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Prepping Health IT for Population Health, Value-Based Care

"Even if I create the single ubiquitous EMR and everybody gets smart and buys my solution, it's still not going to be the only data out there."

By Kyle Murphy, PhD

- Population health management and value-based care center on risk. For the former, the key is to identify and limits the health risks of a particular patient population. For the latter, the whole point is prevention while maintaining a high level of care.

Cerner is preparing its health IT for population health management and value-based care

A similarity shared by both is the need the right data at the right place at the right time. In health IT terms, that's interoperability across the continuum of care and health data exchange beyond the clinic.

For one of the leading EHR vendors in the health IT market, collaboration among various stakeholders is necessary for doing business in the healthcare industry moving into the future.

"We all have to be ready to think about how we are going to aggregate data, not just in one single EMR," Cerner President Zane Burke told EHRIntelligence.com earlier this month.

Data siloes may have served the fee-for-service model of reimbursement, but they have no part to play in a value-based care environment, asserted Burke.

READ MORE: Health Information Exchange to Build on 2015 Advancements

"As much as I want it to be an all-Cerner everywhere, that's not realistic because I don't do claims data or PBM data," Burke continued. "Even if I create the single ubiquitous EMR and everybody gets smart and buys my solution, it's still not going to be the only data out there."

For the past year, Cerner has held open and interoperable to be key features of future health IT. Coming off its recent user conference, the company's leadership now view these qualities as essential to the transition from volume to value, which Burke argues is not a possibility but an eventuality.

"Whether your organization is still living in a fee-for-service world today, it eventually will not be," he maintained. "Risk is here. You're again better to get on the pop health side of this, and the progress we have made there is incredible."

According to Burke, value-based care and population health management require health IT vendors to compete in different areas, not on interoperability and data exchange.

"Get on board with the interoperability component. Be part of the solution. It's coming. The faster you get past that you can start moving and working on some other things," he said.

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A wave of change

The benefit of the rising tide that raises all ships is the ability to leverage large stores of healthcare data to better serve the patient as consumer. Cost is one such factor Cerner is hoping to use its EHR network to address.

"Now let's all get together to solve this other problem which is 30 cents out of every healthcare dollar goes to the administration of a claim — ridiculous," he stated. "Twenty cents goes to the insurance companies themselves and ten cents goes to trying to get paid the darn money for the service you provided. Let's go after the first dollar together."

Cost, however, is only the starting point. Patients have much more to offer than just dollars. They also have their own data to share with providers, added Burke.

"We all have to become much more consumer-oriented," he argued. "There is study after study that proves that that information is as reliable or more reliable than a fair amount of the medical studies that have been produced today."

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Under a fee-for-service reimbursement model, this information can mean very little, part of the reason why providers need to be more forward-thinking according to Cerner leadership.

"The payment models have put us into this weird zone of we care about scheduled appointments, procedures, and all this as opposed to pollen count is up I bet we're going to have some issues around sinusitis," said Burke.

Preparing for consumerism

The Kansas-City-based company is putting its money where its mouth is in multiple ways.

Cerner is investing more than $600 million in research and development to advance its health IT platforms. Likewise, it is collaborating with the likes of Geisinger Health for population health management and Mosaic for application programming interfaces (APIs) and the use of the Fast Healthcare Interoperability Resources (FHIR) standard.

According to Burke, a top priority for Cerner is preparing its clients to meet the demands and expectations of consumers, tomorrow's patients.

"If we don't help our clients to become the most consumer-friendly organizations at the individual app level, our clients are going to be left behind and consequently we'll be left behind as well," he revealed.

To that end, the company like its competitors in the industry are taking a closer look at the ways in which its health IT platforms need to change in order to support a new kind of consumerism in healthcare.

"You've got to take some of the hardness off of this thing," Burke maintained. "There's a platform layer by which we need to accept the data and really take that into account as part of the medical record, and then there is this other piece which is a pure consumerism piece where we have got to be a much friendlier place to deal with it."

While healthcare organizations and providers are currently straggling between fee-for-service and value-based care, they will eventually need to be positioned to square up to only one and have the tools to do so effectively.

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