare organizations. But organizations need not and should not try to build the technology necessary to automate PHM. Most of the necessary tools are already commercially available, and few healthcare systems have the kind of expertise needed to create and maintain systems required to improve the health of their entire patient population.
Population Health Management Tools Track All Patients
To effectively provide PHM, it is simply not sufficient for care teams to address patients’ care gaps during office visits. Automation tools are required to track the health of all patients continuously, whether or not they visit their physicians. For an organization to do this cost-effectively, they must use patient registries based on clinical and administrative data, as well as automated outreach, care management and patient engagement programs.
Even academic medical centers have found it difficult to manage population health well for more than one or two chronic conditions. And if an organization tries to build its own PHM infrastructure one condition at a time, it is going to end up with a lot of nonintegrated, nonscalable applications.
What You Should Know
Providers that try to build their own PHM solutions will encounter myriad problems:
- To start with, hundreds of clinical protocols must be imbedded in the registries to generate reports on population segments, stratify patients by risk and measure performance.
- Data quality can also be a problem if data is missing from key EHR fields, has been entered in the wrong fields or has been attributed incorrectly to providers, among other issues.
- Finally, already overtaxed IT departments must do the mapping from EHRs and practice management systems to the registries.
Automation Focuses Staff on Key Patient Activities
Beyond the registries, providers seeking to implement PHM need some way to connect the care gap reports with outbound messaging to alert patients that they need to be seen. Without an automated way of doing that, staff will tend to let patients fall through the cracks because they have more pressing tasks than calling them on the phone. Care managers, too, need automation software to help them perform interventions with the many patients who need different levels of support and attention.
Why You Shouldn’t Build Your Own Population Health Management Solution
There are other compelling reasons for organizations not to build this complicated infrastructure themselves. These include:
- Development costs
- Knowledge acquisition
- Integration with other technologies
- The ability to comply with federal regulations, including the rules for Meaningful Use and accountable care organizations
But, the key reason to buy rather than build PHM tools is that developing and maintaining this type of technology is not the core competence of a healthcare organization.
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Download a whitepaper, Population Health Management: A Roadmap for Provider-Based Automation in a New Era of Healthcare.