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Customer Experience and Design

PHM: Making the Sum Greater than the Whole

Research suggests that an effective healthcare model focusing solely on evidence-based medicine or preventative does not impact cost and quality as well as programs that merge evidence-based medicine with a healthcare program that encourages preventative care and evidence-based medicine (Cohen, Neumann & Weinstein, 2008). As a result, organizations that are focused on containing costs and increasing quality are turning to population health management (PHM) to meet their related objectives.

PHM relies heavily on the readiness of an organized and coordinated system, because it places an emphasis on primary care to provide preventative, acute and chronic illness care, which is coupled with efforts to educate patients and encourage behavior and lifestyle changes. Because PHM uses robust data from the many sources to evaluate wellness, prevention and early detection of diseases and educational programs to support healthy behavior choices, it requires an organization have a technology infrastructure that can be utilized to influence clinical and business decisions to track patients and impact overall health costs and quality.

A myriad of advanced HIT systems are required to provide the necessary automated risk stratifications, patient registries, appropriate education resources, alert services and adequate reporting. Providers are looking to HIT to provide them with the appropriate data to link care guidelines, disease registries, feedback about performance and patient communication. Providers must have the right technologies to support PHM, which include solutions such as:

  1. Enterprise Data Warehouse: A single repository that serves as the “truth” for multiple areas of an organization’s data. Through the consolidation of multiple disparate sources, an enterprise data warehouse enables business intelligence and powerful analytics.
  2. Electronic Medical Records (EMRs): Computerized medical records that store historical and current patient data. There are multiple EMR offerings to suit any needs and desires. An organization that uses its EMR system well can capture nearly any piece of clinical information desired.
  3. Health Risk Assessments (HRAs): Provide feedback on the wellness and risk factors threatening an individuals wellness. They are comprised of three main elements: questionnaires, risk calculations and personal health advice, to increase awareness of risk factors and ensure that an individual knows the appropriate actions to take care of themselves. HRAs require numerous systems speak to each other in a way that promotes efficiency and effectiveness for the patient, provider or payor and field personnel.
  4. Business Intelligence: Takes an enterprise-wide approach to decision making. It relies on data from all areas of an organization (financial, clinical, operational, etc.) to determine the solution to issues. This is the distinguishing factor between a traditional “data rich but information poor” healthcare organization and a leading edge organization that uses data to drive clinical and business decisions.

These pieces of technology set the stage for PHM to improve the wellness of populations. When cost and wellness is the issue, technology has provided a way for organizations to solve the problem.

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Amanda Buie

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