Population Health Is More Than Just A Buzzword

At Health IT Outcomes, we’ve made it our mission to provide the healthcare industry with expert guidance on technology system selection, integration, project management, and change management. To help achieve this goal, we speak with industry leaders on everything from EHRs to HIEs to HIM, and then share these conversations with you. We recently travelled to Chicago to attend HIMSS15 where we had the privilege to speak with Caradigm’s VP of Population Health Brian Drozdowicz about the company’s approach to population health and the overarching strategies and principles which drive its technology platform.

Health IT Voices: Tell us a little about yourself and provide a brief overview of what Caradigm brings to the healthcare market.

Drozdowicz: I’m a lifetime health IT guy having spent 10 years or so in perioperative, critical care, and emergency department automation. I had the opportunity to come over to Caradigm about three or so years ago based on growth in population health. I thought it was something super interesting, made the jump, and am very happy that I did.

One thing that makes Caradigm unique is that we are exclusively focused on the population health market. We bring to the market an enterprise class population health management platform supported by quite a few different applications on top of that platform.

So at the basis, if you think about the challenge of managing a large, clinically-integrated network across a pretty broad geographic area, the one problem most of these ACOs have in their early days is managing data from so many different, disparate sources. That really is the secret sauce to what we do and we brought into the organization a really robust, sophisticated data management platform. So we’re able to bring data in from payers, providers, pharmacies, labs, the government, and more.

We normalize and standardize that data and really mature it and bring it all to the same level playing field so that we can then drive a series of analytics and applications that sit on top of that. We have a pretty deep selection of analytics to help assess a provider in an at-risk situation as well as some really deep clinical work flow tools with our out-patient care management tool.

Health IT Voices: Big Data and analytics are crucial parts of the patient care process and it’s critical to not make them more complex for either the physician or the patient. What are some of the best practices Caradigm recommends in terms of taking this technology and integrating it into practice and what results can come of implementing them?

Drozdowicz: Most of the customers we’re working with today have spent the past several years spending a whole lot of money on their EMR deployments and have successfully gotten through those. If you look at the technology that’s required to be successful in population health, it’s far more complicated from a data requirement standpoint. Having the expertise and the support from both the IT side as well as the clinical side to get that data and pull it together is very important.

It’s really early times for those of us focused on this market, but one of the core tenants of accountable care is to both improve outcomes as well as reduce cost. Because it’s so early, we’re certainly seeing far more advancements in declaring cost savings. The fact of having this integrated enterprise suite that pulls everything together and is highly automated means skilled workers — whether IT or clinical informatics — are able to focus on higher value activities.

Just a really simple example: One of the customers we’re working with, prior to implementing our solution, was using an excel spreadsheet to perform their own risk assessment based on algorithms they dreamt up on their own and were fine tuning with each point in time. We were able to introduce automation, crunch the data, and the resulting algorithm has their outputs that get injected right into the care management workflow. If you think about the efficiency that brings and the opportunity cost of being able to have that skilled worker, whether IT or clinician, focus on a higher value activity. That is something that is very important to them.

I would say the one other area where we are seeing savings is one that may not be obvious to most is the amount of time to on-board somebody such as an out-patient care manager when they’re hired into a provider organization. So many of the customers that we’ve been working with, their out-patient care managers might have ten or twelve different solutions. They need to come up to speed on every one of those different solutions, create logins, get trained on them, and get certified on them. However, we’re bringing one comprehensive set of applications that are well integrated. The time for them to on-board is drastically shorter learning one solution versus a dozen, obviously.

Health IT Voices: Monitoring and treatment of chronic diseases is a big part of that cost implementation. How does Caradigm approach that and what areas do you continue to evolve in that particular area?

Drozdowicz: Our solution set has a full content library that manages about 30 different chronic diseases; a really interesting concept with most of our customers as they’re stepping into this world of managing patients at risk. They all have different flavours on how they actually want to treat those different chronic populations so we start with our standard content set that we’ve built over the past couple of years and we work with them to finely tailor that to their needs whether that’s something like congestive heart failure or COPD or even transitions of care.

One aspect we found very important as we build up this and manage this content library is having strong analytics to be able to assess how they’re actually treating these patients with these different conditions. So packaged in with the solution is a set of analytics that will help to assess how they’re treating COPD, CHF — all those high cost conditions.

Also bundled with that is a set of tooling which allow them to evolve that content over time to be able to offer different things in care plans, different interventions and that sort of thing. There really isn’t a proven model for this yet, so the ability to adapt and evolve over time is very important.

Health IT Voices: What critical advice would you offer to that provider who is beginning down that path towards population health?

Drozdowicz: Many of the customer situations that we’ve been brought into have some point solutions installed already. If you look at your average provider that’s stepping into these risk based scenarios, it’s only maybe 5 percent of their total revenue to manage this at-risk population. Because of that, they’re not dedicating a lot of resources to getting these solutions up and running. But, they see three or four years down the road, if they’re at 5,000 patients at risk today, they may say, “Oh we’re going to be at 100,000 or 250,000 down the road.” That point solution they’re installing today isn’t going to scale.

We’ve worked with many facilities, replacing these point solutions which have been in place for only a short period of time but have been identified as having major deficiencies when you look at the scale. So I would certainly say take the long view and make sure you understand as you get into this world that you’re investing in something that’s going to change and adapt as your business does.