If health care providers and payers want to improve population health management, they need disease registry tools, says David Howes, M.D., president and CEO at Martin’s Point Health Care in Portland, Maine.

The organization operates nine family practices and two health plans, and registries help it understand the health status of patients and gaps in care. Martin’s Point uses the PopulationManager registry of Forward Health Group Inc. in Madison, Wis., to focus on chronic patients with diabetes, vascular disease, or chronic obstructive lung diseases.

During an educational session at the MGMA 2013 Annual Conference, Oct. 6-9 in San Diego, Dr. Howes will tell colleagues that they will be shocked at the number of gaps in care that they find. “You almost don’t realize how many there can be.”

For gaps in care to be tackled, many patients will need social work in addition to medical treatment as chronically ill individuals often have social and financial struggles, Howes notes. “We’re appreciating that moving people from where they are to where they need to be is much harder than we thought it would be.”

Asked about the lasting impression he wants to leave, Howes says, “Our nation’s delivery system, despite the investments we’re making in it, is really underserving the chronically ill. A registry is a ticket to doing that work, it is the start.”

Education session C 11, “Use of Registry Tools to Improve Care,” is scheduled at 2:00 on October 7.

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