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Pop Health Colloquium: A Glimpse of the Future

March 15, 2013
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Moving from a hospital-centric mindset to one that is patient-centric using population-based care models

Once again this year I had the opportunity to attend the annual Population Health and Care Coordination Colloquium put on by the Jefferson School of Population Health here in Philadelphia and its dean, David Nash, M.D.

(See my colleague Rajiv Leventhal’s interview with Dr. Nash.)

This is the 13th year of the conference, which reminds us that the issues of care coordination and managing populations of patients are not new. However, I think that there was a real sense among the attendees, speakers and vendors at the event that something has changed. The issues they have been working at over the past several years have swung into clear focus, as payment reform initiatives force health systems of every stripe to consider how paying for value translates into both individual care plans for patients and system-wide changes to better study how looking at data differently might impact the quality and cost of care. In two or three years, the research they are doing on care coordination will likely be even more crucial.

In a March 14 talk, Michael Taylor, senior vice president, health and benefits, forconsulting firm Aon Hewitt, said that utilizing more technology for connectivity and practice efficiency is one of the key issues facing providers in 2013, along with participating in new delivery systems like accountable care organizations and considering employment by hospitals or larger physician organizations, as the pace of consolidation rapidly increases.

We heard from Mark Lester, M.D., M.B.A., an executive vice president for 25-hospital Texas Health Resources. He talked about a transformation process underway at THR, which involves moving from a hospital-centric mindset to one that is patient-centric using population-based care models. “Our emphasis will be on adding value for people seeking health care throughout the entire care continuum, and not only on adding hospital-based volume,” he said. THR is consolidating its entities and services across three geographic zones in the Dallas-Fort Worth area, each overseen by a “dyad” of a chief operating officer and chief clinical officer.

Lester said that THR is taking advantage of registries, databases, and predictive modeling in support of three work streams: physician-directed population health; care coordination and readmission avoidance; and a diabetes service line, extending glucose control across the continuum of care. The goal is that clinicians will create customized care planswith interventional support for every patient.

We also got to hear from John Cuddeback, M.D., Ph.D., chief medical informatics. officer for Anceta, the clinical analytics subsidiary of the American Medical Group Association. Anceta extends the AMGA’s model for shared learning based on comparative clinical analytics using the analytics solution MinedShare from Humedica, which recently became part of OptumInsight. Working along seven disease lines, medical groups share data to identify opportunities for improvement and to recognize best practices.

Currently Anceta has 25 large medical groups contributing data from the electronic health record systems. Physicians receive performance reports with comparative data, and MinedShare uses predictive analytics to help them identify patients who may soon fall into one of the chronic disease categories.

Cuddeback said Anceta is moving from pushing data to physicians, which can feel like they are being judged, to a pull model, in which the physicians get curious about querying the data themselves and find it more useful than just a reporting mechanism.

For instance, medical groups can do a query to see which medications their physicians are prescribing for glycemic control in any subgroup of patients with diabetes, and see comparative data for similar patients of other medical groups participating in the Anceta Collaborative Data Warehouse.

Anceta is working on regression models to take into account patient factors such as age, gender, socio-economic status, he said, and then examine which medical groups are doing the best on similar sets of patients and which care process factors are having the most impact.