How technology can help hospitals support population health: Philips chief nursing officer for population health

Cindy Gaines, MSN, RN, brings more than 30 years of experience in quality and operations across the healthcare continuum to her role as chief nursing officer at Philips.

As a leader on the company's population health team, Ms. Gaines is not a stranger to overseeing patient care. Previously, she served as president of administration for the West Michigan market of Ascension Medical Group and Ascension Borgess in Kalamazoo, Mich., as well as vice president of population health for Ascension Borgess.  

Ms. Gaines was a customer of Philips while working in health systems for more than 10 years. Now, as the company's CNO for population health management, she is poised to apply her clinical background to help Philips support population health tools that customers need for value-based care.

Here, Ms. Gaines discusses her priorities as CNO, a new role within Philips.

Editor's note: Responses have been lightly edited for clarity and length.

Question: What are some technologies that hospitals can implement to improve patient care?

Cindy Gaines: I think the technologies we need to think about are those that go beyond a hospital's walls. Traditionally, hospitals are very good at measuring what happens within its four walls and then for 30-day readmissions on key conditions. And yet, from a population health perspective, a hospitalization should be more of an event in a patient’s healthcare journey. The majority of their care happens outside of the hospital in physician offices, outpatient centers and even online.

With population health, our job is to look at care of the patient as a whole. That's what I'm really excited about with our population health solutions at Philips. They allow you to aggregate the information from all the care locations a patient uses, in and outside of the health system.  Bringing together inpatient data, outpatient data, health plan data, skilled nursing facilities and the lab data to give a complete picture. Giving providers tools to see comprehensive patient information and then identify patients who may need support or intervention, such as case management or remote monitoring is crucial.

Q: How has technology evolved to support population health?

CG: Organizations struggle to identify patients who are high risk. Traditionally, they identify risk by a trigger using data they have access to, such as a discharge from a hospital is high risk for 30 days. A patient with three emergency room visits in six months is high risk. One hospital even defined any patient with greater than seven medications on their record as an indicator or risk.

Now at Philips, we are looking at solutions that go beyond a trigger. By aggregating data, normalizing it and then applying risk algorithms, we cannot only show you the high-risk patients, but we can show you the rising risk. Meaning patients who may not have triggered a traditional event, such as a hospitalization, but may be heavily using the health system. Giving one the ability to manage patients and intervene to prevent them moving up to a higher-risk level. Our health systems put a lot of resources into some really great programs and you want to make sure the right patients are being directed to these programs. And how do you identify them? It's identifying patients with rising risk.

Q: What are some technologies that can help identify what patients are high risk or rising risk?

CG: I think of population health and what we do as being like a toolbox — we have different tools to offer based on the needs of the patient and the organization. One of our foundational tools is our ability to take your data from disparate sources and then to aggregate this data, normalize it, risk stratify it and segment it into manageable groups that you can take action on based on your data.

This is where we begin scalable care management. At the lowest level, this may be managing gaps in care and hierarchical condition category coding. At a moderate level, the organization may have care managers already embedded in their practice, but they need a solution that can help them to track their activities and care for their patients. That is technology that Philips can provide, but it's the organization that is the resource. Often, they focus on disease management, transitions of care, coaching and self-management plans with patients. For patients who are high risk, Philips can do remote patient monitoring with a call center to engage with the patient and support their care in the home setting. These devices may include vital signs, pulse oxygen, weight collection, Philips Medication Adherence Solution, and Lifeline patient emergency response service. And all are supported with patient reported outcomes through surveys.  

Q: What role do analytics play in helping determine the effectiveness of a program?

CG: Analytics are vital. Many great programs have been implemented in healthcare over time. Many have been in place for years. Healthcare facilities are passionate about these programs and believe they may make a difference but have not always been as rigorous on evaluating the return on investment. In our current healthcare environment, everyone needs to use the resources effectively and efficiently. Both in terms of current programs and new programs. When hospitals implement a program, analytics will provide insights to the organization to determine if it's effective. Did it demonstrate what was expected? Getting this information monthly and ongoing allows the organization to shift and make changes as needed. This level of analytics is vital to an organization taking on risk contracting.

Q: What are some of your top priorities throughout the rest of the year?

CG: I'm really excited because this is a brand-new role for Philips, and it is an investment in their population health solutions and services. So, my priority right now is getting to know all the solutions that Philips has to offer for population health. It is reaching out to our solutions and services and asking, "How can I help? How can I be supportive?" And just being present for that.  

I have been out in the health systems working as a leader doing this work. And my role is to say how can I, as a clinician — because I'm a nurse — help provide insights on our solutions and what our customers need. How can I connect with customers in our organization? I'm kind of that liaison in many ways between the two. It is an exciting opportunity.

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