Alejandro Reti, M.D., joined the Charlotte, N.C.-based Premier healthcare alliance early in 2013 as its senior director for population health. Since that time, he has been helping lead his colleagues at the health alliance forward to lay the foundation for a broader set of capabilities in integrated data analytics, as the healthcare industry moves forward on population health initiatives.
Last month, Premier announced that it was partnering with the University of North Carolina at Charlotte in a partnership to leverage UNC Charlotte’s academic expertise and community health technology, developed and led by Dr. James Studnicki, a UNC Charlotte College of Health and Human Services professor, to work with Premier, through its PremierConnect™ Enterprise business intelligence and enterprise-wide analytics platform, in collaborative initiative. Data connected to that initiative will be housed in PremierConnect Enterprise’s cloud-based data warehouse, which is vendor- and payer-agnostic, to enable timelier and more interactive data analysis and use.
With so much going on at Premier, Dr. Reti spoke with HCI Editor-in-Chief Mark Hagland shortly after the April 9 announcement to discuss Premier’s ongoing work in population health and analytics, and his perspectives on the future in those key areas. Below are excerpts from that interview.
Dr. Reti, can you give us a sense of the broader strategy behind the initiative that has been announced between Premier and UNC Charlotte?
Over the last 18-24 months, Premier has been quietly laying the groundwork for expanding our capabilities in integrated data analytics. One of our key initiatives is around population health management; but the other is to move the dial around that next tranche of cost and efficiency savings that healthcare organizations need to create to remain viable. So technically, architecturally, and from a process perspective, we’ve been looking at how to integrate data sets to make them available for data analytics. So we’ve been looking at meaningful community-based health analytics. So with UNC, we’re building on a foundation that Dr. Studnicki and his colleagues have been creating.
Alejandro Reti, M.D.
This is a solution, then?
It is. We’ve been helping our members perform community health needs assessments; that’s a consulting service we’ve been offering. But you end up building a report that ends up sitting on a shelf somewhere and doesn’t get updated. So by integrating key data sets from different sources, we’re helping providers develop a more integrated data stream around things like community well-being indices, crime statistics, etc., that are repeated regularly; and then tying that data with information on things like readmissions and mortality. And the point here is that these things all tie together; and if we can build a more complete picture, we can help them do a better job on what they should be focusing on, from a community intervention perspective.
Let me broaden the aperture a bit. One of the reasons we’ve decided to focus on this area is that our membership has been increasingly vocal that it’s very difficult to move the dial on your most difficult, expensive populations, if you don’t have a good community intervention strategy in place. If you look at the people—the “frequent flyers”—who cause a lot of readmissions and utilization, they typically are sick. But that is not necessarily the defining characteristic; there are mental illness and socioeconomic factors, and you need to address those. And this starts to bridge the gap between being a healthcare provider and a human services provider. So people are starting to ask, how do I address those gaps, and how do I use someone else’s money, to do those things?
So it becomes a public-private partnership, and a community thing. Let’s look at homelessness and lack of appropriate housing; Bon Secours for years has been working in Virginia with local housing authorities, to provide housing for people who need it most, and people with mental illness, and people who are in their ED 30, 50 times, a year, to help those people with those needs. And so our focus here is helping people identify where those priority issues are, and helping them start to make the right moves.
What are the biggest strategic opportunities and challenges that providers face as they try to reorient themselves away from being so inpatient-focused?
Because some of our largest members are non-profit systems, and many are Catholic health systems, they have always had a maybe above-average component of their mission devoted to caring for the population, so they have a little bit of involvement in caring for communities, and have some history in there, so it’s not a foreign idea to some of them. But historically, the reimbursement incentives have been elsewhere. I think organizations are best-positioned… Every organization has someone whose butt is on the line around global goals for care—connecting that person or those people to those who need to create community outreach—connecting those two. Because at the end of the day, it’s usually about a very specific subset of patients with a very specific subset of problems, and you have to improve those outcomes. I think that’s a bridge that’s often difficult to make. So we’re focused on that now.
What are the biggest challenges for those attempting to do analytics for population health right now?