Paper to Platforms: The Journey of Population Health Management
Ed Chung, MD
Physician Advisor
Discussion points
• What is population health management?
• The three D’s of PHM
• The role of a health informatics platform
01
A historical perspective
We are in a post-data age
01
Yesterday’s challenge: get the data
01
Image credit: Juhan Sonin, flickr
Closer to the present
interoperability
01
analytics
business intelligence
informatics
benchmarking dashboards
silos
quality
Personal genomics
Photo credits: mjtmail, Ray_from_LA, Rev Stan – all on flickr
The ground is fertile
Predictive analytics
Rapid cycle improvement
The driver of PHM
01
Payment reform = move to fee-for-value
Payment reform
+ Fertile data ground
Population Health Management
What is Population Health Management?
01
Using data to optimize care for a well-defined
group of individuals
Why is it so hard?
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Why is it so hard?
10/10/2014 10
Instant Replay — A
Quarterback's View of
Care Coordination
Press MJ,
N Engl J Med 2014;
371:489-491
The three D’s of PHM
01
1) Data
2) Define
3) Drive
Data: Is it…
• Complete?
• Clean?
• Timely?
01
Key question: Do I have confidence in my data?
Why is it so hard?
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“Typical IT solution interface map”
• multiple formats
• multiple meanings
• multiple IT solutions
• multiple vendors
Define: Find the right patient population
• What is the clinical question?
• What measure am I trying to meet?
• Whom am I trying to target?
01
Key question: Do I have the ability to isolate and manipulate
this population?
Why is it so hard?
Then: Let’s look at our population of over-65 patients to make sure
they got Pneumovax.
Now: Let’s look at our Medicaid-eligible kids with inner city
residence, persistent asthma, and ED visit or inpatient admission in
the last year to make sure they’re on appropriate controller meds
and have an asthma action plan for school. And let’s slice the data
by their primary clinic and primary care provider to see where we
need to do the most reeducation.
01
Drive: Can I enable…
01
• Engagement?
• Action?
Key question: Can I put the right information in the right place
at the right time?
Why is it so hard?
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right
information
right time
right place
18
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Health Informatics Platform
• Enables the 3 D’s
• Strategic, foundational structure
• Minimize the number of pieces in your
foundation
01
Health Informatics Platform
01
Image credit: Roger Perriss, Peter Curbishley, Vyacheslav Argenberg – all from flickr
Health Informatics Platform
• Success in PHM is directly proportional to
the strength of your health informatics
platform
• Achieve the 3 D’s (Data, Define, Drive) as
fully as possible
• Robust yet simple is the goal
01