EHRs hold population health management promise

Internist Peter Basch, MD, MACP, uses a computer system tied into his electronic health record (EHR) to analyze reams of data to help get patients the care they need.

He analyzes data to identify patients due for colonoscopies, mammograms and other screenings based on their age, gender and other factors. His office then uses automated calls to urge them to get the recommended tests as part of its population health management strategy.

“Having the EHR allows us to have a view into the data and take action on it,” said Basch, chair of the medical informatics committee for the American College of Physicians and senior director for health IT quality and safety, research, and national health IT policy at MedStar Health, a nonprofit, community-based health system serving the Baltimore/Washington, D.C. region.

EHRs hold the promise of helping primary care physicians and their staff execute population health management programs at a level they couldn’t undertake without technology.

How robust those programs can be varies, however. The EHRs on the market today offer different functionality, with some EHRs allowing for more analytic capabilities than others. As such, leading health IT experts say many physicians can’t rely solely on EHRs for population health management within their practices; they may need to layer on an additional system that can extract and analyze data based on clinicians’ queries. But even in those cases, where additional systems are needed, the EHR remains critical at is the system holding all the essential patient data for analysis.

Moreover, the role of EHRs in population health management will expand as the technology continues to evolve and as doctors see more payments tied to quality measures. 

“Increasingly, as we get more and more information that’s available in electronic health records, that [EHR] becomes a source of how to best take care of the patients in your practice,” said Douglas B. Fridsma, MD, PhD, FACP, FACMI, president and CEO of the American Medical Informatics Association (AMIA), a professional association dedicated to the development and application of biomedical and health informatics.         

A vast majority of healthcare institutions already are engaged in population health management, according to survey data presented earlier this year by the eHealth Initiative, an independent, nonprofit organization aimed at driving improvements in the quality, safety and efficiency of healthcare through information and information technology. The organization surveyed its network of accountable care organizations, providers and health plans and found that 76.6% purchased or developed health IT or analytics for population management.

Basch is case in point: His practice, MedStar Physician Partners, invested in a separate reporting tool that analyzes data extracted from the EHR, an investment that he said gives him greater analytics.

Physicians don’t necessarily need to invest in additional technologies to start using computer systems to manage population health; they can generally use their EHRs for some tasks in this space, said Basch.

Fridsma agreed, saying many physicians could, for example, use functions in their EHRs to look at diabetic patients and examine how fast they’re able to stabilize their blood sugar levels once they’ve been diagnosed, with the answer shaping what steps may be needed to improve the speed at which that stabilization occurs.

But there are barriers keeping more clinicians from using EHRs and complementary technologies to better manage patient populations. The eHealth Initiative survey listed barriers such as challenges around change management, data integration/interoperability, impact on workflow and productivity, competing health IT priorities, cost of software or tools, lack of sufficiently trained staff, physician alignment and a lack of patient engagement.

Fridsma stressed the need for more training and education in this area: “To really capitalize on the investment we’ve made in electronic health records, it’s not enough to just know how to use the tool. It’s knowing how to ask the right questions. Those are the skills that doctors need to start learning so they can be good users of all these technologies and not just technicians who know how to manipulate the tool.”