Returning patients to the center of population health — and empowering them with the right tools — can help solve many challenges faced by population health programs.

Ever since Greg Stoddart coined the term “population health” in 2002, health organizations, providers and payers have been continuously learning more about its dynamics, the constant challenges that come with it, and how to overcome those challenges. According to Stoddart, population health focuses on “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” This includes patterns of disease, treatment results and healthcare outcomes, as well as the policies that link them together.

A Diminished Role for Individuals – Until Now

Population health has been a hot topic among healthcare providers and payers for nearly a decade. But it’s been a non-issue for most consumers. Nevertheless, the use of population health strategies by providers and payers have real impact on consumer health and healthcare costs. It also doesn’t matter that individual patients know little about population health. By its very definition, population health was intended to be patient centric. Population health programs are supposed to focus on improving individual patient health, in the context of groups of consumers with similar conditions, environments or challenges. The simple fact of the matter is that individual consumers have so much to offer population health programs. But this resource has often been overlooked by population health initiatives. Until now. Technology is giving population health programs the tools to empower individual patients to drive improved population health results. With the increasing number of healthcare apps being added to online app stores every week, healthcare payers and providers now need to adapt to evolving consumer behavior and expectations.

Technology is giving population health programs the tools to empower individual patients to drive improved population health results.

It would be a mistake to consider this a challenge for population health programs. Technology-empowered consumers actually offer a golden opportunity or payers and providers.

Patient Participation

The primary challenge for population health has always been the evolving needs of each population demographic. Patients with multi-chronic disorders using high demanding services drive healthcare costs up. But there’s often only so much that providers and payers can do. It’s now clearly understood that social and economic factors are more important in the rise of chronic illnesses in various populations. In some cases, it’s the low price of unhealthy fast food or less active lifestyle. In others, it’s environmental stressors or lack of awareness about healthier lifestyles. Unfortunately, health systems have often been the active healthcare providers, while patients are the passive care recipients. Once the patient leaves the clinic or hospital, they too often fall back into their unhealthy environment without any real support for impactful change. Healthcare providers want to help patients change their behavior and improve their health, but they can’t be there to continuously monitor and guide patients. Now, there’s an app for that. Actually, there are now hundreds of apps available to encourage and support patient participation. Today’s apps and the more powerful ones emerging give population health programs the tools to provide more continuous support for individual patients. From nutrition apps to self-managed care apps, individual patients can now use readily available technology to make healthier daily life decisions – every moment of every day.

Dirty Data

Another major challenge facing population health programs is inaccurate or dirty data. This is found by providers in their patient’s health record, as well by payers in their member’s claims file. Incomplete or incorrect information in a patient’s personal health records can lead to medical management errors and could negatively affect their healthcare outcomes. Correcting errors for each patient can be time-consuming and costly, as each individual patient’s records may have different inaccuracies or errors. Most hospitals and health organizations already address the issue of dirty or inaccurate data by improving their digital records and training their employees on proper data entry. But it’s often still not enough. Once again, technology and increased patient participation offers new opportunities for addressing the challenge of dirty data. Through apps that give consumers direct access to their personal health records (PHR), individual patients can help clean up a lot of the inaccuracies and errors in their own records. From there, machine learning systems can learn from those consumer-driven app-powered corrections to develop new rules to prevent similar inaccuracies and errors in the future.

Data Privacy Issues

Another challenge for population health programs is gaining permission to utilize a patients’ critical health data to generate impactful recommendations and conclusions. We know we can use population data to find answers. But many patients are hesitant to allow sharing their personal clinical data between their healthcare provider and insurers for good reason. They’ve heard about or directly experienced the impact of major security breaches to health systems in recent years. For example, Exellus Blue Cross Blue Shield and Anthem Blue Cross both suffered separate breaches in 2015 that affected more than 10 million and 78 million patient records, respectively. With nearly all current medical records in the United States now being stored in digital form, it’s much easier to share data. But it also means that there are more ways for data thieves to get that data. So how do we ensure that patient data is secure and their privacy concerns maintained? Most health systems with digital records have already woken to the threat of data breaches. Fear of fines, penalties and damage to their brands have forced most payers and providers to improve their security, training and compliance monitoring. But the truth is that the weakest links are often not the data record storage system themselves, but the different access points to those storages. And as patient access to digital records is now the new rule, these vulnerable access points greatly increase the potential risk for electronic health records. Again, however, technology and increased patient participation can provide solutions to privacy- and security-based challenges to population health. By providing patients with secure and intuitive apps, consumers will be able to better control how their data is accessed and shared. This also helps address some of the privacy and security concerns that drive patient reluctance to sharing their PHR data. By giving individuals more control over their health data, population health programs can more easily gain permission directly from individuals in specific populations.

Final Thoughts

Traditionally, patients are only motivated to engage after being diagnosed with a disorder. Healthcare providers need to participate more in the community and activate patients to be more involved with their health and management plans. To do so effectively, healthcare professionals should provide patients with the right set of information, as well as provide continuous support and an open dialogue. This will allow patients to make a more informed decision about their day-to-day decisions. Again, there are apps now emerging that allow providers and patients to do this more easily and consistently. Concurrently, healthcare organizations need to develop a sound and reliable technology infrastructure to make population health work. This technology should be flexible enough to allow intuitive and quick data entry, accessibility, and easy data retrieval. This technology should also be adaptable and evolve in alignment with the population’s shifting needs.

Allowing consumers access and control over their own electronic health records is a crucial part in making population health effective as well.  

Allowing consumers access and control over their own electronic health records is a crucial part in making population health effective as well. It simplifies the process of improving public health reporting and surveillance, enhancing the ability to prevent disease, and expanding communications between users and their healthcare providers. This can be achieved by using self-management mobile apps that consumers can obtain from their provider or independently. The healthcare industry is in dire need for a reliable structure to manage population health and their data. In order to understand healthcare information; claims, clinical and personal health data should be used together rather than separately. In other words, healthcare providers and payers need to work together to take on the challenges faced by population health.

Call to Action

Since its emergence, population health has relied heavily on data and available technology to address the needs of specific population groups. But the individual patient’s participation was often missing, especially when looking at it from the population level. Returning individual consumers to the center of population health – and empowering them with tools for more ownership of their PHR and health management – can help payers and providers solve many of the challenges facing their population health movement.