What Defines Success in Population Health?

Population health management (PHM). How can three simple words be defined so differently and drive such complexity in healthcare? This was one of many striking thoughts I had as I participated in KLAS’ recent Population Health Cornerstone Summit here in Utah. All you have to do is thumb through KLAS’ multipage framework to see that PHM is a complex, multifaceted strategy and process—and few people look at it in quite the same way.

My personal take on population health was expanded and enhanced by the meaningful discussions and insights shared from PHM provider and vendor experts from across the country who gathered at the summit.

Here is one insight that stood out. A provider executive shared an interesting viewpoint on population health. She said that the majority (not all) of population health strategies and processes could be distilled into two primary buckets: the clinical bucket and the data bucket. The clinical bucket entails understanding the clinical workflows, which oftentimes is the most difficult issue to solve, and having the PHM data sets and tools built into these workflows appropriately with the end goal of being adopted and utilized by caregivers. In the data bucket, providers have to be able to analyze and aggregate the data coming from many disparate data sources.

This executive then pointed out that the challenge today is that most vendors only execute on one of these buckets well; very few vendors facilitate both adequately. If providers are going to be successful, they need vendors and partners who are excellent and deliver in both areas, not just one.

Another barrier to population health goes beyond “what” and into “how.” Success in PHM isn’t just a matter of whether you can do it or whether the tools are there. It is more a matter of how well the tools actually work and how well the solution enables you to be a better caregiver in the community. Right now, healthcare is too focused on the former.

Why should we focus on how population health happens and its actual effects? Because at the end of the day, the results are most important. This was another topic that was heavily discussed in one of the summit’s many breakout sessions.

Another theme we kept coming back to during the summit is the importance of relationships. The answer to the problems of population health often seem to be better communication, mutual understanding, and partnerships between vendors and providers. Many of the issues that cost the healthcare industry millions of dollars to figure out come down to these simple, yet profound and incredibly complex, answers.

Lastly, there is one entity that isn’t being brought into these population health discussions enough: the payer. Without the payer, what are we agreeing to do? And how will incentives and reimbursements align with population health activities without the voice of payers? Providers and vendors in the population health management space need to recognize that the payers are just as important in these discussions, agreements, and partnerships as they are.

I look forward to future discussions with the attendees at our summit, who are clearly passionate about tackling this complex, yet vital, area of the future of healthcare.