- Population health management deployments are still in their “infancy,” according to industry analyst firm Chillmark Research, as organizations grapple with evolving reimbursement models and vendors vie to ramp up their solutions. Nonetheless, there’s optimism that population health tools will earn their place in health IT integration plans.
“If you really want to make strides at reducing costs and improving quality across the entire network, you need to focus on all of your providers. It is an extremely complex problem that requires a sophisticated product, and that is a very high barrier to entry. But that is the burden that goes along with the opportunity of population health tools,” explained Phillip Burgher (pictured), director of software development, data platforms and PQRS at healthcare analytics company Wellcentive.
HealthITInteroperability.com asked Burgher to elaborate during a recent one-on-one interview, the transcript of which follows below.
HealthITInteroperability.com: What is the current level of use of population health management technologies across the market?
Phillip Burgher: It has grown quite a bit in the last five to 10 years, but still has a ways to go before it becomes a dominant factor for how physicians are paid. The 100,000-foot view is that you can’t really judge how well a provider or physician organization is doing unless you have a longitudinal view of the patient, which to date EHRs really haven’t been that good at. You need this new breed of technology called the population health tool. With the advent of meaningful use and ACOs and Shared Savings Programs, it’s really starting to gain traction. If you look at the wedge that is fee-for-value, it’s getting larger every year. That’s really what’s driving the adoption of population health tools.
HITI.com: What is the interrelationship between the EHR and population health management solutions?
PB: The most basic use case for interoperability is getting data from Point A to Point B. The population health tool serves as an aggregator, gathering all of the data from the entire ecosystem into one patient’s chart in order to do that longitudinal analysis. And we’ve successfully done that for many years, but what we’re seeing now is that customers are realizing that you don’t necessarily want to integrate just data. You also want to integrate workflow.
Providers have many different applications that they need to log in to, and that makes life difficult. One solution is to have your EHR as the central workpoint for the provider side of charting, and then you can bring in the functionality and pieces of the population health tool. It’s a good marriage of functionality.
HITI.com: What kinds of data can be pulled out to the population health tool?
PB: EHRs are great sources of clinical data — vitals signs, immunizations, procedures. Every project is a little bit different, but in general the EHR is a good place to stand up integration to one source and get a good bang for your buck.
Having said that, there are other sources of clinical data, — directly from lab systems, for example. Some providers also have their own e-prescribing tools where you can get good medication data.
In general, you’re talking about grabbing the low-hanging fruit from the integration perspective and working your way up the difficulty scale. Claims systems are a good place to start because they’re standardized and you can get a lot of information quickly. However, they’re just not complete for what you need to do.
The EHR is the next-best option, but it seems to be the point where everybody is getting stuck.
HITI.com: What could be done to “un-stick” them — to get beyond those current barriers?
PB: In general, ONC has done a good job of laying out the barriers that we’re facing in its Interoperability Roadmap. Those barriers include information blocking, lack of standardization and format, and lack of semantic consistency. In more simplified terms, if we could settle on a standard data format that is more prescriptive and less flexible, a transport method that is secure yet not prohibitive to set up, and, finally, a set of coding systems that everybody could understand, that would go a very long way toward solving the interoperability problem from a technical perspective.
HITI.com: Looking out over the short term, what are some of the ways in which population health tools will be used?
PB: The first thing that comes to mind is the goal from the Department of Health and Human Services to have 50 percent of payments be linked to a value-based reimbursement rate by 2016. That’s right around the corner. The only way to do that is to have a complete patient chart — not episodic but longitudinal. That is where I think population health tools really shine.
Other areas where you’ll see increased use of population health tools would be in risk stratification and care management. Those are really two sides of the same coin, enabling you to target high-risk patients while identifying areas for cost reduction. Analytics allow you to see where you are, where you’ve been and project out to where you are going from a quality and cost perspective as an organization.
However, one important note in regard to next steps is that you really have to pay attention to data quality. You may be able to get data from Point A to Point B, but you won’t be able to do anything with it if the quality is not sufficient. Data must be complete, accurate and traceable to a trusted source.