The paradigm shift currently occurring in the healthcare industry is unprecedented. Longstanding fee-for-service care delivery models are rapidly evolving to a value-based system that rewards providers based on outcomes performance and cost-efficient care.
Survival under this new risk-bearing system will require the implementation of effective population health management (PHM) strategies that leverage the rich storehouse of data that exists across healthcare systems. When healthcare organizations can achieve a bird’s eye view of health trends within patient populations and then build quality initiatives around that data, performance metrics begin to fall into place.
Big Data has become an all-too-common buzzword appearing regularly in industry thought leader columns and key note addresses across the healthcare landscape. And while familiar in presentation, the term is indicative of one of the industry’s greatest challenges and opportunities as it relates to PHM.
A 2011 report from McKinsey and Company suggests that the healthcare industry could potentially benefit from Big Data to the tune of $300 billion. Another report points to successful ventures like that of Kaiser Permanente, where an integrated technological infrastructure that leverages population health data has achieved improved cardiovascular disease outcomes and saved an estimated $1 billion.
It makes sense. When population health is managed proactively instead of retroactively, the end result is healthier patients and minimized need for higher cost interventions. The primary roadblock currently is two-fold:
- A lack of consistent data standardization across disparate systems to support better reporting and analytics;
- Technological infrastructures that are advanced enough to manage large amounts of data in a meaningful way to support quality metrics improvement.
Deployment of flexible EHR infrastructures to create the needed repositories of data is the first step. The next step is integration of advanced tools that can manage large amounts of data to support clinical and business intelligence needs to drive effective PHM.
Industry advancements with surveillance technology delivered over a cloud platform continue to show great promise for laying the best foundation for PHM by supporting real-time analytics in a way that elevates patient care and saves lives. Consider the highly effective response by a 537-bed Michigan-based hospital when faced with an unexpected outbreak of fungal meningitis.
Following nearly 20 admissions of patients with fungal meningitis over a two-day period in the fall of 2012, the hospital had to quickly develop a clinical pharmacy monitoring program to optimize care delivery and safety for patients. The clinical team immediately turned to its rules-based electronic surveillance solution to aggregate, monitor and deliver the critical patient data needed in real time.
If the organization had relied on its EHR alone, staff resources that were already heavily taxed would have been needed to manually run reports for patient monitoring. Due to rapid uptick in admissions over a short period of time, the ability to keep reports from becoming outdated would have been nearly impossible, leading to retroactive responses rather than proactive.
Rules were created to identify all patients receiving antifungal medications within minutes of arrival and later to aid in the management of complicated care issues that could require dose adjustment for renal and liver dysfunction and drug interactions. At the peak of the outbreak, the hospital was able to manage approximately 80 patients at one time effectively.
Surveillance technology provided over Web-based cloud platforms negates the issues of interoperability, pulling key data from disparate systems and expanding real-time information sharing. By leveraging these tools for PHM, healthcare organizations can effectively extend the value proposition of their technological investments to best position for current and future quality expectations.