Digital data analytics can enhance the productivity of healthcare providers, reduce operating costs and increase quality. It also helps them navigate the complexity of value-based practices.
The best population health management software combines clinical, financial and operational data across an organization into actionable insights. It should offer tools for risk stratification, care coordination and quality reporting.
Automated Claims Adjudication Processes
Population health management tools will be critical as the healthcare industry moves towards value-based care. Using data analytics, improved patient engagement, and a strong focus on social determinants of health will help healthcare providers improve outcomes and lower costs.
Many components are needed to effectively manage populations, including a strong team of individuals with diverse skill sets and familiarity with the required tools. CIOs, CMIOs, and other healthcare executives must work with informaticists, data scientists, and information technologists to cultivate innovative workflows and build new skill sets necessary for a successful transition. This will require hard work and patience, as many staff members resist changing their workflows.
Choosing the right technology tool is also an important part of the process. Many vendors, such as Foresee Medical, offer different platforms that meet the needs of a particular industry. Before reaching out to potential vendors for pricing estimates, healthcare organizations should identify their specific requirements and create a detailed RFI outlining the areas they’d like to improve with a population health management solution.
The right platform can make transitioning to a value-based healthcare model much easier. In addition to improving internal reporting and workflows, a strong population health management tool can assist with prior authorizations, which is one of the most time-consuming and painful aspects of working with payers. Claim scrubbing can be particularly helpful in this area, as it allows healthcare organizations to check their claims before submitting them to a payer, allowing them to catch any errors and avoid denials before they occur.
Improved Patient Engagement
Healthcare providers need to engage patients to improve outcomes and reduce health disparities. While many strategies exist to promote patient engagement, they must be carefully implemented to avoid overwhelming busy clinicians. Fortunately, incorporating a digital toolset that supports patient engagement strategies can be a great way to help clinicians focus on the important tasks at hand.
For example, a patient engagement tool can help providers understand their patient’s unique needs and preferences by using data from EHRs, claims, surveys, and other sources to identify specific trends affecting patient outcomes. By sharing this data with the patient, providers can make recommendations based on their unique circumstances, likely resulting in better overall outcomes.
Another way to enhance patient engagement is by leveraging an analytics tool that uses EHR and other data to predict a patient’s risk of being hospitalized or experiencing a serious health event. By assigning each patient a risk score, providers can take proactive measures to address the chances by offering them services like a social worker or mental health counselor, medication adherence support, or an invitation to join a community-based patient support group.
Implementing these tools requires a strong business case. For some organizations, the best option may be to partner with a consulting service vendor to facilitate implementation.
Enhanced Care Coordination
Healthcare organizations using population health management software must define their goals and prioritize what functionality they’ll need from new technology. This will help them select a tool that fits their needs and budget.
For example, a robust platform will enable clinicians to quickly identify high-risk patients and coordinate with other providers to provide home visits or telehealth consultations. This reduces re-admittance to emergency rooms and helps patients get the necessary care.
Integrated business intelligence tools also make it easier to identify gaps in care that could be improved with a better understanding of the patient journey. Most importantly, it enables them to focus on reducing those gaps and optimizing the patient experience by providing the right care to the right people at the right time.
The shift towards value-based care will also continue to shape population health initiatives. This includes the growing emphasis on addressing social determinants of health, such as poverty, housing and education. It’ll also continue developing new payment models that incentivize focusing on quality and outcomes rather than merely volume of services.
A good way to plan for and implement a population health management tool is through a collaborative process involving leaders at the healthcare organization, including those responsible for setting and accomplishing goals related to the project. This helps to ensure the goals are realistic, financially sensible and aligned with the organization’s mission. It will also help develop a project charter endorsed by the leadership team.
More Effective Reporting
For many healthcare organizations, implementing population health management tools is important in moving to a value-based care model. The most successful tools allow clinicians to track and improve patient outcomes while reducing healthcare costs. These tools also provide valuable insights that can be used to drive future health innovations and improve patient outcomes.
The best PHM tools offer advanced data analytics that can be used to identify and track a wide range of metrics. These include cost savings, enhanced patient engagement and improved clinical outcomes. Additionally, these tools can identify potential risks and improve efficiency.
These tools can also track internal metrics, such as provider productivity and patient satisfaction. These metrics help determine whether or not a specific device is delivering the desired results, and they serve as a guide for selecting new technologies that can be integrated into existing workflows.
Choosing the right PHM tool for an organization requires collaboration between leaders and staff. This can ensure that the selected tools meet business needs, are easy to use and make financial sense. It can also help to ensure that the devices can be used to support the organization’s mission. Ultimately, a well-designed PHM strategy can save the healthcare industry millions in the long run and improve patient outcomes.