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Why providers need a consistent definition for population health management

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I attended the HIMSS 2017 conference in Orlando last month. The annual HIMSS conference is one of the largest healthcare IT (HIT) conferences and attracts vendors, consultants, providers, payers, educators, thought leaders, students and fans of healthcare from all around the world.

A recurring theme at most of the vendor booths this year (as in the last two-three years) was a focus on population health management (PHM). To separate the message from the marketing glitz and glamour, I decided to conduct an unscientific study to figure out what PHM really means to attendees and vendors.

I talked to several vendors (startups as well as established players) about how they define PHM and what they saw as the PHM needs of healthcare provider organizations. Also, I had a chance to listen to a few thought leaders who spoke on the size and weight of the elephant in the room. I even managed to chat with some students with dreams of making it big in this space. My goal was to get their thoughts on one simple question: “How do YOU define population health management?”

The way I see it, if the fundamental definition of PHM is not consistent, how do we address the actual use cases rooted in PHM?

What I found was what I feared: The industry is still struggling with a common definition of population health management.

I was amazed at the variety of answers I got, with many of the answers depending on the individual’s role in the healthcare industry.

Some people shared their personal definition of PHM. Some shared the most common industry definition (derived from thought leadership articles or Wikipedia). Some people went on and on about the regulatory environment that is dictating the adoption, or lack thereof, of value-based care. Some even managed to confuse me to a point that I forgot the reason why we were chatting in the first place.

Most of the HIT vendors chose to describe PHM based on what their products and services could deliver. The established giants of the industry define PHM as what can be accomplished if, and only if, their ecosystem had total control. They play the classic "spin" game to hide their inability to innovate quickly enough given their size, and in some cases, sheer hubris. They approach the problem with the mindset "We built it, they HAVE to buy it."

Conversely, there were innovative startups with dreams of disruption through innovation, whose survival depends on staying funded as a business. They define PHM through a lens that looks into the future, forgetting that adoption of innovation in healthcare has traditionally been riddled with frustration. They approach the problem with the mindset “We built it, they will buy it (we hope).”

Healthcare provider organizations have gone through a significant disruption in the way they practice and deliver care. They’ve had to face headwinds of change that challenged the existence of the business side of their profession. Naturally, they fear the unknown and are skeptical about new technology or new systems unless they see a clear connection to benefits for their organization.

Provider organizations define PHM by business use cases, as seen through the lens of their individual organizations. They focus on the requirements of value-based care contracts and the potential financial and market position opportunities and risks.

One thing was clear: they are not just looking for technology solutions. They are looking for assistance—help to decode the complexity, help to find an overall strategy for future healthcare delivery. They are tired of being bombarded with technology solutions that promise to answer ALL their needs. They want vendors to be honest with them. It's okay to not have all the answers, because the fact is, as an industry, we don't even know all the questions yet, much less all the answers.

I arrived at this conclusion: There is more confusion surrounding PHM than we as an industry would like to accept. If we can’t define the concept more cogently and concisely, we will have a difficult time offering a plan or solution to effectively manage population health.

In my opinion, it falls on our shoulders, the HIT vendors to challenge the status quo and be intellectually honest with healthcare provider organizations, to arrive at a consistent definition for population health management. We must help them design a strategic vision of a healthcare ecosystem that delivers quality care to all patient populations.

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