Geisinger making Epic, Cerner work together for population health

'We want to get as much information from as many places as we can'
By Skip Snow
09:18 AM
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Geisinger Health System, an Epic shop, has chosen to integrate Cerner's HealtheIntent  platform. In particular, the Pennsylvania vertically integrated care delivery system, often compared to Kaiser Permanante, uses the Data Syndication, HealtheEDW, HealtheRecord, and HealthRegistries products from the platform.

The platform is billed by Cerner as a cloud-based programmable population analytics toolset and is designed for scale to operate in semi-real time; it offers insight on the population level as well as insights and visualizations at a person and provider level.

Healthcare IT News spoke last week with Nicholas Marko, MD, Geisinger's chief data officer and a practicing neurosurgeon, who was a key stakeholder in the decision to use this solution for population management, about the challenges Geisinger faces.

Geisinger selected Cerner over other candidates, sticking with its best-of-breed philosophy. Much is at stake when making decisions to opt for a heterogeneous technology environment: A company's DNA, its partnering and vendor management capabilities, its fundamental technology architecture, and its willingness to spend the time and money integrating new sources of information on the front end – and new methods of doing analysis and preparing visualizations on the back end – must be weighed against the incremental advantages it gets from what Geisinger considered the more desirable product.

According to Marko, the institutional challenges the Cerner system met to beat out the competition revolved around how the tools and partnerships fit into the analytics environment more than any explicit functional gaps with other products the company looked at.   

He cited three main reasons the system was chosen:

  1. It is built on a modern data architecture. "It complements our modern enterprise data stack," he said. "Having a partner that has a very modern back-end system is very helpful for integrating. It makes it very seamless and keeps the amount of work we have to do just manipulating data down to a minimum."
  2. It works on data from many sources seamlessly. "A platform that has robust endogenous support for pulling in information from disparate sources is a particularly attractive platform for doing population health because we want to get as much information from as many places as we can for that," Marko explained.
  3. Cerner is open to being a development partner. "Cerner has been very open and interested in partnering with us. When we have a new idea, when we have come across a need we have not anticipated, or a new angle where we think we can implement something that will help us do a better job in population health, they are pretty open to sitting down and having a conversation about how we get that integrated into their system so that we don't have to go to two or three or four or five places, but we can just put those useful tools in front of the care manger or whoever. We have a legal framework in place to deal with the IP that is created using the platform," he said.

"We have the same challenges and interests that other organizations do with the added piece that we are both a provider and a payer system," said Marko. "We have lots of different ways to look at our patients. We know a lot of things about their clinical course. We know a lot of things from the data we gather from the payer side. We want to be able to look at those individual patients as members of the larger population we take care of.

"We need to make sure that we are doing things right and the best way we possibly can on both a micro level at the individual and a macro level at the population level," he added.

"Our real challenge was to figure out new, interesting, useful, and productive ways to take all of the information we have from lots of different places and put it together into one or more systems where we can really get that kind of quick and easy and also comprehensive and valuable view into our patients and the people we take care of," said Marko.

The tool will assist decision-makers in taking care of populations and patients across a wide array of programs in many chronic disease scenarios. It will serve research and operational clinical care, and will identify both financial and clinical risks.

"One of the nice things about being able to put lots of information together into the same space and then use modern analytic approaches to get at that data is that we can start to see things we did not know were important," he said.

"Both providers and patients will have to change their behavior," he added. "So one of the things we are really interested in is understanding the behavior of providers and patients. That is not just to look at a single metric or outcome point. We try to use our data to understand how and why people do the things that they do in regards to health.

"That is providers doing things with regard for their patterns of care, and it is also patients doing things that they do with regard to how they manage their own health and how they interact with the healthcare system. We are trying to continue to get into behavioral analysis to understand why everybody involved in the healthcare relationship is doing what they are doing and how we can use our data to enforce the positive part of that."

The system will start with the ability to work with clinical data, health plan claims data, and cost data from clinical systems.

"No repository or visualization screen can, in and of itself, change the behavior of any actor, be it caregiver or patient," Marco said, adding that a system can "make data available in an easy-to-use, easy-to-understand, easily organized fashion."