Data-Driven Decisions and the Learning Health System

learning-health-systemAs a healthcare leader trying to navigate the path to patient-centered, quality-focused care, you’re doing your best to drive change through your organization. But invariably you run up against the constraints of an industry model that hasn’t caught up with the aspirations of population-wide health. That’s the dilemma that Dr. John Chessare, CEO of Greater Baltimore Medical Center (GBMC), described at a recent conference sponsored by the Maryland chapter of the American College of Healthcare Executives.

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Dr. Chessare told of imploring his staff to minimize emergency department and hospital utilization by channeling patients to primary care centers; but then walking by the nearly empty ED and realizing that the revenue necessary to finance GBMC’s progressive advanced primary care centers was actually dependent on a busy ED. “The payment system needs to catch up with the reality of what we actually need to do to reach the goals of the Triple Aim,” he declared, adding, “It’s just not changing fast enough.” Nonetheless, he and other healthcare leaders know they can’t afford to wait for payment reform.

So how do you move forward in spite of the obstacles? (more…)

Group Health Outcomes: Analytics and the Road to Excellence in the Real World of Healthcare

In my last two blog posts, I talked about analytics in the real world of healthcare. The first post discussed how hospitals can reduce quality variation to lower costs, and the second post discussed how hospitals can use analytics to improve surgical outcomes. In the last post of this series, I profile two outstanding examples of how analytics can play an important supporting role in both guiding strategy and achieving operational excellence. Bellin Health of Wisconsin and Atrius Health of Massachusetts are two healthcare providers that have embedded a disciplined, measurement-oriented approach to population health in the operations of their organizations. And both have achieved impressive results to show for it.

Atrius and Bellin are among the success stories of the Pioneer ACO (Accountable Care Organization) program. Each ranks among the 10 Pioneer ACOs that delivered statistically significant savings in both of the first two program years. Even more significantly, they together represent two of the three organizations that accounted for 70% of the Pioneer program’s overall savings. But the Pioneer ACO is just one of many examples of populations that Bellin and Atrius manage.

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4 Ways to Get Started with Population Health

Human resource conceptPopulation health – it seems everyone in healthcare is talking about it, but few have actually done much about it. Population health can certainly seem overwhelming, and as a result, many organizations just freeze and do nothing about it. But like many things in life, with population health, it’s important to work on the little things first in order to make progress on the big initiatives.

So what exactly is population health? Here is a definition from the Institute for Healthcare Improvement (IHI):

Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group. These groups are often geographic populations such as nations or communities, but can also be other groups such as employees, ethnic groups, disabled persons, prisoners, or any other defined group.”

Improving population health is one of the three goals of the IHI’s Triple Aim, which seeks to:

  • Improve the patient experience of care
  • Improve population health
  • Reduce the per capita cost of healthcare

The IHI believes that all three of these must be done in conjunction with each other to optimize health system performance.

If you are looking to embark on a population health initiative, here are 4 small ways to get started that can serve as the initial steps for a larger initiative. (more…)