NHIT week: the impact of population health on the HIT space
As we approach National Health IT Week, I spoke with Healthcare Informatics Editor-in-Chief Mark Hagland about a major trend impacting the healthcare IT space: population health management. Mark also provides insight into other HIT trends his readers will be tracking in the coming year.
1) Population health management is clearly a major focus in healthcare right now. How do you see technology influencing this critical approach?
The intelligent, thoughtful, strategic deployment of information technology solutions will be absolutely essential to success with population health management for healthcare providers of all types. The challenge here is that there is no single “off-the-shelf” set of commercial vendor solutions that can handle all of the IT needs around population health. Right now, success in leveraging IT for population health management will require very skillful, strategic approaches on the part of healthcare IT leaders.
2) With the traditional role of clinicians focused on individualized care of one patient at a time, altering the approach with population health requires a paradigm shift. What impacts and challenges do you foresee accompanying adoption of the model?
It is absolutely correct to say that virtually all physicians now practicing were trained to think primarily (and for many, nearly exclusively) of patient care in the context of the individual physician-patient encounter, with that encounter driven by immediate patient care needs. While physicians in practice will always need to remain skilled at core patient care visits and/or hospital care of patients, they are now increasingly being asked to think at the same time of longitudinal care (thinking about how to manage the care of individual patients over extended periods of time) and of the care of broad patient panels and populations. Population health management, disease management, patient-centered medical homes, and accountable care organizations all speak to new approaches. The core challenge will be providing physicians with the coaching, the IT tools (especially including analytics), and above all, the reconstituted physician culture, to support physicians in these new endeavors.
3) The newly created Registered Nurse Ambulatory Care Coordinator Association (RNACCa), which aims to support and strengthen evidence-based practice among nurse care coordinators and other population health management professionals, is the first national organization of its kind. Do you see a growing trend of groups like RNACCa and are they essential to support the shift to population health?
I believe that inevitably, new groups will emerge such as the RNACCa that will help to nurture and expand evidence-based practice among all types of clinicians and care coordinators. Shifting towards evidence-based types of clinical practice is highly challenging and requires intense collaboration among all stakeholders charged with caring for patients and managing care in evidence-based models. It cannot be accomplished without a tremendous amount of cooperation and coordination.
4) In addition to population health, what are other key trends that HCI is looking to showcase/cover in the coming year? How do you see these trends shaping your editorial focus and goals?
If there were a single term that might encompass everything that HCI will be covering in the next several months, it would be “healthcare reform,” defined very broadly. That term encompasses not only a variety of mandatory and voluntary programs under the Affordable Care Act (mandatory programs including value-based purchasing and avoidable readmissions reduction, and voluntary programs including the Medicare Shared Savings Programs for accountable care organization development, and bundled-payment contracting), but also every kind of private-market initiative around population health, patient-centered medical homes, accountable care organization development, etc., as well as the entirety of the meaningful use process under the HITECH Act, the transition to the ICD-10 coding system, and mandates such as the enhanced HIPAA “final rule” patient privacy requirements, and compliance with Medicare “RAC” audits, etc. Fundamentally, the public and private purchasers and payers of healthcare are demanding that hospitals, physicians, and health systems shift away from a volume-based fee-for-service reimbursement system to a broadly modified payment system that takes quality outcomes and numerous other factors into account.