Provider organizations expecting to increase their exposure to population health contracts should designate a chief medical information officer to lead the initiatives, a leading consulting firm is suggesting.

Population health requires organizations to track data for outcomes, says Pete Rivera, director of informatics at Hayes Management Consulting and a former IT provider leader. Chief nursing officers, for example, track clinical data, and chief information officers track the data warehouse, among other duties.

Pete Rivera
Pete Rivera

The CMIO can use that data to provide the big picture to the C-Suite and individual physicians, giving them metrics, financial data, claims data and data from disparate electronic health record systems to define what population health management means and the resources needed from leadership to achieve optimal patient outcomes, Rivera contends.

When adopting population health management, an organization should start by tackling just one chronic disease, build on that and then move to others, Rivera counsels. For example, data can be analyzed to identify which diabetic patients are managing their AIC levels well and which are not because of challenges, such as difficulty paying for medications. Finding all the barriers to care that chronically ill patients face can be an important job for CMIOs, whether they have that title or another one, such as physician champion.

Some provider organizations find their efforts diffused; they buy population health management technology, tells the vendor to install it, plug in the data warehouse and try to measure everything at once.

The CMIO also may create a governance structure with stakeholder representation that includes expertise in patient-centered medical homes, plugging into registries and collecting and using quality measures that the organization already has on hand, because of EHR meaningful use reporting requirements.

With the right data in place, a CMIO then can begin to analyze practice variations among physicians within the organization that can affect patient outcomes, according to Rivera. The focus, Rivera contends, should be on outcomes, using data to change the behavior of physicians by showing how their patient outcomes compare with those of peers.

Too often, however, there isn’t a cohesive reporting strategy and governance structure to report consistently. Organizations need to define a “system of truth,” with a defined methodology for assessing physician performance.

A CMIO may find that outcomes for a particular physician lag compared with peers, with the physician saying that‘s not true because an analyst is giving him data on his patients. But the analyst needs to also give validated data across other physicians’ patients so comparisons can be made, and the CMIO can show the physician where he matches peers on outcomes and where he lags. The CMIO also should work with the CNO, CIO and CFO to structure incentive payments to physicians who are meeting their benchmarks for outcomes, Rivera says.

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