Shared by Dr. Jerry Osband, Former Chief Medical Officer for EXL and Member of the Impresiv Health Executive Advisory Board
As described in previous articles, Population Health Management (PHM) is a key driver of reducing clinical and financial risk while improving health outcomes for healthcare organizations. We’ve already described the key components of PHM and approaches to maximize time to value within those capabilities. This review focuses on future improvements in data management and technology to give insight into remaining effective and competitive in PHM programs.
Technology trends
Artificial Intelligence
Artificial intelligence and machine learning are at the forefront of improving risk identification and stratification of individuals and populations for inclusion in PHM programs. By incorporating AI tools, operations leaders can better direct resources to apply and manage clinical interventions at the most effective level of engagement and impact.
Enhancing AI integration can improve automation tools that expedite enrollment and engagement of participants through more reliable communication programs. Automation also reduces the direct costs of file setup and management, facilitates portal engagement, and enhances reporting for real-time performance and productivity improvements.
Interoperability
The future of PHM performance and productivity improvements lies in the ability to share disparate data across systems and platforms without siloed interference in organizational territorial disputes. This is inclusive of integrating behavioral health information for use as a key factor in addressing impactability of interventional PHM programs.
Organizations should have project plans focused on the new interoperability standards, including assessing, selecting, implementing, and managing software to allow full PHM capabilities around data management, identification, stratification, engagement, and reporting.
Communications
Advancing key stakeholder communications capabilities is a significant trend. Expectations are evolving for enhancing not only the collection of patient and provider portal capabilities, but also adding functionality to create real-time stratification and assessments, appointment scheduling, email communications, and access to records.
In addition, care managers are looking to use newer software functions to integrate data from digital devices and add advanced communication tools for care coordination. Care managers will also need to address the use of evolving telemedicine and virtual care technologies to provide more cost-effective care plan updates, improve access to health resources in outlying areas, and for those with disabilities and/or transportation issues.
PHM participants and their families will also expect greater transparency in the ability to review care plans, PHI, and medical record information. PHM will adopt a collaborative approach, enhancing care coordination as data sharing improves and outcomes become more personalized.
Data management
Social Determinants of Health (SDOH)
The integration of data sets from claims, pharmacy, laboratory, medical records, etc., is well understood as a current requirement for PHM identification and stratification purposes. The advancing trend is now focused on integrating SDOH data.
Regardless of whether there is federal funding for SDOH initiatives, it will still be necessary to support electronic health record data by integrating information that provides insight into addressing barriers to improving health status. This future trend requires that platforms include Health Information Exchanges (HIEs) incorporating SDOH data charters.
In addition, new data inputs will be required to support and address the SDOH information collected, including community resource integration.
Value Based Modeling
Data aggregation and acquisition will trend towards supporting value-based care models to support reimbursements focused on health status improvement and improved health outcomes.
PHM data will need to shift towards gathering and identifying improvements in prevention, wellness, and the associated impact on utilization patterns. To gain greater provider participation in PHM programs, the data captured needs to produce full transparency for providers as to the financial and clinical outcomes that are part of the reimbursement process.
The transition from fee-for-service to value-based products will be part of any future PHM strategy.
Your Next Steps
PHM is trending toward greater dependencies on data management and technology solutions. Impresiv Health can provide your organization with consultative insights into meeting the challenges of incorporating these PHM trends into your current programs.
To learn more, click here to schedule a call with our SVP of Healthcare Partnerships.
