Population health insights

Three populations — and how to activate them to better health

Sign up for news and updates in population health

Dec 12, 2017

Many healthcare organizations talk about engaging patients as part of their population health management (PHM) strategy. But, what does engagement mean, and is it sufficient in PHM? And what is the role of technology?
 

In prior blog posts, we’ve described the first two steps to successful PHM – understanding your population and helping them navigate to proactive care. We view the third step in this journey as activating people to better health. We use that term because we think organizations need to go beyond merely engaging patients via patient portals and other approaches to activating them to become the most important member of their care management team.

Connected technology promotes activation

Activating clinicians is typically a first step to engaging and activating patients. A good PHM platform can deliver actionable information into their workflow, helping clinicians coordinate care for those at rising risk, provide clinical pathways and enable better visibility into the ‘white space’ of patient behavior between medical visits. Technology can arm care teams both with the data and analytics they need and digital tools that make it easier and less expensive to reach and engage patients.


Consumers may be more disposed to use technology to help manage their health than their clinicians are. The majority of American adults own a smartphone and fitness bands are the most popular wearables, arming them with the tools to track their health. Nonetheless, the challenges to getting people to take a more active role in their health are significant and require tailored approaches that take their risk levels and preferences into account. That means developing appropriate action plans for all three of your subpopulations, not just the ones at highest risk. Your strategy should also address the healthy and the rising risk subgroups so you can drive a comprehensive PHM strategy. Some examples of activating each group follow.

1. Activating the ‘frequent fliers’

Connected technology like telehealth can help healthcare organizations reduce utilization in the highest utilizer or ‘frequent flier’ population. A review study confirmed that remote monitoring that employs telemedicine and other connected devices can help clinicians detect small changes in health metrics for those living at home with chronic conditions like stroke, heart failure and pulmonary disease. For example, small weight gains in someone with heart failure can signal disease exacerbation; using an ecosystem of connected devices, clinicians can quickly intervene through telehealth or other cost-effective measures to help prevent an ER visit or hospitalization.

 

Technology also can play a role in activating those with severe mental health issues to better self-manage their disease.
 

2. Activating the rising risk population

To activate the people in this rising risk group to better health, a robust analytics platform can help you accurately target and activate those who have or are at risk for conditions like metabolic and cardiovascular diseases. Studies have found that even small changes in weight can significantly reduce risk. This population can be activated to make lifestyle changes supported by a care team or by using technology-enabled employee programs. Providers can also activate them to take appropriate preventive measures such as aspirin therapy, smoking cessation and/or statins.
 

Statin treatment can significantly reduce the risk of developing cardiovascular disease in select populations. Newer guidelines recommend using low to moderate doses of statins in adults ages 40 to 75 without a history of cardiovascular disease but with at least a 10% risk of having a cardiovascular event in 10 years.

 

3. Activating the healthy population

For the healthier subgroup, a robust PHM program that incorporates evidence-based prevention programs, supported by connected devices and solutions, can help you activate the healthier subgroup to stay healthier longer. Programs that include support for weight loss or maintenance, healthy habits like exercise and good nutrition, and human and digital coaching can help people avoid or reduce their risk of common metabolic or cardiovascular diseases.

Engaging people in actively managing their health is a challenging but hugely rewarding third step in the PHM journey. PHM platforms can provide the necessary data to target care interventions, and connected tools that include telehealth and smart phone applications can help to cost-effectively activate patients to better health.

To learn more about how your organization can successfully undertake the PHM journey, read our white paper, “Beyond frequent fliers: why healthcare organizations need a comprehensive PHM strategy.”  If you missed our first two blogs in this series,

 

About the author

Mason Beard
Mason Beard, 
Chief Solutions Officer, Philips PHM
Mason Beard is Chief Solutions Officer for Philips PHM. He leads the strategic and operational development and programs of the Philips Population Health Management group. He is the co-founder of Philips Wellcentive and has deep experience in developing flagship healthcare IT innovations.

More in population health management