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by Jagwant Grewal
Published on 9 June 2017

In part two of his population health series, Jag Grewal discusses the importance of ‘know, engage, manage’ and how HealtheIntent® makes it all possible.

While the term population health is becoming commonplace, it lacks a uniform industry agreed definition. As such, its huge potential to impact change can be misunderstood or misrepresented.

Population health is more than simple information queries and analytics – to make a real difference it must provide actionable outputs and clinical recommendations for proactive healthcare.

A powerful intelligence platform layered across the health system can interpret and analyse many data sources and apply clinical recommendations at both person and population level to inform commissioning and care decisions.

The right intelligence platform is part of the solution, but we believe that in order to deliver ‘true’ population health management, health organisations and their partners need to be able to ‘know’ their populations, ‘engage’ citizens and ‘manage’ outcomes.

Many organisations get stuck at the ‘know’ stage and can only react to patients’ needs, often by relying on a health information exchange which, while an important enabler at point-of-care decision making, is a long way from a comprehensive vision of population health, as mentioned in part one of this blog series.

A platform for the future

To connect care, health organisations and their partners across the health economy will need to invest in intelligent and flexible big data solutions designed to enable the management of a network of care, and work with a partner with population health platform and tools and expertise to meet ambitions.

Engaging the person requires organisations to leverage these tools and connect the person and organisations across the health economy. Sharing information with the individual so that they can be part of the care team is key to both engagement and management to drive healthy outcomes. This engagement allows the person to be part of their wellbeing and allowing people to take greater responsibility for their own health and wellbeing.

Case study: Advocate Physician Partners

The largest Medicare ACO in the US had the goal of creating the technology infrastructure to enable enterprise-wide change. It did this by implementing an integrated, comprehensive strategy to support value-based healthcare delivery.

The unique partnership between Advocate and Cerner with innovation at its core seeks to fundamentally shift the healthcare business model to provide new focus on proactive population health and clinical efficiency. A shared goal of leveraging Advocates experience as a provider as well as Cerner’s experience in health care technology and automation to has led to a development partnership that is improving population health capabilities for both Advocate, and other Cerner clients around the globe.

This now covers 865,000 at-risk covered lives within HealtheIntent across 12 facilities, served by over 5,000 care professionals. Results are positive too, with an asthma control rate of 76.5 percent – 26 percent above the national average – and a 33 percent reduction in high-risk medication use by patients.

“Our strategic partnership with Cerner around population health and big data has allowed us to build one of the most impressive data warehouses of clinical, claims and demographic data across the continuum of care” said Rishi Sikka, MD, senior vice president of Clinical Transformation, Advocate Health Care.

Want to discover more about population health management? Discuss it with Jag today via