Population health data integration: A team effort

As hospitals, health systems and independent practice associations nationwide continue on their journeys to achieving value-based care delivery models, there has never been more population health data available to care teams.

Connected electronic health records (EHRs) are collecting clinical data from physicians and care coordinators, claims data from health plans, and even wellness data from wearable devices and home caregivers. But for all of the data being amassed, it's often a struggle to make use of it in a way that improves patient experiences and overall health. Care teams are still starving for insights because they don't have the right tools in place to aggregate and analyze health information. Before we can integrate data sets to develop this much-needed, complete picture of individuals and populations, there are a few obstacles we'll need to overcome together.

Interoperability and Standardization of Disparate Data Systems

Of these obstacles, the biggest challenge often lies in making disparate data systems interoperable and standardized. Hospital integration systems tend to evolve very differently; for example, a given hospital's pharmacy and billing systems are likely not integrated, using the same coding scheme or even collecting data in the same computer language. Historically, aggregating these systems has simply not been a priority. In many cases these systems were designed and installed by distinct technology companies years ago, with no standardized data ecosystem in mind, and with not much consideration into the value of health information and how it can be used beyond recording purposes.

A Limited View of Holistic Health Profiles

EHRs are also often missing key details from an individual's insurance claims, such as specialist-provided prescriptions or surgeries conducted at other hospitals. Without this up-to-date claims data from an individual's health plan, care teams unfortunately have a limited view of their patients' holistic health profile, which is a hurdle for any successful population health strategy.

Population health data and an individual's health histories are thus spread unevenly across companies and systems, and have been developed in fragmented and administratively burdensome silos. This needs to change: for the good of our businesses, for the good of our service quality and – most importantly – for the good of the individuals we serve.

Breaking Down the Walls to Interoperability and Data Aggregation

The good news is that a number of tools and standards are in the works today to address this issue, such as the Fast Healthcare Interoperability Resources (FHIR) specification, and increasingly, hospitals are giving Information Technology (IT) managers the authority and executive influence to make real change in health IT possible. Furthermore, both sides of the supposed schism between health plans and care teams have vested interests in breaking down the walls to achieve interoperability and data integration.

It's with good reason, too, that the walls are coming down. Early successes in population health data integration point to how value can be realized and shared across health plans, care teams and individuals. Take cancer screenings, for instance. Humana analysis of claims information coming from health systems is processed overnight. These analyses scan for a number of warning signs, including disease risk factors and individuals who are of a certain age. In a recent case, the claims data revealed that an individual over the age of 55 had yet to come in for a cancer screening or even his regular check-up. The health plan care managers promptly got in touch with him and scheduled a screening, where an early-stage cancer was detected. Thanks to this early detection, he is now healthy and cancer-free, all because of the routine analytics that came in from the health plan to the individual. It's an ideal data-driven outcome: the individual's life is saved, and the care team and health plan have one less costly care regimen to coordinate.

That is just one of myriad cases where the right population health analytics delivered individual data at the right time and led to a positive result. But as bears repeating, the healthcare industry has a long way to go in terms of information integration. Until we have a unified system in place, there may naturally be some doubt and trust barriers between the health plan side and the care delivery side. With all parties moving full-steam ahead into integrated care and population health management, the business and quality incentives of health plans and care teams are today much more aligned than they used to be. In order to truly commit to population health, we will need to collaborate closely.

So, as a hospital or health system leader, you may be wondering what steps you can take right now to accelerate your data integration efforts.

Accelerate Data Integration Initiatives

First, we would recommend engaging the information system personnel. Whether it's the chief information officer, chief medical information officer or equivalent, consider bringing him or her in with the C-Suite leadership for all strategic business decisions, because electronic information will soon be at the nexus of all of our businesses. Look for platforms that offer integrated data management and leverage sophisticated analytics for insight into your information.

Data Integration Takes a Village

Second, engage in national programs and work groups like FHIR that are establishing standards for the sharing and analysis of data across various systems and areas of the industry. Data integration takes a village, and even small contributions can lead to great gains later on.

Eliminating the Barriers to Population Health
Lastly, traditional health plans are becoming more like health partners, with various options, resources and capabilities that can help care teams invest in population health and benefit from integrating claims, clinical and wellness data.

It's a new world of integration, where health plans are providing care, and health systems are offering their own insurance plans, so let's make sure we do right by the individuals and businesses we serve by integrating our data, standardizing our systems and breaking down the barriers to population health.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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