Tips for successful population health management from Mayo Clinic

CHICAGO—A good business plan is a better route to successful population health management than new IT, said Claudia Blackburn, PMP, MBA, manager and consultant with Aspen Advisors, speaking at the Clinical & Business Intelligence Symposium during the 2015 HIMSS Annual Conference & Exhibition.

Mayo Clinic formed the Office of Population Health Management in 2012 and developed a framework, said Tim Miksch, MBA, IT section head for the organization. Mayo noticed the shift in reimbursement models and wanted to be prepared for it. “We can’t turn on a dime. This is a mindset. Changing that mindset is not something you can do overnight.”

They also realized that small changes would not be enough, he said. “Our survival is at risk. We need to be prepared to do it well.”

Mayo created a formal process—“not just a suggestion”—of a patient-centered, integrated care delivery model supported by wellness and continuity of care and driven by analytics. Fifteen percent of their patients account for half of their costs. “If we don’t help manage them, there will be a severe financial impact.”

Early intervention is not only better care but offers cost savings. “Detecting breast cancer early is much less expensive than a long treatment and hospitalization.”

As of this year, Miksch said all Mayo sites are actively engaged but noted that “standardizing across sites and regions is a challenge. Fee-for-service remains a driver for many. We got funding approved to help sites hire additional staff to help with the transition.”

Mayo is working on “an ancient EMR” so getting data pulled out, normalized standardized and put into context “is not an easy thing to do. Analytics is all about creating an action. If you’re not taking an action, what’s the point?”

Miksch also cautioned his listeners about good physician buy-in. Without it, “you’ll struggle. Mayo is physician led but there is still plenty of opportunity for people uninterested in changing the status quo to throw up roadblocks.”

Organizations should focus on primary care, he said, because those are the clinicians stuck in the middle. “As our resources are getting crunched, we need to do things to make life better for primary care providers—the right support, the right team in place so it’s easy to do the right thing because right now it’s not.”

It’s a challenge to implement new tools and technology but the software market for population health is still pretty immature, Miksch said. “The holy grail is integrating top health activities with the EMR. There are promising things coming out but they looked promising a year ago.”

Mayo will work on enterprise metrics, a point-of-care registry and care management integrating with the EMR, he said. “It can be difficult to do but very important if you want to actively manage patients.

Data governance is “chaotic at best,” he acknowledged, because people enter information in all sorts of places. Miksch suggested the use of an outside vendor.

“I am a zealot about opportunities we have to fix the way we interact with systems because what we have right now is a crime,” he said. They are set up as transactional systems and do not incorporate the knowledge of physicians in order to support their workflow. “It’s not as much about training as how do we redesign these systems so it makes sense.”