Physician Data Analytics – Challenges and Tips for Deployment (Part 1 of 2)

By Richard Howe, PhD, Executive Director, North Texas Regional Extension Center

Over the last 3 months, I discussed how the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) legislation, Merit-Based Incentive Payment System (MIPS) for physicians, Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (VBPM) and meaningful use (MU) will become integrated into a single program. This legislation is part of the Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) goals of moving to a value-based model of care. All of these changes will require using your electronic health record (EHR) to support population health management (PHM) functions.

A recent article in Healthcare IT News (09/14/2016) discussed how the efficiency of any PHM program relies on the ability of the caregivers to leverage population data. This may be an obvious statement, but in reality is difficult to do.

Key adoption challenges
Advanced population health analytics (PHA) solutions are still in the early stages of adoption. Some of the key challenges for adopting these analytics programs include:

1. Getting the data in one place.
Major data challenges to getting the data in one place include:

• Aggregating data from diverse sources into one place.
• Need to standardize large unstructured datasets.
• Lack of clean, normalized data in EHRs.
• Significant effort to address issues like reconciliation, eliminating duplicates, interfacing and patient matching.

Providing a single source of truth for analytics applications is key for effective use. Data needs to be aggregated from diverse sources such as personal health records, consumer health applications and de-identified databases without disrupting the care management workflow. As an industry, we are not there yet, but moving in that direction.

2. Building collaborative processes across the care continuum
This requires a robust health IT infrastructure to collect, process and share information from different providers, patients, payers, public health agencies, home care, labs and other stakeholders.

3. Addressing care delivery team challenges
A PHM program relies on the ability of care givers to leverage population data to make informed decisions while in the process of seeing patients. To make PHM work, practices will need to redefine caregiver roles across the continuum of care and design ways to most effectively assign staff based on their highest licensure level to manage their patients.

Next month I will present some of the deployment tips for PHM.