Population health management demands an effective set of measures

Michael A. Stoto, professor of health systems administration and population health at Georgetown University. (Photo courtesy Georgetown)

By and large, population health measurement efforts are poorly developed and uncoordinated – and without effective measurement, success will remain elusive.

Without population health measurement, in other words, there can be no population health management.

Part of the problem is different people mean different things when they say "population health," said Michael A. Stoto, professor of health systems administration and population health at Georgetown University.

"For some, population health is using predictive analytics to identify groups of people who need intensive care, and thus measures are required to see how their care is being managed," he explained.

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"For others, population health is hospitals and ACOs identifying groups of beneficiaries and members whose care you are trying to manage, and that's a related but somewhat different set of measures," he added. "And for still others, population health means the population in a geographic area. All of these legitimately are called population health, and they all need measures that in some ways overlap but in other ways need to be distinguished."

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So healthcare and related organizations undertaking population health must agree on what population health is, harmonizing on goals and measures, Stoto said.

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"Imagine a hospital and a community both decide reducing obesity is a priority," Stoto said. "What are they going to do about it? Hospitals can offer weight loss clinics, physicians and other providers at the hospital can counsel patients about physical activities and diet, the community can do work through its parks and recreation department, and so on. Then you need performance measures to see whether the hospital, providers and the community are doing these things. All of these things can be measured."

The hospital, the local health department and other organizations share responsibility for the obesity problem. Measures indicate how well the group is doing meeting population health goals; organizations harmonize in the way they define and work on obesity and measure progress, Stoto said.

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"There are standard measures for obesity, physical activity and diet, for example, available from organizations such as the CDC, and hospitals and other providers can use these same measures for their population health programs," Stoto said. "So if those are the problems we are trying to address, what are we doing about it? This is where you need process measures. For example, how many people are using the programs a hospital provides? Track the use of these things. Track physical activities of kids in school."

The key is to study through a "driver diagram," Stoto added.

"What are the outcomes we want to achieve?" he asked. "What are the steps needed to achieve those outcomes? Who is going to do these things? And how do we measure what they are doing?" 

Twitter: @SiwickiHealthIT