Black Book: PHM Growing in Importance, but Providers Lack Tech Infrastructure to Support it

Jan. 30, 2017
Black Book’s most recent report on the state of population health management (PHM) has revealed that it is among the fastest-growing areas in the healthcare IT space.

Black Book’s most recent report on the state of population health management (PHM) has revealed that it is among the fastest-growing areas in the healthcare IT space.

The research also found that several effective end-to-end solutions are emerging. “Record population health management spending underscores its increasing importance with a reported $8 billion invested in digital health in sum in 2016, with the majority going to population health and patient experience tools,” the report stated.

However, even as PHM solutions are quickly becoming a priority for healthcare organizations, in Q1 2017, 81 percent of providers are tackling population health projects without a strategic technology purchase that meets all their needs. Nearly a third of those providers are using value-added tools from their electronic health record (EHR) vendor as a stop-gap solution.

The research included more than 6,600 respondents from physicians practice, hospitals, health systems and chains, ACOs (accountable care organizations), IDNs (integrated delivery networks) and IPAs (independent physician associations), who responded over the last nine months of 2016 to measure vendor performance in eighteen Black Book key performance, satisfaction and usability indicators specific to the population health and value-based care solutions.

Indeed, the majority of hospitals (83 percent) and physicians (86 percent) responding to the Black Book survey state their community health information exchanges (HIEs) are still too insufficient or simply not operating at the point where they solve the reliable data needs of population health modeling.

What’s more, there have been many recent mergers and acquisitions (M&A) in the healthcare IT space this past year aimed at achieving end-to-end PHM and value-based care solution offerings. “We’re also seeing consultants utilizing the M&A strategy to beef up their EHR, interoperability and data analytics bases, as well as the merging of some consulting firms and PHM companies, and company rebranding to maximize focus on PHM solutions,” Doug Brown, managing partner of Black Book Research, said in a statement.

“In order to maximize the value and benefits of a PHM solution, it is imperative that providers and payers master the art of data capture,” added Brown. “Collecting continuous data on whole populations, from the sick to the healthy, will help fuel the immense data appetite for next-generation PHM solutions.”

Researchers noted that clinical data has previously been mostly limited to EHRs, which is “why it’s no surprise that six of the top 20 PHM vendors are EHRs with two-thirds of the installs represented in this survey.”

Historically, EHR clinical data consisted mostly of health snapshots during doctor and/or hospital visits. “As PHM solutions continue to grow, there will be a concurrent expansion in all the different ways of gathering clinical data at the point of care (POC) and in near-real time,” said Brown.

Also on the rise are solutions that utilize both claims and clinical data to identify at-risk patients, help locate missing or inconsistent clinical documentation, and enhance collaboration between providers, patients and payers. “As payment models continue to shift toward value and payers and providers assume greater risk, they will need tools to help improve collaboration and communication as they work to meet the Triple Aim (improve patient satisfaction and care quality while reducing unnecessary cost),” said Brown.

“Next generation PHM will not be achieved via old-school directives to cut staff, slash expenses, and pushing PHM work with the lowest-cost tech vendor,” noted Brown. “The new era of how providers get paid is going to impact the entire organization, and most hospitals aren’t remotely prepared for it.”

Black Book measured end-to-end capabilities of PHM vendors on six criteria of functionality—six for non-EHR vendors and four for EHR vendors as the majority of best-of-breed/non EHR vendors focus entirely or primarily on big data and analytics.

The top three core EHR PHM vendors (end-to-end solutions) were Allscripts, Cerner and Epic, in that order. The six best-of-breed PHM vendors (end-to-end solutions) were: IBM Watson Health, Evolent Valence, The Advisory Board, Optum, Wellcentive Philips, and Caradigm, in that order.

Meanwhile, organizations on the transition path to PHM must prioritize three foundational elements, according to survey respondents: information-powered clinical decision making (98 percent); primary care-led clinical workforce (96 percent); and patient engagement and community integration (93 percent).

And, 90 percent of all surveyed decision makers on hiring an external consultancy agree that they prefer an advisor with both population health management and revenue cycle management expertise in 2017. Of the 58 PHM head-hunting firms contacted by Black Book, about one-half claim they are currently experiencing difficulties finding qualified PHM process experts to fill open positions, and 90 percent anticipate longer searches ahead for next generation-qualified PHM staff as the industry confronts PHM expert shortages through the next year.

Hospital executives primarily attributed the increased demand for PHM advisory services on several factors out of their scope of current experience, according to the research:

●      77 percent have no strategic plan activated for transforming PHM or value-based care solutions end-to-end to confront known deadlines because there are no internal experts identified;

●      Of the 84 percent stating they are either acquiring, replacing either (or all) PHM IT solutions, vendors, current service delivery processes or outsourcers within the next 12 to 18 months, less than 20 percent of hospitals have begun comprehensive vendor selection activities and 79 percent are considering external consultants to assist them;

●      89 percent of CFOs confirm they are confident that the hospital does have the appropriate FTEs budgeted for PHM transformation activities; and

●      80 percent of CIOs responding to the survey state they do not have the information technology or staff in-house needed to transform PHM end-to-end as their executive team envisions.

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