Succeed in Value-Based Care.
Create Sustainable Health and Care Systems.
A comprehensive, shared record for each patient is key.
Achieve Your Population Health Goals by Optimizing Care for Individuals
InterSystems HealthShare and companion products from our partners close the loop on population health management. They make it easier and faster for you to
- Identify cohorts of patients in need of intervention
- Expose the most important EHR information, including narrative data, for each patient at the point of care
- Coordinate personalized care across settings and providers
- Aggregate care histories for individuals
- Measure progress toward goals for the entire population
Become a Learning Healthcare System
The success of any population health endeavor depends on continuously measuring results and learning where to make improvements in care and processes. With HealthShare and partner solutions, you can
- Measure the quality, outcome, and process of care for each patient relative to best practices
- Apply predictive models to a cohort’s data to identify population members who will benefit most from increased attention
- Use measurements to inform all care team members about best practices and the delivery of personalized, coordinated care for patients and their families
- Expand each individual’s longitudinal record, which further enriches measurement and the total body of evidence for enhancing care
In Rhode Island, a state-wide commitment to shared longitudinal health and care records has made it possible to reduce unnecessary readmissions by as much as 18%. There, clinical event notifications tell primary care providers when their patients are being discharged from the hospital, supporting an evidence-based transition of care model.
Northwell Health, based on Long Island, New York, is one of the largest private health systems in the United States. Its growth has been simplified by leadership’s decision to avoid the disruptions of “ripping and replacing” the different EMRs used by acquired organizations. Instead, Northwell uses InterSystems HealthShare® to aggregate, integrate, store, and use information from the disparate EMRs and other clinical systems across its 23 hospitals, 655 outpatient facilities and more than 18,500 affiliated physicians.
In Chile, a pilot program spanning healthcare regions has created comprehensive virtual care records to support the automatic identification of patients at risk for chronic conditions such as diabetes or high blood pressure. This makes it possible to employ best practice interventions – that is, standardization – within the context of the unique local Chilean healthcare system.
In London, a clinical service of the Royal Marsden Cancer Hospital is supporting evidence-based international best practice for patients with serious illnesses through shared care plans. The system takes into account the governance and care delivery structure of the local English NHS. Comprehensive patient and provider identity management and consent-based information sharing ensure that only legitimate care relationships are supported. The shared care plan is accessible to patients and their families as active members of the care team. Continuous data gathering supports further research into how best to deliver personalized, urgent and end-of-life care to seriously ill citizens.
Enabling connected care for population health success
As the healthcare industry shifts to quality-based reimbursement, healthcare organizations are looking for tactics to help them succeed. Population health is one of them. You need to think about how your organization can empower clinicians to be more effective in improving the overall health status of a population by optimizing care for individuals. Among other things, this requires standardization, localization, personalization and adaptation. Read the entire article, by Dr. Turner Billingsley, InterSystems Chief Medical Officer, here.
Democratizing data to transform population health and care
In the United Kingdom, Lincolnshire Health and Care is using an integrated Care Portal system, based on InterSystems HealthShare, to help transform healthcare for an aging and widely dispersed population. Lincolnshire Health and Care’s Gary James explains how.
Predict the future, one data point at a time
HBI, an InterSystems partner, is helping providers see not only their patients’ pasts, but also their likely futures. They even see the distribution of risk — for chronic diseases, for example — across entire populations under an organization’s care. This bridge between past and future is critically important for patient-centered population health management. Eric Widen, co-founder and CEO of HBI Solutions, explains.