Population Health

Providence Health and Services also joins consortium of hospitals teaming with Syapse to establish OPN that will advance data sharing and speed development of personalized cancer treatments.

Mayo Clinic will provide the infrastructure to store, analyze and host data for researchers as part of a program that aims to enroll one million people to boost President Obama’s Precision Medicine Initiative.

Simplified regulations around MACRA meaningful use could address the loss of efficiency and usefulness of electronic health records software to enable more flexibility for the doctors using them, said Shawn Griffin, MD, of Memorial Hermann Physician Network.

Chipmaker said that Lumiata will use the money to drive predictive analytics to improve risk and care management for organizations practicing population health. 

(SPONSORED) Jim Bresee, VP of Solutions Management, talks about how Allscripts' solution addresses both fee-for-service and value-based needs simultaneously.

Financial incentives, information technology advances and new care models have created fertile soil for population health management programs to grow. But for these efforts to flourish healthcare organizations need more sophisticated analytics, patient stratification, community involvement and care management, according to a May 2016 report from PwC Health Research Institute. “So far, most efforts have been narrow, with promising results. These early results signal the full potential of population health if scaled across geographies, diseases and the continuum of care,” PwC’s “Population Health: Scaling Up,” report noted. “Yet many organizations still struggle to scale their efforts – an essential step as they take on more risk in value-based payment contracts.” [Also: The essence of population health: Design and user experience] Seventy percent of clinicians do not participate in risk-based, incentive-based or shared-savings reimbursement models, PwC said, even though adoption of these payment models is a major goal of the Centers for Medicare and Medicaid Services. Healthcare organizations with evidence that population health programs are working well on a large scale are more likely to be rewarded under these reimbursement models. The PwC report suggested six steps healthcare organizations can take to advance population health programs to highly effective levels. First, healthcare organizations should “pick a major,” PwC said. So, for instance, carrying on the university area of study example, an academic medical center might “minor” in population-based care at the community level and “major” in acute and chronic health population health. Second, healthcare organizations need to “think retail,” the report continued. “Today’s consumers are expecting health providers to offer the personalized levels of service and convenience they receive from other industries,” PwC said. More than 80 percent of consumers are open to non-traditional ways of receiving care, PwC added, such as virtual visits, at-home diagnostic monitoring and home care visits. Establishing a funding mechanism is a third step healthcare organizations must take to achieve success in population health management, PwC advised. “Organizations should design a payer strategy for population health to manage risk and sustain operations,” the report said. “Some providers are partnering with insurers to outsource activities such as risk score optimization, actuarial analysis and claims administration. Others are on their way to becoming licensed health plans, a growing trend in a value-based health economy.” Healthcare organizations also should plan for early losses and contract accordingly, the PwC report suggested as a fourth step. “Organizations should evaluate their abilities to tolerate risk and assess their capital positions to support population health strategies,” the report said. “Organizations should structure partnership contracts so that risk is shared appropriately among all partners in their population health delivery networks.”  [Also: Healthcare analytics has long journey to deliver real value, data scientist says] Fifth, healthcare organizations should be prepared to redirect pent-up demand. “Organizations with excess demand may have smoother transitions as they operate more efficiently,” PwC said. “They can replace lost volume, continue to operate at high capacity and improve their returns on fixed costs.” Finally, to succeed in population health, providers must evaluate programs often and make adjustments promptly, the PwC report advised “Population health programs require heavy operations investments and have high fixed costs,” the report said. “Organizations should build care services around patient cohorts and actively monitor health outcomes. They should regularly reevaluate whether patients assigned to each group still belong there.” Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

The document outlines eight guidelines for achieving precision medicine principles, including a ‘participant-first’ system.

Much the way consumer analytics fundamentally improved how products and services are sold, healthcare analytics will one day change the way providers deliver care. But Sriram Vishwanath contends that a lot has to happen before that day comes.

The network will modernize facilities to embrace a new model of care that is more efficient and strengthen its focus on population health and integrating research about genomics and digital medicine for personalized treatments.

By Michelle Andrews, Kaiser Health News In his recent book, “The Finest Traditions of My Calling,” Dr. Abraham Nussbaum, 41, makes the case that doctors and patients alike are being shortchanged by current medical practices that emphasize population-based standards of care rather than individual patient needs and experiences. Nussbaum, a psychiatrist, is the chief education officer at Denver Health Medical Center and practices on the adult inpatient psychiatric unit there. I recently spoke with him and this is an edited transcript of our conversation. Q. Your book is in some ways a lament for times gone by, when physicians were “artisans” who had more time for their patients and professional independence. But you’re a young doctor and you must have known at the outset that wasn’t the way medicine worked anymore. Why do you stick with it? A. The first thing I’d say was that I didn’t know right away that medicine is no longer universally understood as a calling instead of a job. We are describing health as if it is just another consumer good, and physicians and other health practitioners as the providers of those goods. That is the language of a job. When you remember that being with the ill is a calling, then you remember that it is a tremendous privilege to be a physician. People trust you with their secrets, their fears and their hopes. They allow you to ask about their lives and to assess their bodies. So my lament is not for the loss of physician privilege — goodbye to that — but to the understanding of medicine as a calling. Q. You don’t like checklists and quality improvement measures that dictate how physicians care for patients because you say it turns doctors into technicians and is an obstacle to “moral reasoning.” But those tools, which generally take a systems approach to providing care and rely on evidence-based guidelines, aren’t going away anytime soon. How do you do the kind of doctoring you want to do in this environment? A. Quality improvement seems to be here to stay. Regulators at all levels require it. But I believe that evidence of its success is not as clear as they suggest. Just last week, the British Medical Journal published a study that found no evidence that introducing quality metrics has resulted in a significant reduction in patient mortality. The leaders of the quality movement’s version of quality improvement developed out of industrial engineering, so they are always comparing the care of patients to things like the production of cars or the flying of airplanes. People are far more varied than cars on assembly line or planes on the runway. So quality metrics always feel forced to me, especially for the more interactive medical encounters. In my own specialty, the current quality metrics all encourage me to perform standardized screens on patients or to document carefully. None of them require me to develop a relationship with a patient so that I can, say, foster hope after a suicide attempt, or knit a psychotic person back into the life of their family. Yet that it was my patients want, those human relationships. It is also what physicians want, and the most recent studies suggest that most physicians are dispirited by quality metrics. Q. But not all physicians are equally skilled or conscientious. As a patient, I feel more comfortable knowing there are rules and standards that doctors have to meet. A. I don’t think physicians should be free to do whatever they want. Their thinking and decision-making should be held up to scrutiny. A physician’s standard of quality should be evidence-based, but even more, it should be patient-centered. The standard should be what the patient defines as what matters. So if you are suffering chronic pain, it is not just a reduction of your score on a standardized pain scale, but your ability to resume the activities you identify as constitutive of your life. Q. You talk about wanting to be able to sit with patients and talk with them, to really “see” them. All that takes time that physicians don’t generally have. I understand your book isn’t a how-to manual. But, really, how can physicians do this, even if they want to? A. It’s a real challenge. It’s important to use the time you have in service of the patient’s needs. I don’t review records while I’m in the room with a patient. I try to make every question be about the patient. I have to ask standard questions, but I try to do that as way to get to know the patient. For example, if I have to ask questions about what they can remember, I’d ask about a book they have with them. Part of my concern about checklists is that they train you to follow a script instead of following your patients. Q. Only 55 percent of psychiatrists take insurance compared with nearly 90 percent of physicians in other specialties. That puts their services out of financial reach for many people who could use their help. How does that square with your vision of doctors as healers and teachers? A. It’s deeply concerning to me. I’ve made a conscious choice to work at a safety net hospital, so I can see people regardless of their ability to pay. I hope that through things like the Medicaid expansion and mental health parity, more psychiatrists will work with people who have mental illness. Q. You talk about the virtues of “slow” medicine, similar to the slow food movement, where physicians reject providing care in a standardized, mass-produced fashion. One path that some physicians have chosen is to establish boutique practices that accept a limited number of patients who pay extra fees for more personal attention and better access. What’s your perspective on that? A. It sounds appealing to me. In most descriptions of boutique medicine, they talk about it like a lovely restaurant, one that I couldn’t afford to go to every night. I think it’s an interesting model but not a solution to the large problems facing medicine, in particular the ability to provide care to the most needy among us and the indigent. This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.