The transformative power of population health

July 15, 2020

Population health means a patient’s long-term health matters as opposed to treating each sick patient as an isolated transactional episode.

The need for population health services has never been more critical.  The epidemic of chronic disease, coupled with aging populations and shrinking resources, is straining current care systems beyond all measure. Take into account the physician burnout crisis-almost half of clinic time is spent performing burdensome computer-based tasks- and it’s clear that the status quo isn’t working for patients or healthcare professionals. We need to shake up the health system and take a closer look at how to keep our populations healthier.

Why population health is the future

Currently, multiple chronic conditions affect one in three adults around the world. Despite this, only 3 percent of every healthcare dollar is spent on preventive health. This is a drop in the ocean considering the long-term cost savings and benefits that a robust population health ecosystem can deliver. 

Population health-the collection and analysis of public healthcare data across care settings to identify the most prevalent needs of a community-is part of the solution. It can help make the delivery of care more efficient by treating high risk populations early on-before they end up in acute care-therefore putting less strain on health infrastructure and those involved in front-line care. It is revolutionizing the ways in which we provide care, and equally bringing improvements and benefits to all parties.

Population health is closely entwined with risk stratification; the process of identifying and stratifying high risk population groups who are likely to account for a larger fraction of health care costs. By identifying these high-risk / high-cost individuals early on and offering them preventative care tailored to their needs, it is possible to improve their health outcomes and experiences of care.

Early intervention benefits patients by helping them avoid preventable health conditions which may lead to requiring acute care. Population health initiatives are also key to ensuring that individual health needs are met and that they don’t fall through the cracks. This includes those who are well, and those who are susceptible to certain diseases or living with them at home. 

Population health also benefits providers by ensuring more efficient spending of funds so that investments are made where they are truly needed. Population health can lead to cost savings through lower hospital admissions, shorter stays, and reduced readmissions.

Delivering care today for change tomorrow

Changing how medicine is delivered is not going to be done by one entity or individual alone. We all need to take an active part to make population health work, from vendors to insurers and payers to frontline staff.  Here are three important steps that the healthcare industry should put into practice to bring about this vital change:

1. Mindset matters: To build and activate a successful population health ecosystem and strategy, there needs to be a shift in mindset towards value-based care and preventative treatment. Healthcare leaders have an opportunity to lead the charge here; they should communicate their vision to the teams they work with, and help practitioners and others along on the journey. Leaders who involve practitioners in the change, consulting them on key decisions, will experience a smoother transition. 

Haslam College of Business at the University of Tennessee, Knoxville, for example, introduced the Physician Leadership Academy (PLA), a 3-year program that gives physicians a foundation in the business and leaderships aspects of healthcare. After participating in the leadership program, ‘many physicians demonstrated a shift in the mindset from focusing on small, discipline-specific projects to macro-level, hospital-wide initiatives’, showing the return on investment and how the novel example could be applied to educate physicians on the benefits of population health. 

2. Rejoice in the technological revolution: Technology can help physicians implement value-based care faster and better. It has already opened up new and exciting opportunities, helping us better understand patient populations, navigate the healthcare landscape, and activate patients like never before.

Through artificial intelligence (AI), meaningful data from patient records can be converted into actionable insights. This helps focus larger populations into smaller, more targeted population sub-sets based on their precise health needs and provides evidence-based insights to make more informed decisions.

Incorporating tech advancements and new capabilities, such as AI, machine learning, and analytics engines into daily tasks and administrative processes, can free up the demands on physicians’ time which can be better spent with patients.

The rise of remote monitoring and telehealth is also augmenting the population health ecosystem and revolutionizing the way physicians can provide care. In the U.S., a shortage of primary care physicians has been partially alleviated by virtual solutions. By enabling an AI-led virtual assistant to conduct primary care appointments and follow-ups – a tactic employed by UnitedHealth and Aetna patients receive medical support at home when they need it, limiting in-person visits, and reducing the resource burden on physicians.

We need to be realistic about the limitations of this ‘brave new world’ however. When you factor in the reality that many health staff may not have computers with cameras attached to their screens to enable video consultations or that Wi-Fi might lack adequate bandwidth, it is easy to see why technology is not a ‘miracle cure’ as it’s often touted to be. Rolled out gradually in bite-sized consumable ways can ensure a steady approach to tech implementation that is scalable and connected.

3. How collaboration can turn vision into reality: In his paper titled ‘The health care innovation bubble,’ American physician Sachin H. Jain observes:‘there is a “change layer” – the cloud in which visionary ideas about transforming health care resides. But there is also a “reality layer” – the place where most care is delivered. Both are necessary, but there is little mixing between them.’ This perfectly sums up the dichotomy between the long-term vision and the reality of the organizational structures in which we operate. Rome wasn’t built in a day. Nor was it built alone. This is exactly the mindset that all healthcare providers need to have to bring about change. Collaboration is key to bridging the gap between the ‘change’ and ‘reality’ layer.

Vendors, for example, need to be aware of the reality on the ground and make sure that the technology innovation is consumable. Here’s another important point: one vendor will not have all the answers or all the tools. To create the right support system for an organization’s value-based environment, vendors – alongside insurers, payers and frontline staff - need to open up and collaborate with each other to create just the right ecosystem that can thrive and grow in flexible ways. That takes courage and a focus on interoperability.

Striving for a better healthcare future

Why would we abandon a fee-for-service system that’s clean and transactional? Because health and people are complex. Population health means a patient’s long-term health matters as opposed to treating each sick patient as an isolated transactional episode. It’s the right thing to do, and physicians, alongside other parties involved in the transformation, should be highly motivated to making healthcare better and more human. We should all be personally invested in creating a better system because healthcare affects us all at some point in our lives.

Derek Ross is a business leader at Philips Population Health.