Below the Waterline: Is Your Network Population-Health Ready?
By Nancy Ham
Historically, health information exchange (HIE) implied the tactical, the plumbing and pipes that enable movement of health-related information among organizations according to national standards. Today an HIE network is a strategic asset vital to population health management.
Health organizations must supply more than bricks and mortar as our industry moves from what was once a conceptual model of healthcare to reality. They must provide a network solution for powering appropriate population health management capabilities.
HIE capabilities are evolving. Existing competencies are being coupled with workflow and care management processes, essential for analyzing and managing populations of patients − a shift from the traditional retrospective version of care to real-time, preventive care. Today’s care management needs to be informed and powered by high-quality, real-time discrete data from myriad sources across the continuum of care.
To affect population health, the entire healthcare ecosystem from acute to ambulatory to long-term and beyond needs to be connected, moving beyond the traditional reach and capabilities that current health information exchanges offer.
We’re all familiar with the phrase “the tip of the iceberg.” The tip of the iceberg is visible. It glints and shines. This iceberg principle applies nicely to many population health management solutions with flashy dashboards and snazzy visualization methods. They look really good on the surface, but what is imperative is what lies beneath the waterline. Is the foundation − the data asset from which the analysis is conducted − a solid one?
Before adding population health visualizations, ensure that your foundation is complete. Ask yourself:
- Are your patient records correctly and accurately matched?
- Do you have a sophisticated privacy and security infrastructure?
- Do you have pointers established to access clinical data regardless of where it exists?
- Can you manage granular patient consent?
- Do you have a sophisticated mechanism for driving role-based access, including new network participants such as payers?
- Is your solution able to scale to bring more and more participants into your network?
- Does your system represent the entire healthcare community across care settings?
- Are your referrals managed and communicated among providers?
- Do you have alerts to notify providers when a patient experiences a health event so they can make informed and timely decisions for that patient’s care?
- Are your EHR interfaces bi-directional?
- Do you have patient engagement tools such as patient portals and personal health information?
- Can you aggregate claims and billing data in conjunction with clinical data?
- Are you using data standardization methods to furnish mineable data?
- Can you share patient care plans?
Your HIE should do all of this. Your HIE partner should have a track record of linking hospitals with the entire community of providers.
When you have a sophisticated HIE network to enable clinicians to manage their patient population, you have a scalable foundation for improving the quality and cost of care. The foundation is key. From there you can snap on population health analytics solutions, whether from your HIE vendor or from one or more third-party vendors. Now you have evolved your HIE to a strategic network, curating the data flowing through the network to provide contextual, real-time information that engages both clinicians and patients.
Nancy Ham is CEO of Medicity of Salt Lake City, UT.