Almost every day I talk to a CIO or a CMIO who has been tasked with “doing” Population Health Management. More often than not, they complain that it’s almost impossible to know where to start or how to properly define the scope of the effort. The metaphor of the blind men and the elephant comes to mind. Each man encounters a different part of the elephant: the trunk, a leg, the side, and so on. And each draws a different conclusion about the nature of the elephant; the man with the trunk concludes that the elephant must be a snake-like creature — the man with the leg believes the elephant to be like a tree, and the side is like a wall.
Population Health Management is like the metaphorical elephant — your view of what pop health looks like depends largely on your perspective. If you are a Care Manager, it looks like set of tools to view a group of patients and communicate with them. If you are a database manager, it looks like an enterprise data warehouse with links to an HIE or other external data sources. The patient experience manager sees patient portals and in-home devices. And on it goes.
But the CIO and CMIO need to see the entire elephant. They must have a strategic vision of how the different elements of an effective pop health program fit together. And they need to work together to meld the technical and clinical expertise they represent. Neither of them can do it alone. Without a shared vision and a robust governance structure, pop health projects tend to live in different siloes; they focus on process instead of outcomes. Too often, they fail to achieve measurable ROI for a painfully simple reason: they don’t have a reliable way to measure the population’s baseline condition.
There is no shortage of pop health conceptual frameworks. Some are cyclic. Others are linear. One of my favorites combines a 12-step plan with a 5-year framework — sort of a combination of Alcoholics Anonymous and the Soviet Union’s economic plans. I can’t keep that many things in my head, so — at the risk of adding to the framework confusion — I’ve condensed some of my favorite frameworks into this somewhat simpler hub-and-spokes model:
In my world view, analysis sits at the center of any successful pop health program. For many aspects of a pop health, that analysis requires a robust analytics program. But every aspect relies on the ability to analyze data. For example, the first step in any program is a well-defined set of patient populations. If you don’t know which patients should be included and which patients should be excluded from your patient registry, it will be impossible to reliably measure their health outcomes. At the same time, provider attribution — the heavy lifting of reliably and accurately establishing the patient-provider relationship for every patient — is every bit as important as the registry assignments. And all of this is driven by analytics that can identify outliers and resolve conflicts. And all of that needs to happen before anyone tries to manage anything.
For my CIO and CMIO friends charged with “doing” pop health, developing a robust analytics tool set is job one. It’s the infrastructure upon which all other efforts are built. It’s not about providing countless reports — it’s about providing reliable data governance and flexible tools that can not only address the questions we know we need to answer today, but also the questions we haven’t yet thought of. The customers for these tools aren’t just pop health leaders and care coordinators (although they are obviously very important stakeholders). Data is key to engaging the docs and other clinicians as well as the patients.
The AMDIS Fall Symposium takes place in Phoenix this year November 3-5, immediately following the CHIME Forum. The planning committee has assembled an amazing group of speakers who will be addressing the unique needs of CIOs and CMIOs working in pop health. In particular, the agenda focuses on patient engagement strategies, analytics and a particularly critical and timely subject: how do you build an effective pop health team that is truly integrated? It’s going to be a great conference.
[Formerly the CIO and CMIO at Children’s Hospital and Medical Center in Omaha, Neb., George Reynolds, MD, is part of the faculty for the upcoming CHIME/AMDIS Fall Symposium, which will be held November 3-5 in Phoenix, Ariz. For more information on the program, click here.]