By Lisa A. Eramo
When you think of population health monitoring (PHM), you probably think of the Centers for Disease Control and Prevention (CDC) or the World Health Organization. These entities have used PHM programs to prepare for emerging health threats as well as prevent disease, injury, and disability.
However, PHM programs aren’t just for these big organizations anymore. Today, insurers, hospitals, and even individual providers are establishing PHM programs to better understand the populations they serve. This growth in PHM provides plenty of opportunities for health information management (HIM) professionals with health information management and technology (HIMT) training who can ensure accurate data and provide a context for data analysis. Why have PHM programs grown so significantly over the last few years? There are several reasons.
#1: Enactment of the Affordable Care Act (ACA). The ACA stipulates that there are financial incentives for providers who adopt electronic health records (EHRs) and comply with Meaningful Use requirements. These incentives had never existed previously, and they provide an immediate reason for providers to invest in the technology. The adoption of EHR and other integrated health information technology has taken PHM to an entirely new and exciting level. Long gone are the days in which only large insurers or the CDC could access and manipulate healthcare data. Today, providers of every size and specialty that use EHRs can also access their own data to get a “better read” on the populations they serve, cut costs, and provide greater value to patients. Many providers, including universities, hospital groups, nonprofit organizations, and private groups are also creating registries. Accountable Care Organizations rely on PHM to be successful as well.
#2. Big data. PHM programs rely and thrive on data. The good news is that today’s EHRs capture more data than was ever possible before. Technologies such as Natural Language Processing allow providers to tap into the power of narrative data, generating even more information on which conclusions can be drawn. ICD-10 (International Classification of Diseases, 10th Edition) will be a big game changer in terms of data specificity that will continue to drive the granularity of PHM programs.
Big data will become even bigger as more patients filter through the healthcare delivery system thanks to expanded healthcare coverage with the ACA. Health insurance exchanges make this possible, as do other options, such as new and emerging provider-based health plans that are competing with traditional insurers.
For example, MedStar Health, the largest health system in the Baltimore-Washington, D.C. metropolitan area, launched its own health plan—MedStar Select—in 2013. Eric R. Wagner, vice president of external affairs at MedStar Health, told FierceHealthPayer that being able to manage population health more effectively is one reason why the hospital system launched the plan.
“MedStar strongly believes that population health management needs to be a core competency and a key part of our strategy for the future. It’s a fact that our delivery of healthcare in the United States has to change. It has to transition. There has to be more of a focus on value. The growth rates in spending are unsustainable,” he said.
#3. Increase in chronic conditions. According to the CDC, 75% of the nation’s healthcare dollars go toward treatment of chronic conditions. As of 2012, approximately half of all adults (117 million people) have one or more chronic health conditions. Heart disease, cancer, obesity, arthritis, and diabetes are among the most common conditions. Everyone wants to understand how they can treat and prevent these conditions. PHM may be a large part of the solution.
To find out more about the fast-changing field of health information management and how you can earn a degree that will prepare you for success in tomorrow’s technology-driven healthcare environments, visit the UW Health Information Management and Technology degree page or call us at 1-877-UW-LEARN (895-3276) today.
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