Web2pro spoke with Rose Higgins, senior vice president and general manager of population and risk management at Web2pro, about the resources that health care providers need to create and manage a successful population health management strategy. Higgins discusses the technological capabilities required to win at the population health game.
Web2pro: What set of competencies should an effective population health management program possess?
Higgins: A population health management program must be able to do seven things in order to be successful:
- Identify a population
- Identify an individual within that population
- Acquire and aggregate clinical and financial data on that population and for each individual
- Analyze that data
- Develop interventions based on that analysis to address that population’s health issues
- Engage individuals to use those interventions
- Track progress in improving health status.
Web2pro: What technologies do providers need to perform those functions?
Higgins: There’s not one technology that does it all or even just one for each of those competencies. You can come at it from a variety of ways. It definitely begins with interoperability to be able to collect patient data from a variety of sources. That can be through a public or private health information exchange or data warehouse.
You need technology that enables users to collect and input claims data, both pre-adjudicated and post-adjudicated, to know what health care services were performed and what was and wasn’t paid for on an individual basis. You need technology that enables users to collect and input clinical data to know things like a patient’s lab results or what medications they’ve been prescribed.
You need technology that collects and inputs medical assessment and treatment data. All of that combined will produce a rich data set that allows a population health management program to understand individuals, populations and the providers caring for that population, and whether they are doing that effectively and efficiently.
Web2pro: Now you have the data. What technologies are needed to take action based on that information?
Higgins: You need care coordination and care management technologies. Care coordination and care management are different. Care coordination technology makes sure that all the people on deck know what’s been done and what is scheduled to be done. Care management technology is about identifying the specific health and medical needs of an individual patient or patient population and executing a customized medical treatment strategy for that patient or that patient population.
You’ll also need patient engagement technologies like secure patient portals to engage individual patients and patient populations in those customized medical treatment plans. It doesn’t have to be a portal. It could be mail; it could be a mobile health communications app—whatever works for that patient and for that patient population.
Web2pro: How much should providers expect to spend on the population health technologies you’ve identified?
Higgins: It starts with understanding and appreciating the fact that HIEs won’t get you there on their own. EHRs won’t get you there on their own. You need to complement those investments with the right kind of analytics and care management competencies either as products or services so that you really can do the work of population health management. This is not an insignificant amount of investment and varies depending on where you are in terms of your current technology infrastructure. In addition to the technology investment, you must also consider including the talent and headcount you need to be effective at population health management.