Population health management: networking versus data silos

Data silos still prevail in the German health care system: providers store and collect patient data for their own purposes, making it not available to the entire organization. Many still mainly share this data in analog form. Comprehensive, integrated delivery networks would make many practices easier. Patients must also be more closely engaged in digital processes via a common platform to improve activities.

In this MEDICA-tradefair.com interview, Dr. Mania Brusca talks about population health management. She explains how interoperability and data exchange help both patients and health care providers.

Dr. Brusca, what is meant by population health management?

Dr. Mania Brusca: Population health management refers to the collection and use of patient data across various health information technology resources to help improve clinical health outcomes and derive respective financial and care models for a defined group of individuals. It is based on data that is collected by physicians, hospitals or by patients who self-record information at home. The term is more widespread in the USA compared to Germany. German healthcare primarily works with data silos. However, the Hospital Future Act (Krankenhauszukunftsgesetz, KHZG) aims to modernize the system and promotes intersectoral networking. That being said, we still have a long way to go in this setting.

What kind of individual measures does this entail?

Brusca: This requires data pooling where data from different sources is combined. Philips manages this via an interoperability platform that links everyone who is involved in the care process, which includes physicians in private practice or hospitals. Patients can actively collaborate and self-collect data via apps and wearables or patient-reported outcome measurements.

This makes patient care more efficient as it avoids overtreatment or undertreatment: Doctors can use this data to identify patients they see too often and those who truly need more frequent attention, whether via telemedicine or in-person visits. Private practice physicians in the Netherlands implement this approach, for example.

What changes would this necessitate in the German health system?

Brusca: We initially must improve intersectoral networking to create a patient database in the first place.

The next step would be to establish payment incentives in healthcare that are based on health and health outcomes and not on delivered care quantity, using patient-recorded outcome measurements as a foundation. So far, value-based reimbursement models are not yet widespread in the market.

What are the opportunities that lie ahead thanks to the Hospital Future Act?

Brusca: All qualified digitization measures must meet interoperable health data exchange standards, which build the foundation for data exchange platforms. The individual components - for example, the use of cloud computing or the implementation of a patient portal – also allow hospitals to be more agile in their organization. It enables innovative treatment methods and empowers patients to be more actively engaged in the care process.

What is the main idea behind "Philips Engage", a patient portal by Philips?

Brusca: For us, it is an application in an interoperable IT system landscape, which means we give our clients an integrated service approach: They should not only consider the portal a platform for data exchange but also view it as an opportunity to remain flexible and sustainable, to engage patients or other partners and to create benefits.

Digitization for the sake of digitization is the wrong approach. This effort must also garner long-term benefits for hospitals. Reducing burden for the healthcare team and improving process efficiency and hospital profitability - these are KPIs we are familiar with from other countries. Hospitals can reduce the number of no-shows and help patients prepare for appointments. Patients can fill out questionnaires and forms pre-appointment. The portal helps patients manage and track their treatment progress.

The second aspect is focused on improving the quality in patient care and compliance. For example, hospitals can provide patient education videos for better information and preparation. Wearable devices also facilitate long-term remote delivery of care via telemedicine. Ultimately, the Hospital Future Act aims to improve patient care, both in terms of outcome and treatment quality and efficiency.

Which providers benefit most from an implementation?

Brusca: The portal generally covers administrative applications such as hospital admissions and discharges, but also helps manage clinical processes pertaining to any illness or telehealth-enabled program. We jointly discuss the processes and content our clients want to digitally measure and subsequently tailor and personalize the care pathways. The idea is not just to convert analog processes into a digital format, but to also create new possibilities.

What aspects must hospitals consider in this setting?

Brusca: Of course, there are basic technical requirements for a successful integration solution. However, employee engagement and integration at all levels are far more important. This is not just about introducing a new IT system. It also means disruption and process changes. This is a modern IT project, which introduces comprehensive change management.