A quarter-century after the first wave of resource-conserving managed care practices, which resulted in not much other than patient alienation and provider consternation, the technological underpinnings for population health management finally seem to be coming into place.
Pioneering healthcare providers are leveraging information technology to identify which cohorts of their patients are most in need of ongoing care management.
While these efforts are still in the very early stages, the documented care improvement and cost savings results thus far are pretty clear-finding patients with conditions that need care management is possible now, and will become absolutely necessary before long.
Some of these gains have been made through community-wide programs such as the Beacon communities. Under the U.S. Health and Human Services departments Beacon Community Cooperative Agreement Program, 17 disparate community-based organizations receive funding for information technology that can advance healthcare.
Other improvements have come about through the use of in-house or commercial population management tools as adjuncts to electronic health records.
One of the things I see that is very exciting is, we can begin to look at managing populations of patients far more effectively than we did in the 1990s, when we failed at doing capitated healthcare because we didn't really have data to do it correctly, says Jeffrey Galles, D.O., chief medical officer of Tulsa, Okla.-based Utica Park Clinic. We didn't have the tools to create the automated outreach; we didn't have the ability to engage patients because we didn't have the resources in place. We lost lots of money and created ill will with patients and providers. In the next 10 years, we'll have the ability to go out and really, truly provide care for the entire patient, to manage their care in a way it hasn't been managed before, and to improve their health outcomes while engaging them in their own care.
However, Galles says, predictive tools that may not be ready for prime time should be given time to mature. There is no need right now, he says, for overreach in identifying patients with "pre-" conditions such as pre-diabetes and pre-hypertension. Finding-and engaging-patients with clearly defined conditions is already possible and cost-effective.
We don't need to make up disease states, he says. We already have enough disease states that are not managed, so looking at the risk of developing hypertension or coronary artery disease is really secondary to us. Down the road we may want to look at predictive tools, but right now we don't have to. We have plenty of disease to manage in our own practice already.
For more insights on leveraging health IT for population health management, click here for the cover story in the February issue of Health Data Management magazine.
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