Population Health Transformation Best Achieved in Real-World Evidence

crowd

 

 

 

 

The transformation of healthcare is critical for improving population health.  As we continue the shift to value-based care, real-time evidence will continue to drive real-time solutions with significant impact for underserved populations.

A recent article by Dr. Jeff Bloss, Senior Vice President, Astellas Medical Affairs, Tapping Real-World Evidence to Achieve Better Value in Healthcare,  notes that real-time data is the key to real-time value in healthcare.   This can have significant implications for populations with complex healthcare needs, who often require specialized care and have  challenges accessing quality care. We need to ensure evidence-based decision-making reflects real-patient experience across all populations.

Healthcare is personal and individualized. Whether people access healthcare for prevention, diagnosis, treatment or research, they expect it to meet their specific needs.  By definition, healthcare is designed to address the care of each person’s health. For populations with unique or complex needs due to social economic circumstances and/or chronic disease, using real-world data can greatly improve the healthcare experience at all levels…physician, payer and patient.  It can be difficult, though, to capture this experience data if a population has limited access to quality care due to their status and ability to access care.

Populations composed of racial/ethnic minorities, ability challenged persons, and people with low socioeconomic status typically have worse health than their counterparts. How providers and payers collect, track and utilize such data is impacted by their ability to share data due to imposing regulatory processes  to prevent and manage chronic disease and disability. Although numerous models of implementation processes are available, they are broad in scope, often with vague guidelines and few address the special issues in reaching vulnerable populations.

Blass rightly acknowledges that we are seeing clarification of regulations with the 21st Century Cures legislation to promote greater sharing of real-time data among providers and payers.

The development of new drugs and treatment modalities is of particular concern for populations with access barriers. They stand to benefit the greatest from new drug therapies. At the same time, they stand to lose if data don’t accurately reflect the real-time experience of disparate populations. Again, it’s the ability of these populations to be included in the real-world data collection and analysis that will determine real transformation in population health.

Data-driven healthcare can dramatically improve healthcare for everyone. We need to ensure data reflect the real-time experience of all populations. While this is a challenge for physicians, researchers, clinicians and patients alike, the efforts of health systems, pharmaceutical firms and insurance companies indicate cautious progress.  We need to be diligent in developing accurate data-driven, real-world evidence that produces high-value, quality care for all populations.

Cerebral Palsy Foundation (CPF) Holds First Major Women’s Healthcare and Disability Workshop

cpfLast weekend, I was invited by the Cerebral Palsy Foundation to participate in the “Transforming the Healthcare of Women with Disabilities” Workshop to provide input and expertise on critical healthcare policies, practices and solutions and design a long-term research agenda on best practice care guidelines. It was a honor to be among such a distinguished group of medical experts (Dr. David P. Roye, Dr. Deb Gaebler-Spira, Dr. Laura Glader, Dr. Katharine Hayward and Dr. Eileen Fowler), health and disability leaders (Diana Zuckerman, June Isaacson-Kailes)  and national patient advocacy groups (Judy Panko Reis, Alicia Thomas) to enhance patient and other stakeholder involvement in the analysis, interpretation, application and dissemination of the first major survey of the obstetrics, gynecological and breast health for women with disabilities.

It was personally empowering to know that the result of our spirited discussions and projected research recommendations will empower women with disabilities everywhere to have greater control over their healthcare and be able to advocate for what they need to have a positive patient experience. I applaud CPF and Richard Ellenson, CEO, for their vision, leadership and execution on critical real-time issues impacting people with disabilities with real-time, transformative solutions.  I look forward to working closely with the Foundation to advance improved healthcare processes, optimizing the larger patient engagement experience for women with disabilities. The workshop is part of the Foundation’s Women’s Health Initiative a collaborative network of nationally renowned medical institutions joining to identify the barriers to better healthcare and begin to develop and implement new approaches. This effort is funded with the generous support of 100 Women in Hedge Funds, one of the nation’s leading philanthropic organizations. The workshop was supported through a grant from the Patient-Centered Outcomes Research Institute (PCORI).

post

Caregiver Action Network (CAN) Honors Individuals and Institutions

Last night, I was honored to be a guest at the 4th annual Hands-on-Help awards presented by the Caregiver Action Network (CAN) to recognize the work being done to support caregiving for families caring for loved ones with Alzheimer’s, disabilities or veterans reintegrating back into their family lives and communities. The event was held at the historic Cosmos Club and attracted political celebrities and caregiving professionals alike. One of the highlights for me was to see Senator Bob Dole receive CAN’s “Staying Healthy Together” award for his tireless work on behalf of our nation’s veterans and to ensure those who served and their families receive the care they fully deserve. 

Elizabeth Dole, who heads the Elizabeth Foundation for Wounded Warriors, is a Board Member of CAN and was in the front row to watch John Schall, CEO, engage in a “fireside chat” with the Senator and to officially bestow the award.  It was particularly exciting for me as I worked on Mrs. Dole’s personal staff when she was the Secretary of Labor under President George Herbert Walker Bush. She has been such a great mentor throughout my career, talking about using our abilities and talents to reach our full potential. It was fun to see them and to talk up close and personal.  Others recognized included Congresswoman Michele Lujan Grisham (D-NM), Meryl Comer, President of the Geoffrey Beene Foundation and David Badeen, Vice President, Sam’s Club HealthCare.

I can’t say enough for the work of CAN and John Schall, who has catapulted the organization in just three years to serve over 90 million Americans who care for loved ones across the country.  Yes, it was an honor to be among such dedicated and impassioned  people who make a true difference in health and healthcare for everyone. We all need to support CAN and help double the number of caregivers they empower.

post

Better Value in Health Care Requires Focusing on Outcomes

A recent article in the Harvard Business Review (HBR), “Better Value in Health Care Requires Focusing on Outcomes” by Caleb Stowell, MD and Christina Ackerman, MD,  discusses the need for providers to shift from a volume-based model of care to a value-based model in lower costs or better outcomes.  While a challenge to accomplish, Stowell and Ackerman find that successful value strategies in health care focus on producing measurable outcomes to create real transformation. They point to factors such as meeting mission and differentiation, integrating around the patient and greater collaboration among physicians, comparison of practices, controlling cost through knowledge sharing and shifting payment from volume to results.

To achieve better performance and noted cost-reduction for providers and patients, putting systems in place that track performance behavior and outcomes is imperative to effective health transformation.  I find this particularly true when factoring in the role of population health and tracking outcomes that reflect the specific characteristics and needs of populations that require greater coordination and integration.  At-risk and vulnerable populations can have the greatest impact from valued-based care models. clearly many successful hospitals and health systems that provide models to replicate. The Massachusetts General Hospital (MGH) model cited is an excellent example of reducing cost, increasing value and enhancing the patient experience by decision-support tools that are relatively easy  to use and can track outcomes for patients and providers.  Just like an Olympic champion obtains “value” with optimal performance and “tracking” outcomes (i.e. performance and process goals), a healthcare value shift will happen when tracking outcomes is fully embraced and integrated industry-wide. If you are a leading a health care provider organization and are uncertain how to navigate the shift, you might start by measuring your outcomes.

Measuring Improved Population Health Requires Shifting Our “Value” Mindset

pop-healthA recent article published in the Harvard Business Review (HBR) by Dr. Sandro Galea, M.D., Dean, Boston University School of Public Health, rightfully claims that measuring the value of population health programs is challenging. “Measures” are focused on groups of individuals within a given population as a whole. The issue comes in the gaps created in the socio-economic, life-style, health status and ethnic characteristics of those constituting the group. For example, diet behavioral modification programs to combat obesity using Smartphone and iPad technology will likely be more successful for “populations” within populations who have access to these technologies.

Ideally, these programs would target those who don’t have readily-available access to technology to produce improved results across the socio-economic spectrum. It’s widely documented that obesity levels are higher among people in lower-income brackets. Dr. Galeo suggests that the gap be closed by targeting the lower end of the spectrum among defined populations to level the success rate of healthy living programs. Doing so creates more equitable outcomes, higher rates of success and, thus, healthier populations.

This seems logical and easy, yet it requires a shift in our “values.” I tend to agree with Dr. Galea’s conclusions in that bridging health equity gaps closes social divides, defies the “Cadillac-care” notion and allows for greater, streamlined connectivity for everyone. Moving population health measures from absolute to inter-group differences may be a challenging shift, yet it would seem to create greater equity … achieving the larger goal in health and healthcare.

Advancing Medical Innovation through Public Policy Ensures Quality Healthcare for Everyone

pulse-583782_1920On Monday, March 16, the Bipartisan Policy Committee (BPC) convened government and private sector experts to discuss the policy actions needed to accelerate the discovery, development and delivery of medical products. Aligning public policy with innovation will save and improve lives, reduce the burden of chronic disease, and maintain global competitiveness in medical innovation. This is particularly relevant for underserved and at-risk populations who often have challenges accessing new drug therapies and treatment modalities due to socio-economic status and population health disparities. It was particularly enlightening to hear Marc Boutin, CEO, National Health Council, make specifc mention of persons with disabilities and those with chronic disease as populations that can particularly benefit from medical innovations to improve their health and well-being, daily living activity and overall quality of life. These groups can often be over-looked or side-lined when discussing and advancing policies to improve access to innovative health solutions. As a policy professional in the field of population health, who also happens to have a physical disability, I was heartened by BPC’s “inclusive” discussion to ensure quality healthcare for everyone.

http://bipartisanpolicy.org/events/advancing-medical-innovation-through-public-policy/