By Egor Kobelev, Vice President of Healthcare & Life Sciences and Daniel Piekarz, Vice President of Business Development, Healthcare & Life Sciences, DataArt The concept of population health was first introduced in 2003, when David Kindig and Greg Stoddart defined it as “the health outcome of a group of individuals, including the distribution of such outcomes […]
The Pop Health Forum, a conference put on by the Healthcare Information and Management Systems Society (HIMSS) in Chicago this week, was as much about patient engagement as it was about population health.
This makes sense, because it’s difficult to manage populations without reaching out — engaging — members of those populations.
Jeffrey Springer, a vice president at Princeton, New Jersey-based health IT vendor and consulting firm CitiusTech, said that getting to population health means checking all nine squares on a 3-by-3 matrix. The X axis covers acute, ambulatory and whole-patient care, while the Y axis is about execution on clinical, financial and operational metrics.
Patient engagement falls under all three care rows and at least two of the execution columns. Yes, financial performance has elements of patient engagement.
At University of Chicago Medicine, about nine miles south of the downtown conference site, the annual operating plan for fiscal year 2017 has patient experience as one of the five pillars of the plan, along with people, quality/safety, finance and long-term strategic positioning. Debra Albert, chief nursing officer and vice president of patient care services at U. of C. showed this slide during her presentation:
(Click here for a larger version.)
“We’re really trying to drive a consistent patient experience across all of our platforms [of care],” Albert said.
In fact, patient experience is part of what Albert called the “value-based core” of the academic health system’s goals for 2017. In her view, value equals quality — including the patient experience, proper resource utilization and clinical outcomes — divided by cost.
University of Chicago Medicine hasn’t reached true value-based care delivery yet. However, the goal is so important to the organization that the chief medical officer is in charge of implementing the core of enhancing collaboration, promoting telemedicine and selling faculty members on the concept of value-based healthcare, Albert explained.
Indeed, clinicians are empowered as much as the health system aspires to empower patients.
About three years ago, U. of C. instituted what Chief Experience and Innovation Officer Sue Murphy called “leader rounding.” At the time, rounding on inpatient wards and in the emergency department was paper-based. “We had no way of knowing what was going on,” Murphy said.
The organization standardized inpatient and ED nurse rounding on iPads, consulting unit leaders and rank-and-file staff on redesigning rounding processes. U. of C. created a system of alerts and accountability, analyzing rounding trends and rewarding nurses for good work.
Initially, Murphy and other executives didn’t realize that every nurse leader had a different comfort level with the iPads and with technology in general. Patients also had varying reactions to the presence of a tablet with each nurse who stopped in the room. “We came up with some keywords to say to patients,” Murphy said, to help reassure those who saw the iPad as an intrusion on the patient-clinician relationship.
Individual nursing leaders also have been given autonomy to make process improvements within their departments and wards. “We strongly believe that the leader of a unit is kind of the mayor of that unit,” Murphy said.
According to Press Ganey surveys of University of Chicago Medicine, 81.9 percent of inpatients in August 2015 reported that a nurse manager checked in on them daily. That number rose to 93.8 percent in July 2016.
Overall hospital ratings, as reported to the Centers for Medicare and Medicaid Services, jumped from about 60 percent in 2011 to nearly 75 percent in the reporting period that ended in the second quarter of 2016. There was a sharp increase in 2013, the year the health system started rethinking nurse rounding.
“Those many patients were touched,” Murphy said, gesturing to data on a PowerPoint slide. “They were touched by a kind word, by technology, by a caring nurse.”
The next big step in population health is greatly expanding what defines a population. And that process will require a new generation of technologies, according to Adrian Zai of Massachusetts General.
In response to Cerner missing projected revenues, financial analysts said the market for other technologies is heating up and can increase deal sizes.
By now, everyone's got an EMR. And most providers are also making use of ancillary technologies to help harness patient data toward more efficient care and better outcomes. But many species of health IT are still surprisingly underused in the U.S. hospital market.
I'm excited to share that HIMSS Media has acquired MobiHealthNews.
The entire MobiHealthNews editorial team – Jonah Comstock, Aditi Pai, and I – are joining HIMSS Media. Apart from more content from me – this deal has kept me busy in recent months – the MobiHealthNews you know (and hopefully love) won't change.
Ever since consumerism hit healthcare, the oft quoted objective is to give consumers the same kind of personalized experiences they have in other consumer-focused industries. Retail and financial services companies have gotten so good at this that they regularly provide personalized recommendations and interactions that are just short of eerie.
The U.S. Supreme Court on Thursday voted 6-3 against the plaintiffs in the case of King v. Burwell. The ruling means more than 6 million residents in the 34 states with federal insurance exchanges can keep their tax subsidies for health coverage.
Read more at Healthcare Finance, and also check back later today for more on this story.
As anyone who either attended HIMSS15 or followed the ensuing conversation can attest, population health is currently all the rage. While reporting from the show floor, in fact, it seemed just about every vendor, from all walks of life, was trumpeting "population health" in one form or another.
What has become eminently clear is that defining population health depends on whom you ask.