February 25, 2013

Making an investment in population health management

As you’ve probably read, today we announced our intentions to acquire a company called PureWellness. Co-founders Ken Kaufman, Ron Keen and the rest of their team have developed a remarkable online health and wellness platform available to millions of individuals across the United States, and we couldn’t be more excited to work with them moving forward.

As new reimbursement models emerge, the individual will play an increasingly important role in health care ecosystems around the world. Organizations are realizing they will need to shift their focus from what we’ve referenced as “sick care” to a model that prioritizes keeping healthy people healthy and helping people with illnesses manage them better. Part of that involves providing them with tools that facilitate engagement with the various aspects of their health and care, and we think the combination of our Millennium solutions and Healthe Intent platform with PureWellness’ engagement platform creates the most comprehensive set of capabilities on the market to support an individual’s health and care needs. Individual engagement is an important piece of a comprehensive approach to population health management, a concept we see playing a vital role in the evolution of health care.

Neal and others here at Cerner have spoken repeatedly about how digitizing hospital systems is just the first step in the journey to transform health care. Digitization enables the second- and third-order effects that start to drive true transformation in health care. In this post-EHR world, where sophisticated organizations have already made the major step of removing most of the paper from their processes, the new challenge is how you realize benefits for your organization, patients and membership. Population health management has become an imperative for health care organizations driven by extreme market pressures to achieve better outcomes with less overall spend. This story is unfolding around the world, thanks to a series of common market pressures.

How organizations choose to respond to these pressures is where we will see organizations that have a long term vision focusing on the importance of population health management. At Cerner we believe that there is a three-step approach to the creation of high performance health networks in this new landscape:

  • Decrease costs – All organizations will need to focus on continuing to maximize the efficiency and effectiveness of their provider services. There is no alternative to increasing productivity through improved workflow, reduced waste and an greater quality. EHR implementation and the associated process redesign is a critical component of this step.
  • Secure income – In the new world organizations will need to develop more robust service lines that deliver within the the funding available, manage patients within their network of care and ensure that they are optimizing their revenue against the incentives that payers are offering. As they step into the wider challenge of reducing the total cost of healthcare by better population health management, organizations will also need to renegotiate their contracts with their payers to ensure that they are rewarded for doing the "right thing" and their contracts with network of supporting providers to ensure that they are aligned around the same goals. These new challenges are why Cerner is developing its population health solutions and next generation revenue cycle management as part of our Healthe Intent platform.
  • Optimize care delivery – Those organizations that take on the challenge of population health management by managing risk will need to rethink both the role of the hospital and the role of the individual. For example, fewer patients will be managed in hospital, many reviews show that up to 40% of patients in hospital could be managed in a lower cost setting. We are developing the ability to create a managed health network that supports extended care and the medical home through our integrated Healthe Intent platform. This platform will enable evidence-based care and decision support to be provided in the location that is most suitable for the patient, even their own home.

But, more than this, we recognize the need to engage the patient or member in maintaining their own health; this is where the PureWellness platform fits in. The platform will enable us to support individuals directly in reducing their health risks, and managing their chronic conditions. This will empower people to have a higher quality of life and lower costs for the whole health system.

We expect ACOs to adopt the PureWellness platform to help manage their populations, health plans to use it engage their members in reducing health risks and employers to use it to improve the health of their workforce, which will improve productivity and lower health care costs.

With these activities under way, the question shifts to how can a health system use its full, integrated network to drive its population(s) to improved outcomes. We think the answer looks like this:

In short, you need to identify members of a population that may require management of a particular health condition. You also need the ability to predict where health interventions will be effective and attribute that person to the accountable provider(s). Finally, you need to take the appropriate action, measure the outcomes for the person, and manage the effectiveness of the programs well as the performance of the network.

A common saying here at Cerner is that “health care is too important to stay the same,” and I couldn’t agree more. Population health management will be a key driver of the continued evolution of health care around the world, and we’re well on our way to creating the framework our clients need to succeed. The PureWellness platform is a piece of that framework, and one we think will integrate nicely with the solutions we have now and those in development. Ultimately, what we’re creating is a unified platform and executable knowledge that will allow our clients to program their network to deliver team-based care across the continuum in line with the capabilities and objectives of the organization.

To learn more about Cerner's approach to population health management, visit us in booth 4941 at HIMSS13.

Matthew drives Cerner’s population health management strategy development. He brings more than 20 years of health care, technology and policy experience to Cerner, including his work with the UK Department of Health and front-line health sector and leadership experience at Royal Surrey County Hospital.