Population Health: Our lives, Our data

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By Bernadette Keefe MD

On July 16th 2015 I had the pleasure of being on a panel discussing Population Health Management with eloquent, smart colleagues: Dan Munro (@danmunro) Janice McCallum (@janicemccallum), Deryk Van Brunt (@HCI_Solutions) and Justin Lanning (@LanningHlthcare). It was a fascinating wide ranging discussion covering the definition of population health, the mechanisms and strategies of population health management (including the overriding importance of data collection/analysis and practicing medicine/providing healthcare in teams), the value of universal medical coverage (despite ACA still too many uncovered), issues around security and privacy of data and the lack of health information technology standards and EHR interoperability (need for a patient identifier), patient empowerment and access to records and relevant health data to enable better self care, issues regarding the social determinants of health and examples of strategy/success stories, incentives and tools for value based care and optimal outcomes, the challenges of behavioral/ lifestyle change, health literacy and patient engagement, the importance of context to better treat patients and obtain improved outcomes, the role of community in population health and the utterly unsustainable level of cost of healthcare in the U.S., among other topics.

 

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The 100 Year Lifespan.

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The quality, not the longevity, of one’s life is what is important.

– Martin Luther King Jr.

100 Year Lifespan: The coming reality

The 100 Year lifespan is coming. As of 2014 there were 72,000 centenarians (U.S.) and projections of as many as 1 million by 2050. In the industrialized world, people over 90 years of age are the fastest growing segment of the population. By the end of this century the average life expectancy is expected to be 100 years. Notably, Japan’s centenarians, who number about 30,000, have quadrupled in the last 10 years.

Now there are 43 Million Americans over age 65 years age. By 2050 that number is expected to rise to 108 million. The number of those over 85 years could increase five-fold by that time.

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population health: that means us

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Population Health: ACA and ACOs

Population health has become the lynchpin of healthcare delivery in the United States, especially since the passage of the Affordable Care Act (ACA) in March 2010. (This law was passed due to the unsustainable costs of US health care coupled with less than stellar population health outcomes in the US.) A key way the ACA proposes to reduce health care costs is through the formation of Accountable Care Organizations (ACO). These are networks of doctors, hospitals, and ancillary health care providers who form networks to coordinate patient care and share financial and medical responsibility for that care. Required by ACOs is coordination by primary care physician, care of Medicare patients, and answering to multiple measures of quality. Providers get paid more for keeping their patients (their local population) healthy and out of the hospital.

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joint clinician/patient EHR

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Question number 4 for our “20 Questions for Health IT” project. Please comment in the comments section or on twitter using the #20HIT tag. View the other questions and comments here 

Question from Bernadette Keefe, MD:

How can an electronic health record (EHR) combine the formal record from clinicians with the patient’s ongoing chronicling of their health status? Continue reading

unstructured data: the star waiting in the wings

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Data-filled electronic health records hold the promise of predictive, personalized medicine and improved population health. Up until now, much of the data retrieved from records is structured data, information recorded in specific data fields. However, the total amount of structured data accounts for as little as 20% of the EHR with as much as 80% of EHR data unstructured. For example, all MD and other health care provider notes anhd all written reports accompanying examinations (e.g., radiologic data) is unstructured data. Continue reading