Seven signs you need help with population health management
February 07, 2018
By August Calhoun
Attend almost any health care industry event, or read health care social media and news headlines, and you will see a lot of messaging around population health and value-based care.
The volume of information can be overwhelming, so how do you know if you’re on the right path to value-based care transformation, or if you should even be on the path? Here are seven signs that might indicate you could use some help with your value-based care or population health management strategy.
You don’t know where to start
As a world-class health care leader, you want to own the change from sick care to lifetime wellness, but where do you start? The evolution from quality of care to quality of life requires serious strategy and a deep dive into data to understand your population, your capabilities and your resources. What are the disease management/care management opportunities that most impact your organization?
Before you purchase software, before you start new community-based initiatives – look at your existing technology, workflow, care pathways and resource investments and determine what you need to optimize these to best care for your population.
Design a roadmap that plots how your organization will transition from a delivery model of volume-based care to one that allows for better risk contracting, reduced costs and healthier, happier patients and employees. Don’t be afraid to bring in outside consultants for advice.
You have an EHR to manage your population, and you think that is enough
You may want to consider population health or value-based diagnostic solutions that better leverage the data in your EHR and other connected health care information technology (HIT) solutions. They tend to be more longitudinal and are designed for care collaboration between providers and patients.
You might be missing key diagnostic data
According to a review published in the Journal of General Internal Medicine, “doctors in the U.S. are failing to follow up on results of up to 62 percent of laboratory tests and up to 35 percent of radiology tests.” As a result, they are missing critical diagnoses, including cancer, and causing delays in treatments for many conditions. Those are enormous care gaps.
Incidental findings, previously undiagnosed medical conditions discovered unintentionally during diagnostic testing or treatment for an unrelated medical condition, are a challenge for both laboratory diagnostics and diagnostic imaging. The challenge is even bigger for tests performed on patients in the emergency room. Incidental findings have a high prevalence in the emergency room setting. A 2011 study found that incidental findings were documented in 33.4 percent of 682 CT scans performed in the ED on discharged patients. Of these, only 9.8 percent were reported to patients, according to discharge paperwork. The impact on readmission rates and malpractice claims is certainly substantial.
You aren’t getting the ROI you expected
Your health system purchased population health management technology or has decided to use their electronic health record (EHR) solution for value-based care, yet you aren’t getting the return on investment (ROI) you intended. As a wise colleague of mine once said in a recent webinar, “Sometimes software alone is not the answer when it comes to value-based care transformation.”
Successful transformation may require change – change in workflow, change in clinical practice or change in workforce structure. It is extremely challenging to get stakeholders in health care provider organizations to change. Identify a trusted partner who knows your business and can help you leverage your existing and future investments for maximum impact.
You have a patient leakage problem
Are some of your patients seeking services outside of your health system, or being referred out of network by health care providers? Then you may have a leakage problem, which can impact your reimbursement and likely contribute to care gaps (when you don’t have access to complete patient data). One way to better manage and reduce leakage to outside competitors is by focusing on patient convenience from the perspective of the patient experience.
• Don’t just verbally suggest or give a paper order for a specialist, primary care physician or diagnostic test. Schedule the appointment for the patient or simplify their access by sending them a link to resources that they need (and happen to be within your health system). A referrals management solution takes the burden off the patient.
• Patient engagement can also help reduce leakage. Regular communication and proactive outreach keeps patients engaged and helps your patients see you as a valued resource for promoting wellness.
Your readmission rates are affecting your bottom line
Are readmission rates bringing your reimbursement down? The leading cause could be a lack of patient compliance and follow-up, or a gap in care due to incidental findings. Create a strategy to reduce readmission rates and emergency room “bouncebacks” due to noncompliance and care gaps. Patient compliance and follow-up may be the key. How do you maximize reimbursement and avoid costly penalties while demonstrating value to your community? A recommended practice includes implementing targeted, customized patient outreach campaigns aligned with quality and care initiatives that best support your population and individual patient compliance.
You don’t have enough staff or time to engage with every single patient
Your team takes the best care of your patients while they are in your health system or health care facility, but what happens once these patients leave? It makes sense to focus on your high-risk patients, but make sure you aren’t forgetting about those who may have rising risks to their health. Preventing and sustaining patient health and recovery “takes a village” – caregivers, patients and family members – but it can also require a lot of staff time and resources.
Consider an automated patient engagement solution with targeted campaigns to communicate with every single patient in your care community. The right patient engagement solutions should be able to:
• Uncover gaps in care, including missed appointments, screening tests, rising risk due to diagnostic results, etc.
• Communicate discharge plans and reminders to promote patient compliance and reduce readmission.
• Send links for scheduling follow-up appointments.
• Improve staff efficiency by automating, identifying and grouping patient contacts.
• Send information about potential diagnostic screenings to groups of patients that meet the criteria.
• Allow patients to add supportive family members to receive these communications and reminders.
• Allow patients to choose their desired means of communications – phone, text and/or email.
• Help optimize appropriate diagnostic test utilization, but also simplify the scheduling process for patients by identifying imaging locations with available appointment slots close to their home or office.
It is possible to communicate with every patient in your care community.
Population health management and value-based care transformation can be daunting, so don’t go it alone. Together, we can be victorious over disease before it takes hold. We can help you proactively engage with your population to create a community of wellness. Let’s lead the evolution from quality of care to quality of life, together.
About the author: August Calhoun, Ph.D., is senior vice president of North America Services at Siemens Healthineers. He is responsible for all Services business lines in the U.S., including Customer Services (preventive maintenance and repair for imaging and laboratory diagnostic equipment, and education and training), Enterprise Services (advisory services, multi-vendor management, asset management and other enterprise services offerings) and Digital Services (workflow, data and analytics software and services). Calhoun is based at the U.S. Services headquarters in Cary, N.C.
Before joining Siemens Healthineers in 2016, Calhoun was senior vice president and general manager of Provider Solutions at Truven Health Analytics, a cloud-based health care data and analytics firm in Ann Arbor, Mich. In this role, he oversaw global sales, marketing, services, consulting, operations and product management, providing products and services that leveraged data and analytics to guide business leaders and clinicians.
Prior to his tenure at Truven, Calhoun spent six years with Dell, Inc., most recently as vice president and general manager of the company’s Healthcare and Life Sciences Industry. He began his health care career at IBM and held leadership positions in IBM Global Services, Business Consulting Services and sales, eventually rising to the position of executive director of IBM’s Pharmaceutical Industry.
Attend almost any health care industry event, or read health care social media and news headlines, and you will see a lot of messaging around population health and value-based care.
The volume of information can be overwhelming, so how do you know if you’re on the right path to value-based care transformation, or if you should even be on the path? Here are seven signs that might indicate you could use some help with your value-based care or population health management strategy.
You don’t know where to start
As a world-class health care leader, you want to own the change from sick care to lifetime wellness, but where do you start? The evolution from quality of care to quality of life requires serious strategy and a deep dive into data to understand your population, your capabilities and your resources. What are the disease management/care management opportunities that most impact your organization?
Before you purchase software, before you start new community-based initiatives – look at your existing technology, workflow, care pathways and resource investments and determine what you need to optimize these to best care for your population.
Design a roadmap that plots how your organization will transition from a delivery model of volume-based care to one that allows for better risk contracting, reduced costs and healthier, happier patients and employees. Don’t be afraid to bring in outside consultants for advice.
You have an EHR to manage your population, and you think that is enough
You may want to consider population health or value-based diagnostic solutions that better leverage the data in your EHR and other connected health care information technology (HIT) solutions. They tend to be more longitudinal and are designed for care collaboration between providers and patients.
You might be missing key diagnostic data
According to a review published in the Journal of General Internal Medicine, “doctors in the U.S. are failing to follow up on results of up to 62 percent of laboratory tests and up to 35 percent of radiology tests.” As a result, they are missing critical diagnoses, including cancer, and causing delays in treatments for many conditions. Those are enormous care gaps.
Incidental findings, previously undiagnosed medical conditions discovered unintentionally during diagnostic testing or treatment for an unrelated medical condition, are a challenge for both laboratory diagnostics and diagnostic imaging. The challenge is even bigger for tests performed on patients in the emergency room. Incidental findings have a high prevalence in the emergency room setting. A 2011 study found that incidental findings were documented in 33.4 percent of 682 CT scans performed in the ED on discharged patients. Of these, only 9.8 percent were reported to patients, according to discharge paperwork. The impact on readmission rates and malpractice claims is certainly substantial.
You aren’t getting the ROI you expected
Your health system purchased population health management technology or has decided to use their electronic health record (EHR) solution for value-based care, yet you aren’t getting the return on investment (ROI) you intended. As a wise colleague of mine once said in a recent webinar, “Sometimes software alone is not the answer when it comes to value-based care transformation.”
Successful transformation may require change – change in workflow, change in clinical practice or change in workforce structure. It is extremely challenging to get stakeholders in health care provider organizations to change. Identify a trusted partner who knows your business and can help you leverage your existing and future investments for maximum impact.
You have a patient leakage problem
Are some of your patients seeking services outside of your health system, or being referred out of network by health care providers? Then you may have a leakage problem, which can impact your reimbursement and likely contribute to care gaps (when you don’t have access to complete patient data). One way to better manage and reduce leakage to outside competitors is by focusing on patient convenience from the perspective of the patient experience.
• Don’t just verbally suggest or give a paper order for a specialist, primary care physician or diagnostic test. Schedule the appointment for the patient or simplify their access by sending them a link to resources that they need (and happen to be within your health system). A referrals management solution takes the burden off the patient.
• Patient engagement can also help reduce leakage. Regular communication and proactive outreach keeps patients engaged and helps your patients see you as a valued resource for promoting wellness.
Your readmission rates are affecting your bottom line
Are readmission rates bringing your reimbursement down? The leading cause could be a lack of patient compliance and follow-up, or a gap in care due to incidental findings. Create a strategy to reduce readmission rates and emergency room “bouncebacks” due to noncompliance and care gaps. Patient compliance and follow-up may be the key. How do you maximize reimbursement and avoid costly penalties while demonstrating value to your community? A recommended practice includes implementing targeted, customized patient outreach campaigns aligned with quality and care initiatives that best support your population and individual patient compliance.
You don’t have enough staff or time to engage with every single patient
Your team takes the best care of your patients while they are in your health system or health care facility, but what happens once these patients leave? It makes sense to focus on your high-risk patients, but make sure you aren’t forgetting about those who may have rising risks to their health. Preventing and sustaining patient health and recovery “takes a village” – caregivers, patients and family members – but it can also require a lot of staff time and resources.
Consider an automated patient engagement solution with targeted campaigns to communicate with every single patient in your care community. The right patient engagement solutions should be able to:
• Uncover gaps in care, including missed appointments, screening tests, rising risk due to diagnostic results, etc.
• Communicate discharge plans and reminders to promote patient compliance and reduce readmission.
• Send links for scheduling follow-up appointments.
• Improve staff efficiency by automating, identifying and grouping patient contacts.
• Send information about potential diagnostic screenings to groups of patients that meet the criteria.
• Allow patients to add supportive family members to receive these communications and reminders.
• Allow patients to choose their desired means of communications – phone, text and/or email.
• Help optimize appropriate diagnostic test utilization, but also simplify the scheduling process for patients by identifying imaging locations with available appointment slots close to their home or office.
It is possible to communicate with every patient in your care community.
Population health management and value-based care transformation can be daunting, so don’t go it alone. Together, we can be victorious over disease before it takes hold. We can help you proactively engage with your population to create a community of wellness. Let’s lead the evolution from quality of care to quality of life, together.
About the author: August Calhoun, Ph.D., is senior vice president of North America Services at Siemens Healthineers. He is responsible for all Services business lines in the U.S., including Customer Services (preventive maintenance and repair for imaging and laboratory diagnostic equipment, and education and training), Enterprise Services (advisory services, multi-vendor management, asset management and other enterprise services offerings) and Digital Services (workflow, data and analytics software and services). Calhoun is based at the U.S. Services headquarters in Cary, N.C.
August Calhoun
Before joining Siemens Healthineers in 2016, Calhoun was senior vice president and general manager of Provider Solutions at Truven Health Analytics, a cloud-based health care data and analytics firm in Ann Arbor, Mich. In this role, he oversaw global sales, marketing, services, consulting, operations and product management, providing products and services that leveraged data and analytics to guide business leaders and clinicians.
Prior to his tenure at Truven, Calhoun spent six years with Dell, Inc., most recently as vice president and general manager of the company’s Healthcare and Life Sciences Industry. He began his health care career at IBM and held leadership positions in IBM Global Services, Business Consulting Services and sales, eventually rising to the position of executive director of IBM’s Pharmaceutical Industry.