Population health: 'Let's leave CMS out of this,' experts say
NEW YORK – Population health management is approaching an impasse triggered by the difficulty for private and nonprofit hospitals, social welfare systems and public health entities to understand exactly who is responsible for what.
“Population health is like six blind men looking at an elephant and trying to figure out what the elephant looks like,” Northwell Health Senior Vice President Ram Raju said Monday at the Health Impact conference.
One of the biggest challenges is that the responsibility demarcation that once existed between private health providers and public health departments is now blurred and riddled with far too many care managers, said Shahid Shah, a healthcare consultant.
“That line is gone. That part is killing us. If we can’t decide who picks up what responsibility where, it’s completely unsustainable,” Shah said. “Population health vs. public health — we have to solve that together or IT systems are not going to do anything.”
Today’s EHRs, in fact, were not built to handle non-clinical data types, notably social determinants of health, which speakers agreed are a big opportunity for treating patient populations.
Shah suggested that moving beyond the federal government’s meaningful use EHR incentive program will open new opportunities and resources for providers to pursue population health management initiatives.
“We should leave CMS out of this. Hopefully with the death of meaningful use after stage 3, we can get back to some semblance of reality,” Shah said. “Let’s do this proactively. The smartest thing we can do is come together and say ‘this is our job.’”
Saint Barnabas Health is already doing just that.
“You don’t need the government for everything,” Jitrenda Barmecha, CIO of Saint Barnabas said.
He added that Saint Barnabas is planning to unveil by 2019 low-income housing with kitchens so it can educate people, based on a community needs assessment, about eating habits and chronic conditions.
It’s not just about doctors and hospitals. Barmecha said that population health programs should include anyone with a touch-point on its system, and that includes social workers, community care providers, those people helping find food of shelter for patients.
“If systems can come together it will have a big impact on the health of the population,” Barmecha said. “It’s a huge culture change because we’ve been siloed. There has been a huge change away from episodic toward longitudinal care. It wasn’t there 7 years ago.”
Whether such population health programs will be widespread five years from now, however, comes down to finding innovative business cases, Shah said.
“We need a different business model than the sick care model,” Shah said. “I don’t see the idea of pop health if we don’t drive it through business models. All we’re going to say five from now is ‘oh pop health didn’t work.’ We need to reorient for pop health.”