By Tara Tesch, MHSA, Senior Manager, GE Healthcare Camden Group
This is the third of three articles in the Population Health Alliances series. The first article examined physician engagement strategies and detailed specific strategies that have proven successful for alliances. The second article focused on the value of true care redesign.
High-performing organizations possess robust information technology ("IT") infrastructure and associated tools to deliver, track, and document patient-centered, evidence-based care at the point of service and can disseminate actionable and meaningful data quickly and transparently. IT infrastructure implementation is an iterative process and rarely do organizations have a “fully baked” IT solution at the onset of implementation.
There is no single vendor that can provide a comprehensive data analytics solution to meet all needs (see graphic below) at this time.
Future State CI Network Platform
© The Camden Group 2015
In order to truly impact how care is delivered, end users must have actionable information in real time to support care redesign efforts. Providing patient-relevant decision support at the point of care can improve provider effectiveness in delivering appropriate and necessary interventions, furthering the organization’s goals of improving individual and population health. Too many organizations stall in developing their IT infrastructure by letting “great get in the way of good.” IT should support the care not drive it, therefore, systems and tools must translate and support care redesign. Too much data that is not well organized or analyzed can simply create confusion and cloud the necessary focus required to impact population health.
It is critical for population health alliances to have a well thought-out IT strategy and data management plan that will provide connectivity between members. The strategy should call for a means to collect the data, offer a robust tool to aggregate the data, and support reporting that will translate information into behavioral change and allow providers to more effectively communicate with and engage patients. The key factor for success: build your strategy beginning with the end in mind.
Data Governance Strategy Build
© The Camden Group 2015
Success begins with the development of an information management and data governance strategy, which includes a data governance structure (who is going to own it, clean it, analyze it), organizational structure (what resources and types are required), and core data needs (reportable, transactional). An objective of the strategy is to take data and create meaningful information that leads to action-oriented knowledge. Out of the strategy, capabilities will be identified that drive interoperability and analytics requirements. These requirements should provide the criteria for selecting health information technology (“HIT”) that support the business and clinical needs of the alliance. Avoid buying the tool then trying to create a strategy around it; this will inevitably fail.
Designing the data strategy requires a sophisticated understanding of the alliance’s business and clinical objectives, clinical guidelines and care processes, and requirements of analytics to support these activities. First, define the end goal (outputs) such as care management or value-based contracting, and identify the data sources that will be used (i.e., EHR, claims, ADT, etc.). Next, determine how the data will be used to support the outputs; will it be reportable and retrospective (e.g., risk stratification, predictive modeling, scorecards) or transactional and action-oriented (e.g., point of care, gap closure, alerts, real time analysis to support decision-making).
To be successful, this planning process must include clinical/operational leadership (e.g., chief medical informatics officer, care management leads), in addition to finance and the member organization chief information officers. Staffing should include a data architect and a clinical informaticist able to translate the data into clinically meaningful information.
Once the strategy has been defined, identify the data requirements and associated capabilities. This may include standard processes and reporting templates – tools to automate the current state and optimize care delivery. Next, select a vendor that either has the ability to grow with your organization as it evolves or decide to pursue a “plug and play” vendor approach. Either way, the vendor must support the alliance’s CIN data requirements and capabilities.
In the end, it is critical to maintain strong, positive relationships with clinicians during the design and development of these key technology capabilities. Clinicians drive the clinical care of patients and care models to support the delivery of clinical protocols. Organizational and individual needs will evolve based upon initial successes and challenges, and clinicians will bring forth a multitude of suggested and needed changes after the initial “go live.” Technology is the tool to support the clinical requirements, and developing ongoing processes to solicit clinician feedback for continued improvement is an important contributor to long-term success.
Ms. Tesch is a senior manager with GE Healthcare Camden Group in the clinical integration practice with more than 18 years of experience as a healthcare leader and strategist. Ms. Tesch specializes in value-based care delivery strategic planning, CIN development and implementation for commercial, Medicare, and Medicaid populations, health information technology data governance and analytics strategy, as well as care management strategy, design, and implementation. She has worked with a variety of healthcare providers, including integrated delivery networks, academic health centers, regional referral centers, rural community providers, and national non-profit and faith-based health systems. She may be reached at [email protected].