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Can Providers Survive If They Don’t Get Population Health Management Right?

Posted on August 27, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Most providers know that they won’t succeed with population health management unless they get some traction in a few important areas — and that if not, they could face disaster as their volume of value-based payment share grows. The thing is, getting PHM right is proving to be a mindboggling problem for many.

Let’s start with some numbers which give us at least one perspective on the situation.

According to a survey by Health Leaders Media, 87% of respondents said that improving their population health management chops was very important. Though the article summarizing the study doesn’t say this explicitly, we all know that they have to get smart about PHM if they want to have a prayer of prospering under value-based reimbursement.

However, it seems that the respondents aren’t making nearly as much PHM progress as they’d like. For example, just 38% of respondents told Health Leaders that they attributed 25% or more of their organization’s net revenue to risk-based pop health management activities, a share which has fallen two percent from last year’s results.

More than half (51%) said that their top barrier to successfully deploying or expanding pop health programs was up-front funding for care management, IT and infrastructure. They also said that engaging patients in their own care (45%) and getting meaningful data into providers’ hands (33%) weren’t proving to be easy tasks.

At this point it’s time for some discussion.

Obviously, providers grapple with competing priorities every time they try something new, but the internal conflicts are especially clear in this case.

On the one hand, it takes smart care management to make value-based contracts feasible. That could call for a time-consuming and expensive redesign of workflow and processes, patient education and outreach, hiring case managers and more.

Meanwhile, no PHM effort will blossom without the right IT support, and that could mean making some substantial investments, including custom-developed or third-party PHM software, integrating systems into a central data repository, sophisticated data analytics and a whole lot more.

Putting all of this in place is a huge challenge. Usually, providers lay the groundwork for a next-gen strategy in advance, then put infrastructure, people and processes into place over time. But that’s a little tough in this case. We’re talking about a huge problem here!

I get it that vendors began offering off-the-shelf PHM systems or add-on modules years ago, that one can hire consultants to change up workflow and that new staff should be on-board and trained by now. And obviously, no one can say that the advent of value-based care snuck up on them completely unannounced. (In fact, it’s gotten more attention than virtually any other healthcare issue I’ve tracked.) Shouldn’t that have done the trick?

Well, yes and no. Yes, in that in many cases, any decently-run organization will adapt if they see a trend coming at them years in advance. No, in that the shift to value-based payment is such a big shift that it could be decades before everyone can play effectively.

When you think about it, there are few things more disruptive to an organization than changing not just how much it’s paid but when and how along with what they have to do in return. Yes, I too am sick of hearing tech startups beat that term to death, but I think it applies in a fairly material sense this time around.

As readers will probably agree, health IT can certainly do something to ease the transition to value-based care. But HIT leaders won’t get the chance if their organization underestimates the scope of the overall problem.

A Missed Opportunity For Telemedicine Vendors

Posted on June 29, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Today, most direct-to-consumer telemedicine companies operate on a very simple model.

You pay for a visit up front. You talk to the doctor via video, the doctor issues as a prescription if needed and you sign off. Thanks to the availability of e-prescribing options, it’s likely your medication will be waiting for you when you get to the pharmacy.

In my experience, the whole process often takes 45 minutes or less. This beats the heck out of having to wait in line at an urgent care center or worse, the emergency department.

But what about caring for chronic illnesses that can’t be managed by a drive-by virtual visit? Can telemedicine vendors play a role here? Maybe so.

We already know that combining telemedicine with remote monitoring devices can be very effective. In fact, some health systems have gone all-in on virtual chronic care management.

One fascinating example is the $54 million Mercy Virtual Care Center, which describes itself as a “hospital without beds.” The Center, which has a few hundred employees, monitors more than 3,800 remote patients; sponsors a telehealth stroke program offering neurology services to EDs nationwide; manages a team of virtual hospitalists caring for patient around-the-clock using virtual visit tools; and runs Mercy SafeWatch, which the Center says is the largest single-hub electronic intensive care unit in the U.S.

Another example of such hospital-based programs is Intermountain Healthcare’s ConnectCare Pro, which brings together 35 telehealth programs and more than 500 clinicians. Its purpose is to supplement existing staffers and offer specialized services in rural communities where some of the services aren’t available.

Given the success of programs that maintain complex patients remotely, I think a private telemedicine company managing chronic care services might work as well. While hospitals have financial reasons to keep such care in-house, I believe an outside vendor could profit in other ways. That’s especially the case given the emergence of wearable trackers and smartwatches, which are far cheaper than the specialized tools needed in the past.

One likely buyer for this service would be health plans.

I’ve heard some complain publicly that in essence, telemedicine coverage just encourages patients to access care more often, which defeats the purpose of using it to lower healthcare costs. However, if an outside vendor offered to manage patients with chronic illnesses, it might be a more attractive proposition.

After all, health plans are understandably wringing their hands over the staggering cost of maintaining the health of millions of diabetics. In 2017, for example, the average medical expense for people diagnosed with diabetes was about $16,750 per year, with $9,600 due to diabetes. If health plans could lay the cost off to a specialized telemedicine vendor, some real savings might be possible.

Of course, being a telemedicine-based chronic care management company would be far different than offering direct-to-consumer telemedicine services on an occasional basis. The vendor would have to have comprehensive health data management tools, an army of case managers, tight relationships with clinicians and a boatload of remote monitoring devices on hand. None of this would come cheaply.

Still, while I haven’t fully run the numbers, my guess is that this could be a sustainable business model. It’s worth a try.

Investors Competing For Health IT Opportunities

Posted on June 28, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that investors are hungry for health IT investment opportunities, in some cases battling competitors for particularly attractive companies. The report concluded that investment firms see health IT as a lower-risk way to get a cut of the healthcare market than other possible targets.

The analysis by Bain & Company, which looks at 2017 numbers, said that the number of health IT investment deals completed last year rose to 32 from 23 in 2016.

The value of disclosed deals fell from $15.5 billion in 2016 to $1.9 billion in 2017. This is not a sign of weakness in the sector, however. The 2016 deals volume was pumped up by two megadeals (acquisitions of MultiPlan and Press Ganey), which were valued collectively at $9.9 billion. Meanwhile, in 2017 only one deal exceeded $800 million.

Deal counts and volume aside, there’s no question that investors are still very interested in acquiring or taking a stake in health IT companies, Bain reports. According to its study, there are many good reasons for their excitement.

“Investors find HCIT target attractive not only because HCIT companies play a vital role in promoting technology adoption in healthcare but also because they bear less of the direct reimbursement and regulatory risk that affect other healthcare sectors,” the report says. “With a limited set of scale assets on the market and corporate buyers willing to pay premiums for those that do become available, valuations remain high and competition intense.”

The report notes that most of the health IT buyouts in 2017 involved biopharma investments, particularly among companies using IT solutions and advanced analytics to streamline development a testing of drugs. Such deals include the buyout of Certara, which offers decision support technology for optimizing drug development, and Bracket, which sells technology for managing clinical trials.

However, investors were also interested in EMR and practice management vendors. Given that just a handful of big vendors block of the market for hospital IT, they looked elsewhere.

In particular, investment firms were interested in consolidating some of the many vendors selling ambulatory care EMRs platforms supporting specialties like gastroenterology. For example, investors picked up a $230 million stake in Modernizing Medicine, which offers EMR and practice management systems for specialties such as dermatology and ophthalmology, Bain said.

In the future, investors will gain interest in revenue cycle management software. In addition to investing in or acquiring RCM tools for providers, investors may target RCM software helping patients pay their bills. For example, private equity firm Frontier Capital bought a majority stake in medical card company AccessOne last year.

Bain also predicts that Investors will pay growing attention to clinical decision support platforms, driven in part by legislation requiring doctors to use clinical decision support tools before ordering complex diagnostic imaging of Medicare patients.

In addition, investment firms are keeping their eye on population health management software vendors. It’s not clear yet which companies will dominate the sector, and how these platforms will evolve, so dealmakers are hanging back. Still, within a few years they may well begin to throw money at PHM companies.

Google And Fitbit Partner On Wearables Data Options

Posted on May 7, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Fitbit and Google have announced plans to work together, in a deal intended to “transform the future of digital health and wearables.” While the notion of transforming digital health is hyperbole even for companies the size of Google and Fitbit, the pairing does have plenty of potential.

In a nutshell, Fitbit and Google expect to take on both consumer and enterprise health projects that integrate data from EMRs, wearables and other sources of patient information together. Given the players involved, it’s hard to doubt that at least something neat will emerge from their union.

Among the first things the pair plans to use Google’s new Cloud Healthcare API to connect Fitbit data with EMRs. Of course, readers will know that it’s one thing to say this and another to actually do it, but gross oversimplifications aside, the idea is worth pursuing.

Also, using services such as those offered by Twine Health– a recent Fitbit acquisition — the two companies will work to better manage chronic conditions such as diabetes and hypertension. Twine offers a connected health platform which leverages Fitbit data to offer customized health coaching.

Of course, as part of the deal Fitbit is moving to the Google Cloud Platform, which will supply the expected cloud services and engineering support.

The two say that moving to the Cloud Platform will offer Fitbit advanced security capabilities which will help speed up the growth of Fitbit Health Solutions business. They also expect to make inroads in population health analysis. For its part, Google also notes that it will bring its AI, machine learning capabilities and predictive analytics algorithms to the table.

It might be worth a small caution here. Google makes a point of saying it is “committed” to meeting HIPAA standards, and that most Google Cloud products do already. That “most” qualifier would make me a little bit nervous as a provider, but I know, why worry about these niceties when big deals are afoot. However, fair warning that when someone says general comments like this about meeting HIPAA standards, it probably means they already employ high security standards which are likely better than HIPAA. However, it also means that they probably don’t comply with HIPAA since HIPAA is about more than security and requires a contractual relationship between provider and business associate and the associated liability of being a business associate.

Anyway, to round out all of this good stuff, Fitbit and Google said they expect to “innovate and transform” the future of wearables, pairing Fitbit’s brand, community, data and high-profile devices with Google’s extreme data management and cloud capabilities.

You know folks, it’s not that I don’t think this is interesting. I wouldn’t be writing about if I didn’t. But I do think it’s worth pointing out how little this news announcement says, really.

Yes, I realize that when partnerships begin, they are by definition all big ideas and plans. But when giants like Google, much less Fitbit, have to fall back on words like innovate and transform (yawn!), the whole thing is still pretty speculative. Just sayin’.

New Study Suggests That HIEs Deliver Value by Aggregating Patient Data

Posted on March 5, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Historically, I’ve been pretty skeptical about the benefits that HIEs offer, not because the concept was flawed, but that the execution was uncertain. Toss in the fact that few have figured out how to be self-supporting financially, and you have a very shaky business model on your hands. But maybe, at long last, we’re discovering better uses for the vast amount of data HIEs have been trading.

New research by one exchange suggests that some of the key value they offer is aggregating patient data from multiple providers into a longitudinal view of patients. The research, completed by the Kansas Health Information Network and Diameter Health suggests that the Qualified Clinical Data Registries promoted by MACRA/QPP could be a winning approach.

To conduct the research, the partners extracted data from the KHIN exchange on primary care practices in which more than 50,000 patients visited toward 214 care sites in 2016 and 2017. This is certainly interesting, as most of the multi-site studies I’ve seen on this scale are done within a single provider’s network. It’s also notable that the data is relatively fresh, rather than relying on, say, Medicare data which is often several years older.

According to KHIN, using interoperable interfaces to providers and collecting near real-time clinical data makes prompt quality measure calculation possible. According to KHIN executive director Laura McCrary, Ed.D., this marks a significant change from current methods. “This [approach is in stark contrast to the current model which computes quality measures from only the data in the provider’s EHR,” she notes.

FWIW, the two research partners will be delivering a presentation on the research study at the HIMSS18 conference on Friday, March 9, from 12 to 1 PM. I’m betting it will offer some interesting insights.

But even if you can’t make it to this presentation, it’s still worth noting that it emphasizes the increasing importance of the longitudinal patient record. Eventually, under value-based care, it will become critical to have access not only to a single provider’s EHR data, but rather a fuller data set which also includes connected health/wearables data, data from payer claims, overarching population health data and more. And obviously, HIEs play a major role in making this happen.

Like other pundits, I’d go so far to say that without developing this kind of robust longitudinal patient record, which includes virtually every source of relevant patient data, health systems and providers won’t be able to manage patients well enough to meet their individual patient or population health goals.

If HIEs can help us get there, more power to them.

Some Of The Questions I Plan To Ask At #HIMSS18

Posted on February 23, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As always, this year’s HIMSS event will feature enough noise, sound and color to overwhelm your senses for months afterward. And talk about a big space to tread — I’ve come away with blisters more than once after attending.

Nonetheless, in my book it’s always worth attending the show. While no one vendor or session might blow you away, finding out directly what trends and products generated the most buzz is always good. The key is not only to attend the right educational sessions or meet the right people but to figure out how companies are making decisions.

Below, here are some of the questions that I hope to ask (and hopefully find answers) at the show. If you have other questions to suggest I’d love to bring them with me to the show —  the way I see it, the more the merrier!

-Anne

Blockchain

Vendors:  What functions does blockchain perform in your solution and what are the benefits of these additions? What made that blockchain the best technology choice for getting the job done? What challenges have you faced in developing a platform that integrates blockchain technology, and how are you addressing them? Is blockchain the most cost-efficient way of accomplishing the task you have in mind? What problems is blockchain best suited to address?

Providers: Have you rolled out any blockchain-based systems? If you haven’t currently deployed blockchain technology, do you expect to do so the future? When do you think that will happen? How will you know when it’s time to do so? What benefits do you think it will offer to your organization, and why? Do you think blockchain implementations could generate a significant level of additional server infrastructure overhead?

AI

Vendors: What makes your approach to healthcare AI unique and/or beneficial?  What is involved in integrating your AI product or service with existing provider technology, and how long does it usually take? Do providers have to do this themselves or do you help? Did you develop your own algorithms, license your AI engine or partner with someone else deliver it? Can you share any examples of how your customers have benefited by using AI?

Providers: What potential do you think AI has to change the way you deliver care? What specific benefits can AI offer your organization? Do you think healthcare AI applications are maturing, and if not how will you know when they have? What types of AI applications potentially interest you, and are you pilot-testing any of them?

Interoperability

Vendors:  How does your solution overcome barriers still remaining to full health data sharing between all healthcare industry participants? What do you think are the biggest interoperability challenges the industry faces? Does your solution require providers to make any significant changes to their infrastructure or call for advanced integration with existing systems? How long does it typically take for customers to go live with your interoperability solution, and how much does it cost on average? In an ideal world, what would interoperability between health data partners look like?

Providers: Do you consider yourself to have achieved full, partial or little/no health data interoperability between you and your partners? Are you happy with the results you’ve gotten from your interoperability efforts to date? What are the biggest benefits you’ve seen from achieving full or partial interoperability with other providers? Have you experienced any major failures in rolling out interoperability? If so, what damage did they do if any? Do you think interoperability is a prerequisite to delivering value-based care and/or population health management?

What topics are you looking forward to hearing about at #HIMSS18? What questions would you like asked? Share them in the comments and I’ll see what I can do to find answers.

Health IT Leaders Spending On Security, Not AI And Wearables

Posted on December 18, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

While breakout technologies like wearables and AI are hot, health system leaders don’t seem to be that excited about adopting them, according to a new study which reached out to more than 20 US health systems.

Nine out of 10 health systems said they increased their spending on cybersecurity technology, according to research by the Center for Connected Medicine (CCM) in partnership with the Health Management Academy.

However, many other emerging technologies don’t seem to be making the cut. For example, despite the publicity it’s received, two-thirds of health IT leaders said using AI was a low or very low priority. It seems that they don’t see a business model for using it.

The same goes for many other technologies that fascinate analysts and editors. For example, while many observers which expect otherwise, less than a quarter of respondents (17%) were paying much attention to wearables or making any bets on mobile health apps (21%).

When it comes to telemedicine, hospitals and health systems noted that they were in a bind. Less than half said they receive reimbursement for virtual consults (39%) or remote monitoring (46%}. Things may resolve next year, however. Seventy-one percent of those not getting paid right now expect to be reimbursed for such care in 2018.

Despite all of this pessimism about the latest emerging technologies, health IT leaders were somewhat optimistic about the benefits of predictive analytics, with more than half of respondents using or planning to begin using genomic testing for personalized medicine. The study reported that many of these episodes will be focused on oncology, anesthesia and pharmacogenetics.

What should we make of these results? After all, many seem to fly in the face of predictions industry watchers have offered.

Well, for one thing, it’s good to see that hospitals and health systems are engaging in long-overdue beefing up of their security infrastructure. As we’ve noted here in the past, hospital spending on cybersecurity has been meager at best.

Another thing is that while a few innovative hospitals are taking patient-generated health data seriously, many others are taking a rather conservative position here. While nobody seems to disagree that such data will change the business, it seems many hospitals are waiting for somebody else to take the risks inherent in investing in any new data scheme.

Finally, it seems that we are seeing a critical mass of influential hospitals that expect good things from telemedicine going forward. We are already seeing some large, influential academic medical centers treat virtual care as a routine part of their service offerings and a way to minimize gaps in care.

All told, it seems that at the moment, study respondents are less interested in sexy new innovations than the VCs showering them with money. That being said, it looks like many of these emerging strategies might pay off in 2018. It should be an interesting year.

The Future Of Telemedicine Doesn’t Depend On Health Plans Anymore

Posted on December 6, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

For as long as I can remember, the growth of telemedicine depended largely on overcoming two obstacles: bandwidth and reimbursement. Now, both are on the verge of melting away.

One, the availability of broadband, has largely been addressed, though there are certainly areas of the US where broadband is harder to get than it should be. Having lived through a time when the very idea of widely available consumer broadband blew our minds, it’s amazing to say this, but we’ve largely solved the problem in the United States.

The other, the willingness of insurers to pay for telemedicine services, is still something of an issue and will be for a while. However, it won’t stay that way for too much longer in my opinion.

Yes, over the short term it still matters whether a telemedicine visit is going to be funded by a payer –after all, if a clinician is going to deliver services somebody has to pay for their time. But there are good reasons why this will not continue to be an issue.

For one thing, as the direct-to-consumer models have demonstrated, patients are increasingly willing to pay for telemedical care out-of-pocket. Customers of sites like HealthTap and Teladoc won’t pay top dollar for such services, but it seems apparent that they’re willing to engage with and stay interested in solving certain problems this way (such as, for example, getting a personal illness triaged and treated without having to skip work the next day).

Another way telemedicine services have changed, from what I can see, is that health systems and hospitals are beginning to integrate it with their other service lines as a routine part of delivering care. Virtual consults are no longer this “weird” thing they do on the side, but a standard approach to addressing common health problems, especially chronic illness.

Then, of course, there’s the most important factor taking control of telemedicine away from health plans: the need to use it to achieve population health management goals. While its use is still a little bit lopsided at present, as healthcare organizations aren’t sure how to optimize telehealth initiatives, eventually they’ll get the formula right, and that will include using it as a way of tying together a seamless value-based delivery network.

In fact, I’d go so far as to say that without the reach, flexibility and low cost of telehealth delivery, building out population health management schemes might be almost impossible in the future. Having specialists available to address urgent matters and say, for example, rural areas will be critical on the one hand, while making specialists need for chronic care (such as endocrinologists) accessible to unwell urban patients with travel concerns.

Despite the growing adoption of telemedicine by providers, it may be 5 to 10 years or so before it has its fullest impact, a period during which health plans gradually accept that the growth of this technology isn’t up to them anymore. But the day will without a doubt arise soon enough that “telemedicine” is just known as medicine.

Health IT Continues To Drive Healthcare Leaders’ Agenda

Posted on October 23, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study laying out opportunities, challenges and issues in healthcare likely to emerge in 2018 demonstrates that health IT is very much top of mind for healthcare leaders.

The 2018 HCEG Top 10 list, which is published by the Healthcare Executive Group, was created based on feedback from executives at its 2017 Annual Forum in Nashville, TN. Participants included health plans, health systems and provider organizations.

The top item on the list was “Clinical and Data Analytics,” which the list describes as leveraging big data with clinical evidence to segment populations, manage health and drive decisions. The second-place slot was occupied by “Population Health Services Organizations,” which, it says, operationalize population health strategy and chronic care management, drive clinical innovation and integrate social determinants of health.

The list also included “Harnessing Mobile Health Technology,” which included improving disease management and member engagement in data collection/distribution; “The Engaged Digital Consumer,” which by its definition includes HSAs, member/patient portals and health and wellness education materials; and cybersecurity.

Other hot issues named by the group include value-based payments, cost transparency, total consumer health, healthcare reform and addressing pharmacy costs.

So, readers, do you agree with HCEG’s priorities? Has the list left off any important topics?

In my case, I’d probably add a few items to list. For example, I may be getting ahead of the industry, but I’d argue that healthcare AI-related technologies might belong there. While there’s a whole separate article to be written here, in short, I believe that both AI-driven data analytics and consumer-facing technologies like medical chatbots have tremendous potential.

Also, I was surprised to see that care coordination improvements didn’t top respondents’ list of concerns. Admittedly, some of the list items might involve taking coordination to the next level, but the executives apparently didn’t identify it as a top priority.

Finally, as unsexy as the topic is for most, I would have thought that some form of health IT infrastructure spending or broader IT investment concerns might rise to the top of this list. Even if these executives didn’t discuss it, my sense from looking at multiple information sources is that providers are, and will continue to be, hard-pressed to allocate enough funds for IT.

Of course, if the executives involved can address even a few of their existing top 10 items next year, they’ll be doing pretty well. For example, we all know that providers‘ ability to manage value-based contracting is minimal in many cases, so making progress would be worthwhile. Participants like hospitals and clinics still need time to get their act together on value-based care, and many are unlikely to be on top of things by 2018.

There are also problems, like population health management, which involve processes rather than a destination. Providers will be struggling to address it well beyond 2018. That being said, it’d be great if healthcare execs could improve their results next year.

Nit-picking aside, HCEG’s Top 10 list is largely dead-on. The question is whether will be able to step up and address all of these things. Fingers crossed!

Searching EMR For Risk-Related Words Can Improve Care Coordination

Posted on September 18, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Though healthcare organizations are working on the problem, they’re still not as good at care coordination as they should be. It’s already an issue and will only get worse under value-based care schemes, in which the ability to coordinate care effectively could be a critical issue for providers.

Admittedly, there’s no easy way to solve care coordination problems, but new research suggests that basic health IT tools might be able to help. The researchers found that digging out important words from EMRs can help providers target patients needing extra care management and coordination.

The article, which appears in JMIR Medical Informatics, notes that most care coordination programs have a blind spot when it comes to identifying cases demanding extra coordination. “Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data,” the authors wrote. “However, not all clinically relevant data reside in claims and formatted data.”

For example, they say, relying on formatted records may cause providers to miss psychosocial risk factors such as social determinants of health, mental health disorder, and substance abuse disorders. “[This data is] less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data,” the authors note.

To address this issue, the researchers set out to identify psychosocial risk factors buried within a patient’s EHR using word recognition software. They used a tool known as the Queriable Patient Inference Dossier (QPID) to scan EHRs for terms describing high-risk conditions in patients already in care coordination programs.

After going through the review process, the researchers found 22 EHR-available search terms related to psychosocial high-risk status. When they were able to find nine or more of these terms in the patient’s EHR, it predicted that a patient would meet criteria for participation in a care coordination program. Presumably, this approach allowed care managers and clinicians to find patients who hadn’t been identified by existing care coordination outreach efforts.

I think this article is valuable, as it outlines a way to improve care coordination programs without leaping over tall buildings. Obviously, we’re going to see a lot more emphasis on harvesting information from structured data, tools like artificial intelligence, and natural language processing. That makes sense. After all, these technologies allow healthcare organizations to enjoy both the clear organization of structured data and analytical options available when examining pure data sets. You can have your cake and eat it too.

Obviously, we’re going to see a lot more emphasis on harvesting information from structured data, tools like artificial intelligence and natural language processing. That makes sense. After all, these technologies allow healthcare organizations to enjoy both the clear organization of structured data and analytical options available when examining pure data sets. You can have your cake and eat it too.

Still, it’s good to know that you can get meaningful information from EHRs using a comparatively simple tool. In this case, parsing patient medical records for a couple dozen keywords helped the authors find patients that might have otherwise been missed. This can only be good news.

Yes, there’s no doubt we’ll keep on pushing the limits of predictive analytics, healthcare AI, machine learning and other techniques for taming wild databases. In the meantime, it’s good to know that we can make incremental progress in improving care using simpler tools.