The following is a guest blog post by Marc Willard, President of Transcend Insights.
The health care industry’s transition from fee-for-service to value-based reimbursement models demands a dramatic shift in how medical information is used and shared. The ability to generate a single, comprehensive patient view from an individual’s acute care, ambulatory care and wellness data is vital to support this transition. Ten years ago, the technology to move data out of silos to create real-time, physician-friendly, patient-centered population health management (PHM) systems was simply not available.
Fast-forward to 2015, where recent technological breakthroughs are fueling a new era in PHM that promises to help patients achieve their best health while allowing health care systems to create population health platforms that reward value, improve outcomes and reduce costs. For PHM vendors to successfully navigate this profound shift in the health care industry and provide actionable insights on an individual’s complete health care and health status, they need to deliver three key technologies:
- Community-wide interoperability;
- Real-time health care analytics; and
- Intuitive care tools.
In developing a successful PHM system, one of the greatest challenges is working with disparate electronic health record systems that are not designed to communicate with each other, consequently keeping patient data entrenched in silos. Nothing is more frustrating for health care systems, physicians and care teams than dealing with multiple views and logins that impede the flow of information.
For PHM vendors to be successful, they must offer sophisticated health information exchange technology that integrates both clinical and claims data from diverse sources into a single, comprehensive patient view. Recent advances in cloud-based interoperability technology allow health care systems, physicians and care teams to literally get on the “same (electronic) page” with their patients’ complete health care history and real-time treatment strategies.
Interestingly, for health information exchange technology to successfully meet the needs of PHM, we must think beyond traditional electronic health record system interoperability. In addition to integrating data from health information generated outside the four walls of the hospital in ambulatory settings, successful PHM companies will be able to incorporate the valuable insights generated from the latest wearable health technologies that track activity levels, heart rate and other health information into a single, comprehensive patient view. This patient engagement is crucial in the new value-based reimbursement environment, with its focus on wellness and preventive medicine. PHM companies must know how to capture it and deliver meaningful insights to physicians and care teams without overwhelming them.
Several capabilities are required to ensure successful PHM, including bi-directional semantic interoperability, master patient indexing, both clinical and claims data capture and integration, real-time information sharing, results distribution and order processing, care and consent management tools, and of course privacy and security.
Another aspect that is crucial for interoperability is unobstructed access to patient information within traditional silos, so that data can truly be shared. Allowing data to flow requires open systems and interoperability standards that are clean, and widely and easily adopted.
Real-Time Health Care Analytics
A strong PHM tool combines community-wide interoperability with real-time …read more