Lower spending, Better care, Richer rewards
The physical weight of data is about 1 attogram, which is as minuscule as it can get, but the weight that it carries to enhance patient experience is far bigger.
As far as the healthcare industry is concerned, a lot of effort was put into digitization- the whole charade – developing different types of desktop/web/mobile applications to automate the patient and provider workflows. However, after this initial application development era, industry sensed that providers talk in terms of ‘population health management’ to drive the triple aim of healthcare – viz.
- Improved patient care experience
- Reduced per capita cost of health
- Enhanced Population health
Why do you need Population Health Management?
Population Health Management is mainly about reducing the risk and expenditure across the care continuum. To put it easily, you need Population Health Management (PHM) to:
1. Reduce the frequency of health crises as also costly ED visits and hospitalizations.
2. Lower the cost per service through an integrated delivery of care team approach, which includes clinicians, social workers, physical therapists, and behavioral health care professionals
3. Improve the overall patient experience, in part by providing improved access to care
4. Promote patient engagement and empower patients to better self-manage their health, and participate in the decision making process
What does the future hold for Population Health Management?
You see the diagram we have put together; many PHM platforms will offer you this:

When it comes to processes, it is not very different from a handful of others, but what makes for a great PHM platform is one that has usability, performance, accuracy, and completeness.
Inching beyond PHM 2.0
Going beyond Population Health management 2.0 necessarily means extending your PHM platform’s capabilities to manage the high-risk and high-cost population. It will have to have that whole mix of new data integration services, more detailed insights charts to providers, KPI dashboards, easy on the eye UI and a few more are down here:
Data Aggregation based on the backdrop of increasing mergers and acquisitions
Given the need that will arise for data integration (merging different types of data), PHM platforms need to enhance their existing data aggregation methodologies
Patient centric data like SDOH, behavioural patterns, habits etc.
Holistic patient view to provide quality care is very much dependent on gathering maximum patient data. Providing care to patients only based on episode details is not enough. For a better quality care approach, collecting patients SDOH data, their habits data, their behavioural patterns etc. could play very important role
Truly Automated risk stratification
Existing PHM platforms stratify risks and identify risk scores or risk categories of patients. Can these algorithms give respite to overburdened care teams or nurses? The answer is to add workflow automation along with risk stratification algorithms to reduce the manual work of care teams.
Smart care plan generation
Existing PHM platforms support care teams to derive care plans manually. It would be great if PHM platforms start providing suggestions to care teams/ physician through system generated care plans. In plain English, the system will generate a care plan based on other population data analysis, patient history, patient’s symptoms, patient goals, and the success ratio of the previous care plans.
Pro-Active patient engagement
Most dedicated PHM platforms focus on risk stratification, data analytics, and report generation. ‘Patient Engagement’ is side lined. PHM 2.0 platforms not only focus on patient engagement but also go as far as to come up with a ‘Pro-Active patient engagement’ plan. Including patients proactively in the care delivery process and population health analysis, is necessary to gather accurate patient data and track gaps while generating care plans.
Leveraging our strength
Well, not to blow our own trumpet, but we at Nitor Infotech can help you enhance your patient experience and take you closer to PHM 2.0 because we have:
- The right blend of technology and domain experts to provide technology services
- Dedicated technology and Data science practice team to review and suggest architectural changes
- Dedicated healthcare domain expert team to support technology teams
- Ready to use accelerators which reduce the Go-to market time by 18%
A few last words
For once, I won’t add this as a point as I am speaking off the bat here, if as a healthcare organization your aim is to provide superior care at a lower cost, then, investing in extending your PHM capabilities should be No.1 on that priority list.
What can you do to go beyond PHM 2.0?
- Merge, clean, and relate any structured or non-structured healthcare data set. Get your, data governance, data integration, data remediation, master patient indexing, and deterministic and probabilistic models in place. Yes, I was speaking English! Contact us to know more!
- Gather more patient data like SDOH, behavioural patterns etc. through health accelerators and engage the patient proactively
Execute care communication better by keeping the care team (physicians and patients alike) informed about care plan, allocated tasks, handling patient information securely etc. Build secure messaging, task allocation management, HL7 integration to manage patient data handling etc. to enhance care management.
- Utilize Predictive analysis to get a system generated care plans based on historical patient data and other data mapping points. Invest some time in getting your disease management in order.
- Build intuitive reports and dashboards to represent compliance related measures, actionable insights, data for decision-making etc. through BI.
I have said what I wanted to. You can always write to us to know more about our offerings.
P.S. This blog was written while listening to Benedict Cumberbatch invite everyone to #ReadALetter to heroes on the frontline during COVID-19. I will take this blog as a medium to thank everyone in the healthcare fraternity for their relentless service.