Friday, March 4, 2016

Population Health Management in Three Paragraphs

Population health isn’t as complex or novel an idea as some people make it out to be. We're wringing our hands and making it more complicated than necessary. It boils down to borrowing the concepts from public health in the management of infectious disease in the community; and applying those concepts to population health and the management of chronic disease in the community, and then combining that with a per capita reimbursement model that rewards the reduction of chronic disease rates in that patient population. With rare few exceptions, healthcare delivery systems have never had to deal with the socioeconomic and social determinants of health to the degree that public health systems have faced these issues. With public health as a role model, it's not that healthcare delivery systems have no framework to achieve population health, it's that they've never had to do it before and so they lack the skills and data. Public health was left to city, state, and federal government. In regards to the skills, our current healthcare delivery systems must add public health professionals and epidemiologists to their management and executive staff. They need to build the skills to interact with and develop health intervention strategies in concert with law enforcement; social support services in the community, including charitable and religious organizations; job growth and economic development in communities that ensures patients can afford care when they need it; adequate affordable housing in the community; healthy options for eating in the community; adequate dental care; primary and secondary education programs that encourage healthy lifestyles; violent crime reduction; and environmental strategies to ensure that communities have clean air and water. These are the sorts of issues that public health professionals have been managing for years in the progressive reduction of infectious disease in our communities. Now we need to borrow from those skills and apply them to the new setting of chronic condition management in the community.

In regards to the data of population health, my white paper on the 12 categories of the data required for pop health is still accurate and applicable, but if we wanted to trim that list down to the absolute minimal data sets required by population health— and data which are largely missing in today’s healthcare data ecosystem— the trimmed list would be: (1) Patient reported outcomes data; (2) Social determinants of health data; and (3) Activity-based costing data which will allow healthcare organizations to accurately manage their financial margins in the per capita reimbursement contracts.

If the fundamental, traditional Healthcare Value equation is defined by the Quality of Care divided by the Cost of Care, or HV = QoC/CoC, then  the fundamental equation of Population Health will be the calculation of Return on Engagement, that is, The Total Patient Investment By the Healthcare System in a Patient’s Health divided by the Clinical Outcome Achieved.  Described otherwise, “How much does it cost our Population Health Management system to increase a patient’s clinical outcome by one unit of measure?”  This is why the understanding of costs and patient outcomes is so fundamentally critical to the success of Population Health.  Understanding the patient’s socio-economic environment is also critical to this equation because in Population Health, 80% of clinical outcomes are attributable to the social determinants of health (2011, Robert Wood Johnson Foundation). ROE = COA/TPI. The motive behind a Care Management system-- services and software-- is to reduce the investment (TPI) necessary by the healthcare system to achieve a unit of improvement in clinical outcomes (COA) by engaging patients in both the numerator and denominator of their own health. My dear friend, Marie Dunn, a graduate of Harvard's Public Health Program, points out a very important factor in the economic environment that must be embraced by healthcare executives in their population health strategy: "A public health professional has the luxury of thinking about health over the course of an individual’s life. A population health management professional thinks about it in the context of a year-long contract and an insurer might think about it for a couple years longer. Anything that shows a return outside the period in which you’re accountable for the patient is not incentivized. The longer timeframe over which we see health care systems accountable for a patient’s life, the closer we’ll see population and population health strategies come together."

Tuesday, March 1, 2016

Health Catalyst Announces New Products at HIMSS16

Company integrates analytics at the point-of-care for population health management, personalized medicine and real-time decision support across the healthcare enterprise
SALT LAKE CITY – March 1, 2016 – From the floor of the HIMSS16 Conference and Exhibition in Las Vegas, Health Catalyst announced it is launching the most significant update to its technology and product strategy since the introduction of its industry-changing Late-Binding™ Enterprise Data Warehouse (EDW) in 2008.
The expansion of Health Catalyst’s product development program comes with the strong endorsement of customers as the industry rapidly evolves toward accountable care, population health management and personalized medicine.
With the Health Catalyst EDW and analytics platform still as its foundation, the company has reorganized its product development around nine product lines, all under the umbrella of population health and accountable care:
  • Population Health and Accountable Care
  • Care Management and Patient Relations
  • Clinical Analytics & Decision Support
  • Research Informatics
  • Precision Medicine
  • Financial Decision Support
  • Operations & Performance Management
  • CAFÉ (Collective Analytics For Excellence), comparative effectiveness solution
  • The Health Catalyst Analytics Platform
Health Catalyst’s new product roadmap is designed to give every healthcare professional the same experience of real-time information, collective intelligence, and dynamic decision support they have come to expect in other aspects of their lives, whether via Facebook, Google, Yelp or Amazon.
Some of the notable initiatives currently under development or in beta mode include:
  • Adding text data and natural language processing to the core platform
  • A Bloomberg-style dashboard for decision support for personnel from the Board level to department managers
  • The integration of clinical data with genomic data for phenotyping and pharmacogenetic decision support
  • An Activity-Based Costing system
  • Several applications for ‘closed loop analytics’ embedded in the EHR user interface
  • The integration of very granular, de-identified data from 65 million patient records into a single data repository (CAFÉ).
In developing its new product roadmap, Health Catalyst has adhered to a simple product development mantra: “Deliver the right data, at the right time, to the right person, and in the right modality.”
“The core of our business remains the ability to aggregate and integrate virtually any source of healthcare-related data, to expose that data to our analytics and algorithms, then to turn that knowledge into measurable outcomes improvement for our clients,” said Dale Sanders, Executive Vice President of Product Development for Health Catalyst. “Taking the final step toward outcomes improvement requires using the power of our analytics at the point of decision making, such as during a clinical encounter with a patient. Studies have shown that physicians are 15 times more likely to adjust their treatment protocols if you give them substantiating data at the point of care, rather than in a meeting or other setting later on.”
Sanders continued, “We don’t believe in the commonly-held opinion that healthcare providers, especially physicians, harbor a cultural resistance to change. Instead, we believe there’s a problem with the software that supports them in their day-to-day decision making. We’re building the products that will make it easier for healthcare providers to do the right thing, whether it’s population health management or personalized medicine for individual patients.”

Advanced Care Management and Patient Relations Solution

One of the first examples of Health Catalyst’s new thinking and roadmap is its web- and mobile-enabled Care Management and Patient Relations application. After an extensive review of care management solutions on the market revealed none that lived up to the company’s expectations, Health Catalyst launched development of its own tool. The first of five applications in the care management product suite has already been deployed at client sites and Health Catalyst is on-track to release the next four applications in the next few months.
“The functionality of our new care management suite, powered in the background by our analytics, is going to leapfrog anything that is available in the market today,” Sanders predicted.

Learning from the Nation’s Best Health Systems

In developing its new solutions for population health management, Health Catalyst is relying on intellectual property and experience gained from partnerships with several existing customers, including:
  • Partners HealthCareHealth Catalyst and Partners HealthCare recently launched the Partners HealthCare Center for Population Health to train clinical and administrative teams in best practices for care management and population health. Health Catalyst also licensed technology, content and analytics innovations that Partners HealthCare, the Massachusetts General Physician Organization and the Brigham and Women’s Physician Organization developed as part of its decade-long, nationally-recognized care management and population health management programs.
  • UPMC: Health Catalyst licensed technology, content and analytics innovations developed by its customer UPMC as part of that health system’s effort to advance patient care while lowering costs. Since deploying its cost management tool in 2014 to blend quality data with physician- and patient-specific cost data, UPMC and its physician leadership have been able to drive significant changes in clinician behavior leading to improved care at lower cost.

About Health Catalyst

Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement company that helps healthcare organizations of all sizes perform the clinical, financial, and operational reporting and analysis needed forpopulation health and accountable care. Our proven enterprise data warehouse (EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more than 65 million patients for organizations ranging from the largest US health system to forward-thinking physician practices. For more information, visit, and follow us on TwitterLinkedIn and Facebook. 
Todd Stein
Amendola Communications for Health Catalyst

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