The laboratory is a key ancillary with a large amount of data that can be incorporated into population health management (PHM). With an understanding of PHM, the lab can play a more active role in communicating results and coordinating care. The lab is the “gatekeeper” for patient data that can identify patient populations that can benefit from screening tests or require chronic disease monitoring.
Going Beyond Your EHR: Understand the Specific Tools Needed for More Effective Population Health Management
Population health management (PHM) requires both human interventions and effective, interoperable health information technology (HIT) tools. HIT tools are imperative to house the data and perform the analytic tasks necessary for efficient PHM. HIT tools are also necessary to identify and stratify patient groups, generate alerts or messages that communicate with providers and patients, and perform follow-up metrics to analyze progress (see Figure 1). Interoperability among HIT tools is vital to promote data sharing across healthcare organizations (HCOs), allowing for analytics on a broader scale.
Today’s healthcare system is focused on care across the entire care continuum, including efforts to engage patients in care decisions, with the goal of proactively improving the health of the entire patient population. Population health management (PHM) programs are used to identify and improve the health of specific groups of patients. Using PHM, healthcare organizations (HCOs) can identify and understand their specific members’ diagnoses and needs, make appropriate interventions, and measure the effectiveness of outcomes.