My population health HIMSS17 experience

Population Care Management Symposium 

The Population Care Management Symposium on Sunday provided insights from a number of varied perspectives.

The BCSC S. Carolina CMIO, Dr. Gowtham Rao, re-introduced the definition of Transtheoretical Model of Change:  a continuum of unhealthy patients evolving from pre-contemplation of a lifestyle change to contemplation, preparation, action and lastly, maintenance when the behavior change becomes ingrained in their lifestyle, monitored by the care coordinator.   In my experience, behavior change is one of the hardest metrics to modify due to the various modes of patient engagement necessary to do this;  thus of particular interest for me.

Steve Allegretto, the VP of Value Innovation, Yale New Haven HS shared a study on $60K hip replacement bundles where cost was under $60K in 19 of 32 cases; “the white space below the line provided payment for doing no work”.  This demonstrates the huge upside to implementing best practices and incentives for reduced surgical site infection to increase revenue without increasing cost of care.   I have seen many new clinically integrated networks (CINs) experience rising costs because the value proposition is not present.  Bundling when the provider service is recognized as a center-of-excellence for a service improves all measures of the quadruple aim.

The Intermountain Health CMIO, Brent Wallace, MD, presented standards and described a potential future of vendor EMRs sending data utilizing Fast Healthcare Interoperability Resources (FHIR).  This data is accepted by a data warehouse repository which then presents the data in a standardized format.  The interoperability supports smart-phone app use or use within the EMR.   FHIR is gaining industry traction as evidenced by its adoption by several major vendors.  I asked many vendors in the exhibit hall about FHIR as it seems promising and most have or are beginning to adopt it.

Exhibit Hall 

I participated in a telehealth demo; the derma scope attached to the medical kiosk was of extremely high quality and is currently in use in a Louisiana hospital supporting virtual visits.  Expansion in this area will greatly assist patients especially of Medicaid and Medicare with transportation challenges that impact these populations.

There was a demonstration of virtual reality binoculars used to aid in pain management by focusing the patient on a virtual alternative relaxing experience.  A health system currently employing this innovation has successfully reduced pain scores in the hospital from 5.4 to 4.1.  I wondered if this therapy might provide “drug abusers” an alternative.

If you haven’t attended, I encourage you to go to HIMSS18 in Las Vegas!

About the author: James Wray, a member of HIMSS and the Louisiana Chapter (LAHIMSS) retired recently from service with the Louisiana State Government. Jim now focuses on population health; value based care. Jim spent several years over-seas, providing him a unique understanding of healthcare delivery on a global level.