Take population health management beyond the EHR in 2018

By Pranam Ben

As 2017 ends, it is time for all of us to reflect on our accomplishments and set goals for the coming year. To aid in that process, I would urge you to consider one idea for your organization in the next 12 months: Get rid of your electronic health record (EHR) system.

I'm kidding, of course, but only a little! An EHR contains a wealth of clinical data, but it serves only as the foundation of what an accountable care organization (ACO) or other clinically integrated network (CIN) needs to become a high-performance organization. Analytics and reporting are also important, but again, just part of the picture. If improving population health management (PHM) is a goal next year, it is time to reconsider what role the EHR should play and if other, more effective, tools would help you reach your clinical and financial objectives faster. So, instead of optimizing just your EHR system for PHM in 2018, reposition your EHR as an essential ingredient that supports a more efficient, actionable and effective PHM strategy.
Here's how:

1. Put quality at the center
The EHR has care quality data that healthcare organizations need to improve their PHM performance. That data, however, is often incomplete, difficult to access and interpret, and not necessarily relevant to the organization's goals. With an advanced PHM platform, care quality data targeted to an organization's designated risk population is aggregated from throughout the enterprise and immediately presented so care managers and physician leaders can gauge performance in seconds and take action.

2. Visualize your real costs
Data not located in the EHR, but crucial to an ACO or CIN's performance, is cost information. Maximizing reimbursement under value-based care models means care managers and other clinicians need to know which patients are utilizing the emergency department and urgent care clinics instead of lower-cost, affiliated practices. Internally, organizations need to see which physicians are contributing the most to costs. Knowing this information sooner enables organizations to begin modifying the patient and physician behaviors to result in more cost-effective care and positive outcomes.

3. Engage the patient on their terms
To change patient behaviors, ACOs and CINs must communicate more often and more effectively. Printed patient-education materials distributed during an office visit is not going to generate a large change that results in higher-quality outcomes. Patients want to communicate with providers the same way they communicate with friends and family: online. Organizations need to add telehealth, online and mobile messaging to their patient engagement strategy. Help the high-risk and near-risk patients overcome the daily care plan obstacles they face, and reap the rewards when they start to change their behaviors to directly improve their outcomes.

At a high-level, these three elements are what healthcare organizations need to focus on in the next year to improve their PHM performance, not just their EHR system. Above all, these tools need to be integrated with the EHR and accessible through a single platform. Logging-in to multiple systems and pulling disparate data from disconnected systems is not going to give organizations the accurate, reliable and actionable insight they need to become a high-performance organization.

It's 2018: it's time to unleash PHM from the EHR.

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