Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why you need a population health management IT system

Rosemarie Nelson
Physician
April 7, 2013
Share
Tweet
Share

Why do you need a population health management (PHM) IT system? In our last column we discussed the fact that reimbursement tied to outcomes will demand a greater level of patient management. Greater, perhaps, than your EHR can deliver. The early focus of new pay-for-performance and bundled payment systems is on preventive care for top chronic illnesses.

The 15 most expensive health conditions account for 44% of total healthcare expenses, according to the Agency for Healthcare Research and Quality. To bend the healthcare cost curve, providers will need to redesign care processes so that the focus is on keeping chronic-care patients healthy and out of ERs and hospitals.

One key element in the process is identifying your chronic care patients. Proactive identification of a patient population requires a new approach to decision support. A PHM aggregates data from electronic health records and physician practice management systems to help manage patient outreach, identify gaps in care, stratify risk, provide care management, and evaluate performance.

A PHM analyzes the aggregated data, applies built-in, rules-driven alerts, and presents it to the care team for more effective preventive care and chronic disease management.

A PHM works within and around your EHR and is integrated into your work flow. Some PHM systems present their findings and analysis to the care team via embedded templates and checklists. Others appear to sit on top of the EHR, as if your actionable items are pushed or pop up at you.

A comprehensive, fully interfaced PHM-EHR solution enables providers to execute on all aspects of care management: identification of the appropriate care for the specific patient, outbound reach for patient scheduling, monitoring treatment compliance with evidence-based guidelines and protocols.

Your practice becomes more proactive and more efficient, resulting in a better financial performance. A 10-physician internal medicine group in the Southeast recently earned more than $80,000 per physician in quality and incentive bonuses in one year using a PHM.

Which PHM and how much will it cost is best addressed by starting with your EHR. Look at the gaps and select a PHM that fills those gaps. Here’s what you should have:

  • Rules-based alerts (already built and defined in the PHM) on specific population levels for preventive care and chronic disease management
  • Automated outreach to patients identified in those alerts, including an interactive patient portal
  • Patient queues for care coordinators on your team to drive one-on-one patient communication for compliance to care plans
  • Established reporting (existing reports so you do not have to create your own) to mine population-based data and to report on patient outcomes

Ask your EHR vendor if they support a population health management module or if they partner with a PHM solution. It is likely that you’ll find the partner PHM to be more readily interfaced to your EHR. That means an established implementation for you with less set-up and a quicker go-live time line for your clinical care team.

If your ERH vendor doesn’t support a PHM module just yet, ask your hospital or physician organization if they have a PHM. As reimbursement methods continue to evolve and as accountable care organizations develop, shared population health management will drive larger organizations to aggregate data across the entire delivery system. Participating with a community-based PHM implementation may also provide an affordable entry point for a small-to-mid-sized practice.

PHM solutions are priced on a per-physician, per-month subscription (approximately $100 to $120) or a per-patient, per-month (approximately $.20 to $.40), often with a base minimum.

Is the outlay for a PHM worth it? Quality incentives and bonuses can offset the annual cost in 1 to 3 months.

And, when used in conjunction with an EHR, a PHM solution can help improve patient outcomes as well as your organization’s financial health.

ADVERTISEMENT

Rosemarie Nelson is a principal with the MGMA Health Care Consulting Group and blogs at Practice Pointers.

Prev

Explaining the rise in the autism rate

April 6, 2013 Kevin 7
…
Next

Can Safeway lead the way in controlling health costs?

April 7, 2013 Kevin 12
…

Tagged as: Primary Care

Post navigation

< Previous Post
Explaining the rise in the autism rate
Next Post >
Can Safeway lead the way in controlling health costs?

ADVERTISEMENT

More by Rosemarie Nelson

  • a desk with keyboard and ipad with the kevinmd logo

    Increase patient and provider satisfaction by reducing phone messages

    Rosemarie Nelson
  • a desk with keyboard and ipad with the kevinmd logo

    How to improve patient engagement

    Rosemarie Nelson
  • a desk with keyboard and ipad with the kevinmd logo

    What’s your plan for the transition to ICD-10?

    Rosemarie Nelson

More in Physician

  • Why heart and brain must work together for love

    Felicia Cummings, MD
  • How pain clinics contribute to societal safety

    Olumuyiwa Bamgbade, MD
  • Why frivolous malpractice lawsuits are costing Americans billions

    Howard Smith, MD
  • How AI helped a veteran feel seen in the U.S. health care system

    David Bittleman, MD
  • Why physician strikes are a form of hospice

    Patrick Hudson, MD
  • How a doctor defied a hurricane to save a life

    Dharam Persaud-Sharma, MD, PhD
  • Most Popular

  • Past Week

    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • AI in health care is moving too fast for the human heart

      Tiffiny Black, DM, MPA, MBA | Tech
    • How physicians can reclaim resilience through better sleep, nutrition, and exercise

      Kim Downey, PT & Shirish Sachdeva, PT, DPT & Ziya Altug, PT, DPT | Conditions
    • This isn’t burnout, it’s moral injury [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why heart and brain must work together for love

      Felicia Cummings, MD | Physician
    • Who are you outside of the white coat?

      Annia Raja, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • Love, birds, and fries: a story of innocence and connection

      Dr. Damane Zehra | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why physician strikes are a form of hospice

      Patrick Hudson, MD | Physician
    • The overlooked power of billing in primary care

      Jerina Gani, MD, MPH | Physician
  • Past 6 Months

    • Why transgender health care needs urgent reform and inclusive practices

      Angela Rodriguez, MD | Conditions
    • COVID-19 was real: a doctor’s frontline account

      Randall S. Fong, MD | Conditions
    • Why primary care doctors are drowning in debt despite saving lives

      John Wei, MD | Physician
    • Confessions of a lipidologist in recovery: the infection we’ve ignored for 40 years

      Larry Kaskel, MD | Conditions
    • Why taxing remittances harms families and global health care

      Dalia Saha, MD | Finance
    • mRNA post vaccination syndrome: Is it real?

      Harry Oken, MD | Conditions
  • Recent Posts

    • How denial of hypertension endangers lives and what doctors can do

      Dr. Aminat O. Akintola | Conditions
    • AI in health care is moving too fast for the human heart

      Tiffiny Black, DM, MPA, MBA | Tech
    • How physicians can reclaim resilience through better sleep, nutrition, and exercise

      Kim Downey, PT & Shirish Sachdeva, PT, DPT & Ziya Altug, PT, DPT | Conditions
    • This isn’t burnout, it’s moral injury [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why heart and brain must work together for love

      Felicia Cummings, MD | Physician
    • Who are you outside of the white coat?

      Annia Raja, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...