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Population health management (PHM) gives providers the ability to make informed care decisions based on their entire patient population at-a-glance and in near real-time. Learn about how PHM is disrupting healthcare and how it benefits both patients and providers.
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What is Population Health Management?
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Healthcare is more than medicine, it’s a goal — we want the best possible health
for ourselves and those around us.
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“Today the average doctor in the U.S. manages more than 2,000 patients whose
health information is locked in a paper record.”
*http://www.annfammed.org/content/10/5/396.full
- Ryan Howard, founder and CEO, Practice Fusion
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It’s estimated that a doctor with 2,000 patients would have to spend more than 17 hours a day providing all of the recommended care.
*http://www.annfammed.org/content/10/5/396.full
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With so many patients and only so many hours in the day, it can become an
overwhelming task to try and keep track of things like ‘who is up-to-date on their
vacancies’ or the latest clinical recommendations.
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Typically, there’s no way to look across the patient population to see which diabetics are at goal, or who is due for a vaccine.
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Over 45% of diabetics are not at goal.
Every year, over 40,000 people die from vaccine-preventable diseases.
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Population health management is making it more efficient to identify and help these patients.
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What is Population Health Management
YesterdayCare coordinators combing over thousands of charts and calling patients to provide support or schedule HCP visits
What is Population Health Management?
Information Week, Healthcare Edition. 11/2013.
Population Health Management is a systematic approach to optimizing the health of populations and preventing people from getting sick or sicker
“”
Today Leverage Health IT and point-of-care messaging to empower providers with actionable information to improve patients’ health
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Population health management uses data and technology to drive better health
outcomes for patients by giving providers the ability to monitor their entire patient population at-a-glance and in real-time.
Core Components of Population Health Management
Population health management dashboard
DeliverCDS
+ Patients are identified by demographics and chart values (i.e. labs, diagnosis) and applicable clinical quality measures which are evidence-based, clinical guidelines
Step 1: Identify the Appropriate Patients
Sample Diabetes Quality Measures
NQF# Measure Description
0059Diabetes: Hemoglobin A1c Poor Control
Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period
0055 Diabetes: Eye ExamPercentage of patients 18 through 75 years of age with a diagnosis of diabetes (type 1 and type 2) who had a retinal or dilated eye exam in the measurement period or a negative retinal or dilated eye exam (negative for retinopathy) in the year prior to the measurement period
0056 Diabetes: Foot ExamPercentage of patients aged 18-75 years of age with diabetes who had a foot exam during the measurement period
+ Provide Clinical Decision Support, which is an actionable message to the provider during the office visit
Step 2: Provide Clinical Decision Support at Point-of-Care
Not an actual patient
+ Compares provider to peers
+ Provides guidance on performance
+ Engage patients through clinical email outreach pre and post visit
Step 3: Measure Outcomes of the Patient Population
PHM detail dashboard | Diabetes
You
Practice Fusion providers
You
Practice Fusion providers
You
Practice Fusion providers
% of diabetic patients who have had an eye exam
% of diabetic patients with certain other disease complications and A1c ≥ 8%
% of diabetic patients withA1c ≥ 7.0%
Measurement period
You
Practice Fusion providers
You
Practice Fusion providers
You
Practice Fusion providers
% of diabetic patients withA1c ≥ 9.0%
% of diabetic patients with A1c tested in the last 6 months
% of diabetic patients who have had a food exam
Diabetic patients confirmed by ICD9 with and A1c test in the last 6 months (245/602)
Click here to engage your patients via email
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With population health management, patients get the care they need when they
need it, providers see better outcomes, and by reducing preventable critical care,
population health management lowers costs and save lives.
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Resources
+ For more information about Practice Fusion’s population health management offering, please visit: http://www.practicefusion.com/pharma/
+ For a quick, video overview of population health management: https://www.youtube.com/watch?v=C0w68xbDwEs
+ Set up a completely free, web-based EHR from Practice Fusion in less than 5 minutes: https://www.practicefusion.com/signup/