essentials of population health - tmc houston choices (disease, regional focus) • develop list of...
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EssentialsofPopulationHealth:Whatisit?
JimLangabeer,EdD,PhDProfessor
EmergencyMedicine, Informatics,andHealthcareManagement
June8,2016
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DilbertonPopulationHealth
Source:ScottAdams/Dilbert
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SoManyBuzzwords…
PredictiveAnalytics
BigData
Interoperability
mHealth
ValueReimbursement
RiskManagement
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Population+Health
Population:agroupofpatientswithsomecommoncharacteristics
Health:completestateofwell-being;notonlytheabsenceofdiseaseorpain
Improvingthehealthneedsofadefinedgroupofpeople
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DefiningPopulationHealth
• “thedistributionofhealthoutcomes withinapopulation,thedeterminants that
influencedistribution,andthepolicies/interventions thataffectthem…”
(Nashetal,2016)
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DefiningPopulationHealth
• Targetedinterventionsthatimprovethehealthoutcomesandthedeterminantsofthese
outcomes(medical,societal,behavioral,other)foraspecificgroup
(Kindig etal,AJPH,2003)
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PopulationHealthHasShifted
• Original:emphasisoneconomic tradeoffsbetween$andOutcomes(PublicHealth)• Now: socialdeterminants,healthdisparitiesandimproving‘cost/health/care’equation(Clinical)• TransitionfrompurepublichealthdefinitiontomoreClinicalPopulations
• “Allpopulationhealthprogramsshouldfostercollaborationbetweenclinicalprovidersand
community/publichealthagencies”(HackerandWalker,AJPH,2013)
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ORGANIZEAssemblediverseCommittee
fromallSchools
BASELINEMEASUREMENTIdentifyfacultycapacity
(currentprojectinventory)andDataResources
IMPLEMENTMeasureOutcomes,Finalize
PlansandFunding
ANALYZEGenerateandEvaluate
StrategicChoices(disease,regionalfocus)
• DevelopListoffacultyandclinicianswithPopHealthfocus
• Createaneeds/inventorysurvey
• DevelopListofDataResources• SummarizeProjectInventory• MeetandIdentifyAlternative
PopulationProjects
• ImplementauniqueClinicalprogram• DefinetargetedResearchProjects
• Selectacoresetofpopulationstofocuson• Identifyandpursuefundingopportunities• WorkwithUTSystemforinternalfunding• Structureofongoingprograms
UTHealth– PHPlanningModel
Identify Value Opportunities
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UTHealth
• Wediscoveredthattherewereatleast:• 25facultywithactiveprojectsinPopHealth• $60millionofcurrentfunding• InterestfromallschoolsandacrossallUTcomponents• Collaboratorsfromdozensoflocalandstateagencies• Focusonmultiplepopulations,regions,anddiseases
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UTHealthProjectsbyConditionFocus
Obesity/Nutrition/PhysActivity
39%
Smoking7%Diabetes
1%Cardiovascular
Disease6%
Homelessness7%
SubstanceAbuse…
Environ.Factors7%
MentalHealth6%
Cancer8%
Womens/ReproductiveHealth
9%
Other8%
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PopulationHealthManagement
Adherence;Follow-up
Who?What?Where?When?
MobileApps;Social
networking
Istheinterventionworking?
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ClinicalPHM
• Focusonfindingrevenueopportunitiesorvaluefromaccountablecareorganizations(ACO)orpayers• WorkswellinlargerintegratedsystemsorACOswithfinancially-vestedcliniciansandlargepatientpopulations• Ex:targetingcardiovascularpatientsforpost-dischargeprimarycarefollow-upspriortosecondaryarrivalinanED• PayersseevalueinreducingavoidableEDvisitoradmissions
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PlethoraofPopulationHealthVendors
Source:KLASRankings,2016;PopulationHealthManagement2015:HowFarCanYourVendorTakeYou?
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PharmacistsPlayImportantRole
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SummaryPoints
• Medicationsarecriticalcomponentofcareforhighandmediumriskpatientpopulations• Readmissions,medicationerrors,polypharmacyallissuesforpopulation healthinterventions
• Likelydozensofprojectsgoingonaroundyou,althoughlikelywithdifferentnames• Pharmacistsplayakeyroleasmedicationexpert,healthcareprofessional,andcaremanager