Managing population health requires new skill sets, new infrastructures and automation, according to new research from the Institute for Health Technology Transformation (iHT2).
The findings are from the Automating Population Health Research Project, which seeks to educate the healthcare industry on how best to apply technology in meeting the challenges of population health management.
“Population Health Management: A Roadmap for Provider-Based Automation in a New Era of Healthcare” was prepared in consultation with a broad range of industry experts, iHT2 officials say.
To make the transition from fee-for-service reimbursement to accountable care, which depends on the ability to improve population health, providers will need to automate many routine tasks, ranging from identification of care gaps and risk stratification to patient engagement, care management, and outcomes measurement, researchers found.
"In the era of healthcare reform, provider organizations must change their traditional approach and embrace new ways of thinking about their mission," said Waco Hoover, CEO of the Institute for Health Technology Transformation. "They must not only care for the sick, but also strive to keep their patient populations healthy. Information technology is the key to doing this cost efficiently, and automation can enable care teams to identify and work with the patients who truly need their help."
Report coauthor Paul Grundy, MD, global director of healthcare transformation at IBM, and president of Patient-Centered Primary Care Collaborative, said, "Patient-centered medical homes based on primary care are the building blocks of accountable care, and information technology is the key to successful medical homes. With the help of registries, electronic health records, health information exchanges, and other tools for care coordination and automation, healthcare providers can manage their populations effectively and keep their patients as healthy as possible."
"Given potential healthcare reform and efforts to increase quality and efficiency of care in the setting of persistent fiscal limitations, the importance of leveraging information technology and focusing on population health management has become a top priority for many healthcare institutions,” added Andy Steele, MD, director of medical informatics at Denver Health, and another of the report's contributing authors. “Our goal for the project is to provide resources that healthcare providers can utilize as they are considering and implementing population health management initiatives."
"This important new report underscores the message that Phytel has been spreading among physician groups for the past several years," said Richard Hodach, MD, chief medical officer at Phytel and chair of the report's research committee. "By using technology to identify subpopulations and patients who are at risk, to reach out to those patients, and to automate care management, healthcare providers can provide optimal preventive and chronic care to their patient populations.
“Providers can also use technology to engage patients in their own care, which is the real key to lowering costs and improving population health,” he added.
In addition to Grundy, Steele and Hodach, others who contributed to the Automating Population Health Research Project are:
- Alide Chase, senior vice president for quality and service, Kaiser Permanente;
- Robert Fortini, vice president and chief clinical officer, Bon Secours Health System;
- Connie White Delaney, RN, school of nursing professor and dean, Academic Health Center director, associate director of biomedical health informatics, and acting director of the Institute for Health Informatics, University of Minnesota;
- Margaret O'Kane, president, National Committee for Quality Assurance; and
- Dan Fetterolf, principal, Fetterolf Healthcare Consulting.