How About a "Year-End List" with Just One Item On It? Why 2013 Will Be Remembered as the Year of Population Health

Dec. 20, 2013
If you're like me, you probably have a love-hate relationship with year-end list-making. Certainly, those "best of the year" and "worst of the year" lists are trite, and often boring and even silly. Sometimes there simply aren't ten "best" or ten "worst" things on any particular list of any type--there is an arbitrariness in the process that sometimes simply can’t be overcome. But this year, it seems, one could come to a particularly interesting conclusion when reviewing the events and developments of the year.

If you’re like me, you probably have a love-hate relationship with year-end list-making, as it’s practiced in the journalism world. Certainly, those “best of the year” and “worst of the year” lists in newspapers and magazines, in the broadcast media and online, are trite, and often boring and even silly. Sometimes there simply aren’t ten “best” or ten “worst” things on any particular list of any type—there might be seven best things, say, and fourteen worst of that particular thing, for example. And sometimes, what’s “best,” “worst,” or even “most noteworthy,” is really a stretch. It all feels so arbitrary sometimes. On the other hand, you can just hear the deadline-harried editors barking out orders to their reporter and writer underlings to get those year-end list stories done before everyone heads off for the holidays. And, besides, isn't it human nature to want to compare thoughts with others? Thus, the inevitable argument for the publishing of "year's most whatever" lists.

Still, this December, something feels a bit different when it comes to the healthcare industry, for this editor. That’s because, more than at any time in the past, 2013 seems to me to have been the year in which population health really came into its own, driven forward by healthcare reform in its many manifestations (not just the Affordable Care Act, of course), including, most broadly, pressures from both the public and private purchasers and payers of healthcare for physicians and hospitals to provide greater value for reimbursements paid, through value-based purchasing, outcomes measurement, and so on—and most of all, through population health strategies that shift the focus of care delivery from episodic, downstream-oriented care, to care management that is longitudinal and moves towards comprehensiveness, particularly for patients with chronic illnesses.

Population health was everywhere this year, both as a discussion topic at events like the Healthcare Informatics Executive Summit, and in a slew of articles that our team at HCI has written, including cover stories, interview-based articles of various types, blogs, news stories, and other items.

And appropriately so: as all the requirements for the new healthcare, as we’ve been calling it—the transformed healthcare system that ensures accountability, transparency, improved clinical care quality and patient safety, enhanced cost-effectiveness, and above all, greater value for money spent—come together, they come together as some version of population health. That includes accountable care organizations, patient-centered medical homes, avoidable readmissions reduction work, and a host of other variations on the same underlying theme. And that theme is moving towards taking care of entire communities, beginning as far upstream as possible, and doing so over long periods of time, and with conscious intent, and strategic purpose.

Of course, absolutely none of this can be accomplished without the strategic leveraging of clinical and other information systems, including business intelligence/analytics, data warehousing, dashboarding/performance metrics, and other information technologies that can make these various forms of population health work.

And all that puts CIOs, CMIOs, and other healthcare IT leaders in a position of both unprecedented opportunity and unprecedented challenge. Because for population health to work, indeed, for the new healthcare to work more broadly, successful leveraging of all of those types of IT will be absolutely essential.

As I was saying to a colleague this week, this is a particularly fascinating time in healthcare, because all of the predictions that many have been making literally for decades now are finally coming true. And whether or not you see that development as a “glass-half-empty” or “glass-half-full” kind of development depends on solely on whether you believe the challenges inherent in the opportunity to help forge the new healthcare are a good or a bad thing.

Being an optimist by nature, I’m going to go with “glass-half-full” here, while hoping also to be able to note, one year from now, that we as an industry will have made significant strides towards actualizing the pioneers’ vision of population health, when I write a blog like this (or something like this!) one year from now. Because it would be a most wonderful thing, in my view, if we could say, in December 2014, that the year 2014, too, had also turned into the year of population health. Stay tuned and find out!

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