Drew Nietert, CPHIMS, PCMH CEC, CHPSE, JHD Group
If you know your “ABCs” of healthcare, you’ve undoubtedly heard the term “PHM.” You may know that it stands for population health management. But you may also be like many out there, struggling to understand what this term, and this notion, really means.
The confusion is understandable. Terms such as population health management (PHM) and accountable care organization (ACO) are often interchanged. In practice, PHM is not accountable care, but without PHM, accountable care is unlikely to be successful. The term is also widely defined: PHM has come to be defined mostly by vendors selling PHM solutions, and has adopted a variety of meanings depending on the various systems’ capabilities.
The definition of “population health,” as noted by Kindig and Stoddart in an article they co-authored in 2003, is “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” Population health management is how that gets done or, in other words, the methodology and tools for managing the health outcomes of a defined group of people and ensuring the effective distribution of those outcomes across the group. Key steps in PHM methodologies include, but are not limited to:
- sharing data
- aligning and partnering with all aspects of the care continuum
- changing the mindset and work at the point of care
- incorporating other modalities of care
- understanding which patients are costing the system the most
- proactively reaching out to patients with specific health indicator
- creating solutions for patient engagement
- and others
The tools are the data analytics, the EHRs, the engagement DME and patient portals. PHM must affect the entire continuum of care and be tied into it — otherwise, even small gaps in patient health management will cause great cavernous pit holes of quality and cost.
As you can see, the method is complex and requires a lot of change. In addition excellent and integrated tool sets are needed to drive almost all of the changes. So how does a healthcare entity create a strategy for success that employs and fully utilizes the best of PHM?
First, a group should define its goals around ACOs and PHM. For example, does the group want to become an ACO, become part of an ACO, or simply try its hand at managing a portion of its patient population? Second, based on those goals, a group will need to determine what tools it needs to manage its population. Needless to say, there are dozens available — and choosing the right solution can be time-intensive and mind-boggling.
The JHD Group has developed a comprehensive RFP that helps identify more than 400 software features, as well as how the software and implementation is designed to work with patient engagement, point of care changes, cross continuum workflows, etc. If you are just starting on this journey or are stuck in the middle of it, call the JHD Group and we will help guide you through a strategy, selection and implementation as needed. Simply put, we know the ABCs to PHM success, and we’re happy to spell that for you.
Give JHD Group a call today or send me an email to learn more about this new RFP tool.