A Landmark, 12-Point Review of Population Health Management Companies (Executive Report)

Population health management (PHM) is in its early stages of maturity, suffering from inconsistent definitions and understanding, overhyped by vendors and ill-defined by the industry. Healthcare IT vendors are labeling themselves with this new and popular term, quite often simply re-branding their old-school, fee-for-service, and encounter-based analytic solutions.  Even the analysts —KLAS, Chilmark, IDC, and others—are also having a difficult time classifying the market. In this paper, I identify and define 12 criteria that any health system will want to consider in evaluating population health management companies.  The reality of the market is that there is no single vendor that can provide a complete PHM solution today.  However there are a group of vendors that provide a subset of capabilities that are certainly useful for the next three years.  In this paper, I discuss the criteria and try my best to share an unbiased evaluation of sample of the PHM companies in this space.

 

Is Your Care Management Program Working: A Guide to ROI Challenges and Solutions (Executive Report)

Care management programs play a large part in many health systems’ population health strategies. However, these programs can consume a lot of resources. It is important to know if a care program is effective, and eventually, to show a positive ROI. Many roadblocks stand in the way:

  • Complexity of Environment
  • Prolonged Time to ROI
  • Lack of Access to Disparate Data
  • Difficulty Engaging the Patient

A thoughtful approach and a robust analytics platform can help organizations overcome these challenges. Care management ROI should be a long-term strategy, but cost savings and quick wins are possible using the Health Catalyst® Cost Management Suite.

How to Use Data to Improve Patient Safety (Executive Report)

Healthcare organizations have worked hard to improve patient safety over the past several decades, however harm is still occurring at an unacceptable rate. Though the healthcare industry has made efforts (largely regulatory) to reduce patient harm, these measures are often not integrated with health system quality improvement efforts and may not result in fewer adverse events. This is largely because they fail to integrate regulatory data with improvement initiatives and, thus, to turn patient harm information into actionable insight.

Fully integrated clinical, cost, and operational data coupled with predictive analytics and machine learning are crucial to patient safety improvement. Tools that leverage this methodology will identify risk and suggest interventions across the continuum of care.

A Guide to Care Management: Five Competencies Every Health System Must Have (Executive Report)

The goal and responsibility of every healthcare organization and provider using a care management approach is to deliver the right care at the right time to the right patients. This standard of care management can only be achieved if five competencies are in place:

  • Data Integration
  • Patient Stratification and Intake
  • Care Coordination
  • Patient Engagement
  • Performance Measurement

This guide to care management reviews each competency and shows how to put it all together into an effective program that gets results for organizations and patients alike.

Outcomes Improvement Governance: A Handbook for Success and Achieving More with Less (Executive Report)

For healthcare organizations looking to achieve outcomes improvement goals, effective governance is the most essential must-have. This leadership culture ensures success by enabling health systems to invest in outcomes improvement and allocate resources appropriately toward these goals.

This executive report is an outcomes improvement governance handbook centered on four guiding principles (and associated helpful steps) health systems can follow to achieve effective governance and start achieving more with less:

  1. Stakeholder engagement
  2. Shared understanding
  3. Alignment
  4. Focus

With these four principles, organizations can build a foundation of engagement and focus around the work, where they maximize strengths, and discover and address weaknesses. They establish an improvement methodology, define their goals, and sustain and standardize improvement work.

Preparing for MACRA: A Comprehensive FAQ for Physicians (Executive Report)

The Medicare Access and CHIP Reauthorization Act (MACRA) overhauls the payment system for Medicare providers. It’s a complex program that requires careful study so physicians can make the best choice for how they want to report. This choice ultimately impacts reimbursement and the potential bonuses or penalties associated with each reporting option.

This FAQ covers both tracks of the new rule, the Merit-based Incentive Payment System (MIPS), and the Advanced Alternative Payment Model (APM), with a background review and a comprehensive list of questions and answers.

It’s a practical guide complete with next steps for strategic and tactical planning.

The Best Way to Maximize Healthcare Analytics ROI (White Paper)

When it comes to maximizing analytics ROI in a healthcare organization, the more domains, the merrier. Texas Children’s Hospital started their outcomes improvement journey by using an EDW and analytics to improve a single process of care. It quickly realized the potential for more savings and improvement by applying analytics to additional domains, including:

  • Analytics efficiencies
  • Operations/Finance
  • Organization-wide clinical improvement

The competencies required to launch and sustain such an organizational sea change are all part of a single, defining characteristic: the data-driven culture. This allows fulfillment of the analytics strategy, ensures data quality and governance, encourages data and analytics literacy, standardizes data definitions, and opens access to data from multiple sources.

This article highlights the specifics of how Texas Children’s has evolved into an outcomes improvement leader, with stories about its successes in multiple domains.

Hadoop in Healthcare: Getting More from Analytics (White Paper)

Healthcare data is positioned for momentous growth as it approaches the parameters of big data. While more data can translate into more informed medical decisions, our ability to leverage this mounting knowledge is only as strong as our data strategy. Hadoop offers the capacity and versatility to meet growing data demands and turn information into actionable insight.

Specific use cases where Hadoop adds value data strategy include:

  1. Archiving
  2. Streaming
  3. Machine learning

When Healthcare Data Analysts Fulfill the Data Detective Role (White Paper)

There’s a new way to think about healthcare data analysts. Give them the responsibilities of a data detective. If ever there were a Sherlock Holmes of healthcare analytics, it’s the analyst who thinks like a detective. Part scientist, part bloodhound, part magician, the healthcare data detective thrives on discovery, extracting pearls of insight where others have previously returned emptyhanded. This valuable role comprises critical thinkers, story engineers, and sleuths who look at healthcare data in a different way. Three attributes define the data detective:

  1. They are inquisitive and relentless with their questions.
  2. They let the data inform.
  3. They drive to the heart of what matters.

Innovative analytics leaders understand the importance of supporting the data analyst through the data detective career track, and the need to start developing this role right away in the pursuit of outcomes improvement in all healthcare domains.

The Four Balancing Acts Involved with Healthcare Data Security Frameworks (White Paper)

There’s a lot at stake for healthcare organizations when it comes to securing data. A primary concern is to protect privacy and avoid costly breaches or leaks, but at the same time, data must be accessible if it’s to be used for actionable insights. This executive report introduces four balancing acts that organizations must maintain to build an ideal data security framework:

  1. Monitoring
  2. Data de-identification
  3. Cloud environments
  4. User access

This can be a tug-of-war between IT and security, two groups that often have divergent interests, however well-meaning they may be. Healthcare systems that build bridges between these interests and strike the crucial balance between data utilization and security can dial in on long-term goals, like better care at a lower cost and overall outcomes improvement.

The Who, What, and How of Health Outcome Measures (Executive Report)

Even though thousands of health outcome measures have the potential to impact the work we do every day, how well do we really understand them? In this article, we take a close look at the definitions, origins, and characteristics of health outcome measures. We break down the financial relevance of certain measures, the relationship between outcome measures and ACOs, and which measures impede, rather than enhance, a typical healthcare system. We review the role of an enterprise data warehouse and analytics, and we touch on the future of health outcome measures, all in an effort to provide deeper insight into some of the mechanics behind outcomes improvement.

The 7 Best Ways to Prepare for MACRA Today (Executive Report)

The Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law in 2015, with major impacts starting in 2019. MACRA attempts to prioritize quality over quantity by letting providers choose between two value-based payment tracks: MIPs and APMs. Providers won’t have to choose until 2019; until then, they will receive a .5 percent annual increase.

The industry is conflicted about MACRA. On the one hand, many believe it is part of the overall shift to value-based healthcare. On the other hand, many say the administrative burden will overwhelm providers. Another area of MACRA controversy has to do with meaningful use which, contrary to what the CMS Acting Administrator said in 2016, isn’t going away with the introduction of MACRA.

Although it seems a ways away, MACRA’s base year will likely be 2017. Armed with the seven best ways to start preparing for MACRA today, and an EDW that provides clinicians with the self-service tools to monitor their performance, health systems can be ready to tackle MACRA when it finally goes into effect.

Population Health in Three Paragraphs (Executive Report)

Population health strategy can borrow a lot from public health. However, health systems haven’t had to deal with patient socioeconomic issues and need to build new skills and use new data. The skills can be adapted from the public health sphere, with hospitals developing health interventions alongside law enforcement, community-based social support, etc. The most important data are patient-reported outcomes data, social determinants of health data, and activity-based costing data. With this approach, the fundamental equation for population health would be Return on Engagement, that is the clinical outcome achieved divided by the total patient investment.

The Top Five Recommendations for Improving the Patient Experience (Executive Report)

Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim.

But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:

  1. Use patient satisfaction as a balance measure—not a driver for outcomes.
  2. Evaluate entire care teams—not individual providers.
  3. Use healthcare analytics to understand and act on data.
  4. Leverage innovative technology.
  5. Improve employee engagement.

This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.

9 Ways Your Outcomes Improvement Program Could Be Delayed (Executive Report)

A health system’s outcomes improvement program is an expensive undertaking. It’s worth the results, but there’s no need to make it even more expensive through unforeseen and unnecessary delays. We outline the three phases of managing outcomes improvement programs, from hardware and software acquisition and configuration to resource management to sustaining and scaling the gains. We also examine the nine potential pitfalls that can undermine success in each of these phases:

  • Hardware and software acquisition delays
  • Environment readiness
  • Source system access
  • Lack of resource capacity
  • Lack of analytic and technical skills
  • Data quality paralysis
  • Lack of clinical or operational engagement
  • Punitive culture: data used as a weapon
  • No CEO, no go

The Top Six Early Detection and Action Must-Haves for Improving Outcomes (Executive Report)

Given the industry’s shift toward value-based, outcomes-based healthcare, organizations are working to improve outcomes. One of their top outcomes improvement priorities should be early detection and action, which can significantly improve clinical, financial, and patient experience outcomes. Through early detection and action, systems embrace a proactive approach to healthcare that aims to prevent illness; the earlier a condition is detected, the better the outcome.

But, as with most things in healthcare, improving early detection is easier said than done. This executive report provides helpful, actionable guidance about overcoming common barriers (logistical, cultural, and technical) and improving early detection and action by integrating six must-haves:

  • Multidisciplinary teams
  • Analytics
  • Leadership-driven culture change
  • Creative customization
  • Proof-of-concept pilot projects
  • Health Catalyst tools (knowledge briefs, outcomes improvement packets and worksheets, and care process improvement maps).

The report features a Thibodaux Regional Medical Center sepsis success story that demonstrates how creative customization, when paired with evidence-based standardization, can improve early detection and action efforts, as well as clinical, financial, and patient outcomes.

7 Features of Highly Effective Outcomes Improvement Projects (Executive Report)

There’s a formula for success when putting together outcomes improvement projects and organizing the teams that make them prosper. Too often, critically strategic projects launch without the proper planning, structure, and people in place to ensure viability and long-term sustainability. They never achieve the critical mass required to realize substantial improvements, or they do, but then the project fades away and the former state returns. The formula for enduring success follows seven simple steps:

  1. Take an Outcomes Versus Accountability Focus
  2. Define Your Goal and Aim Statements Early and Stick to Them
  3. Assign an Owner of the Analytics (Report or Application) Up Front
  4. Get End Users Involved In the Process
  5. Design to Make Doing the Right Thing Easy
  6. Don’t Underestimate the Power of 1:1 Training
  7. Get the Champion Involved

The Top Five Essentials for Outcomes Improvement (Executive Report)

Quality improvement in healthcare is complicated, but we’re beginning to understand what successful quality improvement programs have in common:

  1. Adaptive leadership, culture, and governance
  2. Analytics
  3. Evidence- and consensus-based best practices
  4. Adoption
  5. Financial alignment

Although understanding the top five essentials for quality improvement in healthcare is key, it’s equally important to understand the most useful definitions and key considerations. For example, how different service delivery models (telemedicine, ACO, etc.) impact quality improvement programs and how quality improvement starts with an organization’s underlying systems of care.

This executive report takes an in-depth look at quality improvement with the goal of providing health systems with not only the top five essentials but also a more comprehensive understanding of the topic so they’re in a better position to improve quality and, ultimately, transform healthcare.

6 Steps for Implementing Successful Performance Improvement Initiatives in Healthcare (Executive Report)

A systematic approach to performance improvement initiative includes three components:  analytics, content, and deployment. Taking six steps will help an organization to effectively cover all three  components of success. Step 1: Integrate performance improvement into your strategic objectives. Step 2: Use analytics to unlock data and identity areas of opportunity. Step 3: Prioritize programs using a combination of analytics and a deployment system. Step 4: Define the performance improvement program’s permanent teams. Step 5: Use a content system to define program outcomes and define interventions. Step 6: Estimate the ROI.

Why Healthcare Requires an EDW, Analytics Applications, and Visualization Tools for Quality Improvement Initiatives

Business intelligence may not sound like something that belongs in a healthcare setting. After all, what role can it possibly play in medical excellence and compassionate care? But federal mandates that require cost and care improvement and reporting on those improvement metrics, are driving the need for business intelligence tools. For healthcare, this means an enterprise data warehouse with the processing power and architecture to handle the vast volumes of data, analytics applications that will effectively unlock the data, and data visualization tools to easily illustrate areas of opportunity.

PHI Security and Auditing: Reducing Risk and Ensuring Compliance with a Data Warehouse

EHRs and other electronic health information has created many benefits for patients and the healthcare industry, from improved treatment to reduced duplication of services. However, electronic data also increases the risks associated with PHI. Ensuring compliance with PHI security, including auditing trails, is more important than ever. Breaches constitute a violation of HIPAA and can result in stiff financial penalties and tarnished reputations. Health Catalyst addresses security compliance using a multifaceted solution that ensures the right balance between having enough granularity of information available to the people who need it and securing that information from people who don’t need that level of detail.

A Guide to Successful Outcomes using Population Health Analytics (White Paper)

There seem to be a lot of definitions for population health management and population health analytics. But all these definitions share one thing: outcomes. The goal is to provide quality care outcomes with good patient experience outcomes at a low cost outcome. So, how can organizations systematically improve their outcomes? The answer lies in three key questions: What should be done to provide optimal care? How well are those best practices being followed? And how do those best practices move into everyday care for patients? Using a systematic approach to answering these three questions will lead organizations toward becoming an outcomes improvement machine.

The Real Opportunity of Precision Medicine and How to Not Miss Out

Precision medicine, defined as a new model of patient-powered research that will give clinicians the ability to select the best treatment for an individual patient, holds the key that will allow health IT to merge advances in genomics research with new methods for managing and analyzing large data sets. This will accelerate research and biomedical discoveries. However, clinical improvements are often designed to reduce variation. So, how do systems balance tailoring medicine to each patient with standardizing care? The answer is precise registries. For example, using registries that can account for the most accurate, specific patients and disease, clinicians can use gene variant knowledge bases to provide personalized care.

The Changing Role of Healthcare Data Analysts—How Our Most Successful Clients Are Embracing Healthcare Transformation (Executive Report)

The healthcare industry is undergoing a sea change, and healthcare data analysts will play a central role in this transformation. This report explores how the evolution to value-based care is changing the role of healthcare data analysts, how data analysts’ skills can best be applied to achieve value-based objectives and, finally, how Health Catalyst’s most successful health system clients are making this cultural transformation happen in the real world.

Comparing the Three Major Approaches to Healthcare Data Warehousing: A Deep Dive Review (White Paper)

The task to improve healthcare presents a significant challenge to providers, health systems, and payers. But according to the Institute for Healthcare Improvement, if health systems focus on achieving the objectives of the Triple Aim, they will be able to meet the ongoing government mandates to improve care. A key component for meeting the Triple Aim will require the ability to overcome the current data warehouse challenges the healthcare industry faces. Because of constantly changing business rules and definitions, health systems need to choose a data warehouse that’s able to bind volatile and nonvolatile data at different stages rather than the early binding approach that’s inherent with traditional data warehouses. The best type of healthcare data warehouse should offer a late-binding approach, which will provide the following critical characteristics: data modeling flexibility, data flexibility, a record of changes saved, an iterative approach, and granular security.