Whilst the German health care system has only been slowly heading towards Health 3.0, other countries are already taking the next step on their digital journey. In Great Britain and Sweden, Cerner’s HealtheIntent® platform has been integrated into successful projects, which are intended to improve health care in a completely innovative way, allowing health and care providers to Know their citizens, Engage with them, and Manage their outcomes and improve their health.
Ten projects currently being introduced throughout Europe
Sarah Peuling is a sales consultant for population health at Cerner and provides a brief overview on the current status. She says, “A total of ten population health projects are currently being implemented across Europe, with Cerner’s data intelligence and HealtheIntent platforms playing a significant role. There are nine projects being realized in Britain and one in Sweden; the projects in England are of particular interest since some of them are already well advanced at local, regional and national level.”
Sarah Peuling, sales consultant for
population health management at Cerner
For many years, Britain has been discussing how health care management could be improved. At the request of NHS England, the public body that leads the National Health Service and oversees the planning, funding and delivery of health care provision, and in cooperation with its partners OptiMedis-COBIC and NEL CSU, Cerner was charged with creating a national dashboard. It is intended to allow for the monitoring of any activities performed within the health care sector for the purpose of drawing conclusions on opportunities for improvement and to realize such potentials in regional projects. To this end, Cerner relies on its renowned HealtheIntent platform, which has successfully been implemented at more than 140 client sites within the USA.
This platform is not only used to merge and analyze data, but also to promote data output in the form of clearly structured reports and performance indicators. Peuling states, “We should not underestimate the challenge we face. To manage population health comprehensively, a considerable amount of data stemming from various areas must be prepared in such a way that this data can actually be used. Additionally, results must be presented in an organized manner. All in all, we are talking about utterly diverse data, including service data, financing data or even treatment results.”
Analysis at the national, regional and local level
An additional requirement is that conducting analysis must be possible at different levels: from the national or regional level to health care service providers and defined patient cohorts. For this purpose, data stemming from various sources is loaded to HealtheIntent. Such data is sanitized, normalized, standardized and subsequently aggregated to create a longitudinal patient data record. Data is then analyzed using intelligent algorithms; data output occurs in the form of reports, dashboards and other visualizations. Data that has been merged on HealtheIntent may not only be provided to physicians at cohort levels, but also to individual patients (‘Know’), by integrating such data into the caregivers’ workflow to improve medical care.
Referring to the project in Lewisham, south-east England, Sarah Peuling illustrates how the solution works: “The platform is integrated into information systems of affiliated clinics or hospitals. Therefore, instead of increasing the workload for the staff by requiring them to provide the data needed for analytical purposes, the solution allows such workloads to be reduced; the platform may be used for exchanging data arising in the context of treatments. In due consideration of all applicable laws governing data protection, treatment data is transferred to HealtheIntent, where statistical analyses on a patient’s medical history are created. Additionally, information relevant to a patient’s treatment is generated on this platform, including analysis related to cohorts, such as specific categories of pathologies, defined regions or analysis based on integrated predictive algorithms. Unlike other systems, the remarkable characteristic of this structure is that analyses are available almost in real time, which makes them highly relevant.”
As the consultant continues to explain, up-to-date data is particularly important, as this information is integrated into a patient’s treatment process directly: “Data is prepared in such a way that the medical staff can rely on this data for treatment purposes at the point of care (‘Engage’). This allows for the identification of patients with certain diseases or risk profiles, and allows for standardized treatment and care management for a patient, thereby improving care. For instance, patients can be informed that a medical check-up is pending or that relevant vitals must be monitored regularly (‘Manage’). The attending physician receives this information, which they would otherwise be required to obtain manually; it goes without saying that patients benefit from this form of health care that is individually personalized.”
The crucial difference: HealtheIntent’s interactivity
The last point, in particular the capability of providing precise information relevant to individual patient care, illustrates HealtheIntent’s distinguishing feature and how this differentiates the platform from the solutions of other competitors. “Almost all solutions that I can think of are restricted to analyzing data solely statistically, or fail to display data in a clearly structured manner. HealtheIntent goes significantly further by processing data related to treatment processes and is then accessible to health care providers or the patient,” states Peuling. While this may still sound a little conceptual in Germany, Wirral in north-west England has already taken the next step with 50 GP practices and one hospital connected to a network that pulls data for analytical purposes from HealtheIntent.
“Experiences gained within this project demonstrate that physicians working in these institutions suddenly have a significantly wider perspective,” according to the population health consultant. “Not only do they have a view of individual patients, but of an entire region. Let’s take another look at Wirral: depending on where patients live within the borough, their life expectancy differs significantly with a disparity of up to 12 years.
Such statistical information, which seems comparatively immaterial, gains new importance when physicians are provided with information on existing diseases, and at the same time are able to generally order more thorough health examinations than for patients from a cohort, whose risk structure is different. This way, not just therapy can be managed more accurately, but also prevention measures.”
Creating the preconditions for improved health care
Sarah Peuling has frequently been confronted with substantial concerns related to data protection. In Germany, the subject of data protection and the concern of the inadequately developed IT infrastructure is of key importance in many discussions. For her, these concerns do not contradict the approach of implementing solutions for population health: “EU requirements on data protection are highly demanding. For projects in Great Britain and Sweden, Cerner must comply with these requirements. Cerner is pleased to announce that all obligations have been fulfilled. Naturally, there may be country-specific questions on the interpretation of the provisions of the Data Protection Regulation; we have to take into account, however, that there will be no way around population health management, if we want to continue to establish an affordable, powerful health care system in the future which is focused on optimal, preventive patient care. Other European countries have demonstrated that this approach works well and ultimately benefits every party involved: local communities benefit from lower costs and the individual from improved care. We should strive towards this direction, set the stage and realize population health step by step. In particular, Germany – with its federal health care system – could benefit substantially from this way of proceeding. HealtheIntent could contribute significantly to abstracting data silos, allowing for data to be not only exchanged, but also to be analyzed, which would constitute a major step towards a higher degree of prevention and affordable care of increased quality.”