Challenges to a Population Health Approach - Essay Sample

Introduction

Population health approach is collection, analysis and keeping of individual patient data with an aim of improving both clinical and financial outcomes of these patients (Raghupathi & Raghupathi, 2014). The main driving force behind the population health approach is proactive management of public health. It has been realized that the ultimate breakthrough in the health sector will have to be through preventive medicine. This will involve taking into consideration subjects like the cessation of smoking and lifestyle changes to prevent diseases such as hypertension, among others (Drummond, Sculpher, Claxton, Stoddart & Torrance, 2015). Health care organizations must have the ability to collect and analyze patient data since population health management attempts to determine which patients can benefit from preventive interventions instead of waiting on a clinical episode. This is opposed to the traditional method of retrospective use of data to guide clinical intervention.

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Identifying the Challenges

Establishment of a Starting Point

There are very many health conditions in any given population that would need to be addressed by a population health approach. These include conditions like diabetes, hypertension, lung cancer secondary to smoking, hypertension, obesity and it's co-morbidities among others. Most of these conditions are very popular and pose a relatively similar burden in terms of suffering on the patients and the available health resources. An example is that more than 100 million American adults are living with diabetes and pre-diabetes (CDC, 2015), which translates to about 10 per cent of the population. An approximate of $ 245 billion was spent by the United States in diabetes management, translating to a whopping $13,700 per patient per year in the year 2012 ((Drummond et al. 2015). The numbers keep growing over time not only for diabetes but for all these illnesses. The strain on the population and the individuals is overwhelming. This is, therefore, an urgent call for prevention of these conditions as opposed to managing them. Healthcare organizations are faced with the challenge of deciding which conditions to tackle first since all of them are of similar weight (Dall, Zhang, Chen, Quick, Yang & Fogli, (2014).

Financial Constraints

A lot of money is allocated to healthcare. A large percentage of this is used in the management of existing health conditions. The American federal government spent nearly $ 1.1 trillion in the fiscal year 2018 on healthcare. Establishment of a population health management system would require approximately a similar amount to set up (Keehan et al. 2011). This is due to all the expenses that would be required to hire manpower, acquire the necessary technology among others.

Hiring and Reallocating Man Power

A population health model has different staffing requirements as compared to the traditional healthcare system. The traditional health care system is basically a setup where everyone is focused on providing support to physicians who are the only ones who directly interact with the patients. The population health system, on the other hand, involves the integration of services from a wide variety of professionals. These include physicians, behavioural experts, nutritionists, environmental experts, social workers among others. Establishment of a fully functional population health system would, therefore, warrant the hiring of new staff members or reallocation of the available human resource.

Patient Demographics

Demography is the statistic study of populations. Patient demographics, in this case, means a grouping of patients into basic categories such as "children aged 0-5 years" in a specific group of people. This has posed a challenge due to the absence of patient identifiers across multiple settings of care.

Tracking Care Quality and Outcomes

Many health care organizations have struggled with the assessment of the effectiveness of their methods of approach to the achievement of population healthcare management. This is due to the lack of standard quality metrics. Value-based providers may often feel as if they're measuring the same thing in multiple ways and multiple times, therefore, causing ambiguity and lack of clarity thereof.

Implications of Challenges on Population Health Approach

Establishment of a Starting Point

Many healthcare organizations are unable to decide where to start with the implementation of the population health model. The field of population health is vast, with over a thousand different health conditions demanding attention to the same level of urgency. Most of these organizations lack the resources to tackle all these conditions at the same time. This requires that decisions be made on what to deal with first.

Financial Constraints

Estimating with precision the level of funding required to support public health is a challenge for various reasons. First, there's variation in the definition of public health across the different health service providers. Second, there is no evidence or formula available yet that would allow forecast of the magnitude of savings that would be achieved by population health management. This is despite the fact better coordination and less department fragmentation are likely to yield economies of scale in this new model. There is also not a well-defined framework for tracking revenues and expenditures.

Hiring and Reallocating Man Power

The existing traditional health service provider system requires a wide range of professional manpower. For a health care provider to meet all its human resource requirement, there's a need to hire new professionals in the various fields. An alternative is to equip the existing personnel with the necessary skills required to achieve a population health management plan. While this may be argued to be quite costly, it is quite profitable in the long run. An example is hiring a new nurse which may seem to be daunting and costly to an organization operating on a tight budget, the nurse may quickly produce a return on the investment due to more efficient and proactive delivery of services.

Patient Demographics

The first step toward any type of population health initiative is to understand the types of data necessary to meet the organization's needs. Organizations need to understand that not all data collected will be useful. They also need to understand what types of data can be standardized across organizational lines for ease of care multiple organizational cares of the same patients. This is because complex patients often require care from different health providers.

Tracking Care and Quality Outcomes

Health service providers continue to struggle with a lack of quality metrics with which to measure the outcomes of the population health management initiatives. However, once data is aggregated and analyzed, it is easier to calculate returns on investment on a specific public health initiative.

Proposed Solutions

Establishment of a Starting Point

Health care providers must consider initiatives that save on money and produce the most measurable clinical outcomes. An example is increasing vaccination rates for common conditions in children like meningococcal meningitis. This vaccine has shown short term efficacy levels of 85-100% (Sallis et al. 2015). Vaccination is the most efficient way of preventing disease where applicable. Health care providers would consider starting out with vaccination initiatives as a way of starting the long journey to the achievement of an all-rounded population health management system. The initiative, however, has its downside. A considerable fraction of the population is sceptical about vaccines. The point this to the various theories which allege that vaccinations do more bad than good. Some point out that vaccines are tainted with harmful substances that predispose the beneficiaries to health complications such as cancer, infertility among others.

Financial Constraints

The federal government has been urged to allocate funds towards the realization of the population health management initiative. This has been considered to further ease the financial burden of realization of this initiative on non-governmental organizations as well as private health care providers. This, however, has been challenged by various facts. First, projecting the cost of a defined "package" of public health services for every state and locality requires both an agreement on what the package is and a better understanding of how the governmental public health infrastructure will shape itself to deliver the package. This has not been achieved. The government has also argued that the available financial resources are tied up in the traditional method of treating a disease other than prevention.

Hiring And Reallocation of Man Power

Both hiring and reallocation of existing human resource are equally as effective in satisfying the need for labour in the achievement of population health management initiative. However, most organizations have opted to hire fresh professionals rather than training the existing personnel to take up new roles. This is because it takes up time to offer training to the employees. Many employees are also not open to the idea of undergoing tedious and complicated training outside their specialities. This would also bean higher pay for the employees which most service providers are not willing to honour.

Patient Demographics

Collection of accurate data is vital for an effective population management system. Providers concerned with interoperability should invest in technology that would ensure accurate collection, analysis and storage of data. They should also consider joining a local health information exchange network. Specialists, hospitals, primary care providers and other personnel in the health management system must be able to communicate effectively to ensure that individuals are receiving all the care they need and they are not receiving the same services twice. A challenge to achieving this however is acquiring data from various sources (Ginter, Duncan & Swayne, 2018). This is because the data necessary to get a clear picture of patient conditions data must not only be collected from the hospital but also their homes, occupations, environment among others. Some patients are also reluctant to divulge information regarding their personal lives. This, therefore, hinders keeping of accurate records.

Tracking Care Quality and Outcomes

Various stakeholders are trying to address this challenge by runaway measures. However, a global solution is still lacking. Health service providers can work closely with their data analytic experts alongside the available technology to design meaningful metrics for specific populations. The downside of this though, is that this would pose difficulty in coordinating care across the continuum (World Health Organization, 2016).

Conclusion

Population health management is a way of transforming the healthcare system from being entirely about treating medical conditions to preventing them. This is achieved through collection and analysis of data in the population and the ultimate keeping of proper health records. This is done with the aim of identifying high-risk groups and establishing measures that prevent disease development. These measures include vaccination, health education of lifestyle disease prevention among others. There are various challenges that face population health approaches such as; financial constraints, reallocation of human resources, determination of a starting point, tracking care quality and outcomes among others which should be dealt with by the stakeholders in the health sector.

References

Dall, T. M....