It’s Not About The Box Improving Care at Group Health with People, Process and Technology

October 16, 2008

Population Management Tools

Our team visited  three KP regions to better understand how we might address our needs for tools that support population management and care/case management.  As you may know, the leaders of the two operating divisions (Group Practice Division and Health Plan Division) have put forward their A3s for 2009, and there is a clear call for a tool to support population/panel management and chronic condition coding.

Our trips focused on several questions

  • What have the KP regions done to develop and implement tools for panel management?
  • What could we buy from them to implement for our organization/patients at GHC, with either a model of shared future development, or independent future development?
  • What can we learn to develop the tools ourselves?

The requirements for what we need to deliver for Group Health for panel/population management, stated broadly, include:

  • The ability to define populations by clinical characteristics, with the ability to edit patients into or out of the population
  • The ability to flexibly define gaps in care (both clinical and coding) and present that information at any time (including at the time of all interactions with patients)
  • The ability to flexibly identify patients by care gap as candidates for patient-centered outreach
  • Support patients that get their care in both the GPD and the network
  • Support reporting important clinical performance with fresh data
  • A data warehouse that meets both business and clinical requirements (real time data) – and I know – this is a part of a solution rather than a requirement…

Our team is reconciling all of the input and will be meeting to help inform organization decisions about buy/build and timelines.  It will be a stepwise process that we will approach using incremental gains, but hopefully one that can get started relatively soon.

October 10, 2008

KP Colorado’s population management tools

I am just back from leading a team to Kaiser Colorado to assess the toolset they have created to support their population management work.  This was the last stop on our road trip of different permanent groups, having been hosted by KP Northwest in KP Southern California recently.

We have a long history of collaboration with KP Colorado, which in many ways is a kindred spirit to Group Health.  We are about the same size, we both have some patients in contracted networks, and we both have a long history of innovation and sharing.  As expected, they were very well organized and generous with their time.

The backbone of the work Colorado has done is their data warehouse.  They are farther along than other Kaiser regions in developing a flexible and robust data warehouse (for geeks, they are far along towards having true Service Oriented Architecture, or SOA).  It turns out this is probably the most important aspect of any population management system- the ability to bring together different data elements to meet different clinical in business needs.  Our current system (which we are investing to improve) is not really a clinical data warehouse.  It’s refreshed monthly, a frequency this unacceptable for clinical care.   KP CO have organized their tool set in 3 distinct layers – the data layer, the rules engine, and a front end.  This provides flexibility in how data are used for different business needs.  it also makes it much easier to change clinical rules in having them built into the top layer.

Colorado was great about showing us both the “story for publication” (the power point and slick demo), and the “real dirt” (watching the tool in action in clinical teams).  they shared these they would do the work differently if they were to start over.

The cross functional team that went on the trips will organize the information about the 3 different tool sets and begin a discussion about “make/buy” based on our internal capacity and our clinical and business needs.  The  strategic deployment work in the business planning for 2009 that comes up next week will help prioritize the work.

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