Turning Analysis into Care Management Action

When you’re managing population health, you need analytics to harness data so you can better understand your outcomes and identify patterns of causality. This is especially important when evaluating how you’re doing with patients who have complex issues, behavioral health conditions, and/or social determinants that materially impact their health. Can your tool analyze how your care management is performing and turn that analysis into action to improve how you manage care?

Typical analytics-first tools stratify risk, identify and track cohorts, and assess results—providing information that is important, but insufficient because it doesn’t address what to do if those outcomes are not what you want. The only way to improve is to have visibility into the success of the activities you perform to manage your population, not just the outcomes of those activities. The insight into those activities—at a level of detail that enables measurement—will help you figure out what actions are the most effective in making your population well.

Put another way, most outcome measures focus on clinical conditions and utilization, relying on clinical or claims data to assess what has happened and give insight to support improvement. Without knowing what those activities are and measuring them, you can’t know what permutations of those activities are the most effective.

Analysis that measures the non-medical activities that go into delivering care—i.e., how much the care management process contributed to the outcome—can’t typically be performed based using traditional data sources such as EHRs and claims that provide information about the patient, the patient’s condition, procedures performed, and payment factors. No matter how much number crunching analytics vendors perform, they can’t work with information they don’t have.

That’s where GSI Health comes in.

Care coordination data is where we shine. Our entire platform is oriented around what people who are caring for a population have to do to be successful—all activities, not just medical activities. We believe that by optimizing the work, the outcomes will be better. We can zoom in to isolate and evaluate a care management process so that you can tune the activities that surround medical care. These activities yield a different kind of data—data that enables you to assess your work and optimize your processes outside medical treatment so that the outcomes of that work can be the best they can be.

This approach is in harmony with the analytics most organizations are doing today, i.e., creating and prioritizing cohorts to focus on, and measuring the outcomes for those cohorts based on the medical activities performed. Care coordination analytics augment this picture by focusing on the activities that remain unanalyzed. Our care management scorecards and dashboards can be configured to provide care management reporting and tracking on care management outcomes, program insights, and episode activities specific to an organization’s program and strategic objectives. We can also exchange data with analytics tools for additional analysis, or analytics tools can contribute outcomes that we use for a more comprehensive correlation of how care management processes contribute to outcomes.

In the arc of value-based care realization, relying on outcomes as proxies for insight on how to improve is a self-limiting strategy. To move beyond score cards into improvement plans, your analytics need to explicitly account for the work being done.

Learn more about how to gain insight from care management data

Beyond the EHR—Creating an Integrated Population Health Management Strategy

In recent years, the industry has focused a lot of attention on using the EHR as the center of today’s healthcare delivery. While EHRs add value at the point of care, enabling caregivers within a care setting to chart and manage patient information and to administer organizational operation, we can’t stop there. Extending the applicability of the EHR through other population health management solutions will help us look beyond the point of care to get to the real goal—improving how we manage patients—by focusing on the between-care activities and settings to significantly impact patient outcomes. This approach will help us bridge the gaps and pull the maximum value from the EHR in the larger picture of longitudinal care.

Read more “Beyond the EHR—Creating an Integrated Population Health Management Strategy” >