What do common healthcare buzzwords actually mean?
In an industry as vast and complex as healthcare, it’s no surprise there are a number of overused and often misunderstood buzzwords. New terms are coined continuously as new regulations are passed, technologies are introduced and healthcare organizations struggle to identify and address challenges in providing value-based care.
As a result, opportunistic vendors often co-opt emerging terminology to rebrand legacy products, and healthcare administrators and executives feel pressured to use promising buzzwords — often before they fully process their meanings — to describe new initiatives and programs. However, in order to effectively communicate with others in the industry and enact real change, it’s imperative that we cut through clutter and understand the true meaning behind these buzzwords.
Population Health Management
In the wake of the Affordable Care Act, one of the most commonly overused industry terms is “population health management,” or PHM. The regulatory shift from fee-for-service to value-based care has placed responsibility on healthcare organizations to increase quality of care provided, improve the health of their patient populations and reduce the per capita cost of health care — known as the “Triple Aim.”
Capitalizing on this directive, many healthcare IT vendors have integrated PHM into the descriptions of their existing products and services, suggesting their legacy systems have evolved overnight to support population health management. Unfortunately, vendors have diluted and misused the term to the point where its original meaning has been lost.
By definition, a true population health management solution must include three critical components:
- It must aggregate data from the full breadth of sources and create normalized views for the entire care team.
- It must deliver the tools necessary for care teams to leverage that information, update and collect additional data and communicate and collaborate amongst themselves and with their patients in order to improve the quality of care provided and reduce the cost of care.
- PHM solutions must enable healthcare organizations to extract actionable data through broad-based analytics, business intelligence and risk stratification.
While many vendors may provide one or some of these components, true population health management solutions provide all components in one ecosystem to allow seamless data flow and efficient business and clinical processes.
Another overused and largely misinterpreted buzzword is “interoperability.” Much of patient data today resides in a variety of electronic medical record systems (EMRs), claims and eligibility databases, case management systems, laboratory information systems, radiology information systems, pharmacy benefit management systems, and other related databases. While some data exchange standards do exist, such as Health Level Seven (HL7) and Clinical Document Architecture (CDA), very few healthcare organizations and industry vendors fully support them. Consequently, portions of data are extracted from these systems in a time consuming and costly process, producing a fragmented view of the patient at best. This is not interoperability.
Interoperability — in its truest meaning — is characterized by an ability to exchange a full data set, either one way or bi-directionally between two systems, and the exchange must be secure, with proper validation, business rules and error handling, and conducted on a timely basis.
Unless a data interchange standard is imposed on all healthcare IT products nationally, interoperability will remain an elusive term. The best available option for the foreseeable future for those seeking true interoperability is to turn to the software providers able to rapidly and cost-effectively build and integrate new connections for each disparate data source, with a sufficiently broad-based platform to leverage those connections to generate a full 360-degree patient view.
“Telehealth” is another term that has largely lost all meaning due various vendors and providers leveraging the buzzword to describe a multitude of products, services and programs. Telehealth began as the idea of connected devices in the home relaying crucial data to care teams in order to monitor vitals and provide health interventions as needed. The idea as it was initially conceived didn’t quite catch on among industry professionals due to regulatory and reimbursement issues as well as difficulty securing FDA approval, equipment costs and resistance to behavioral change.
Consequently, the meaning of telehealth has evolved to include telehealth visits, which entails remote clinical care delivery by way of secure video conferencing software. Looking ahead, wearables and passive monitoring tools in the home will become more prominent, and will thus create a new, upgraded definition of “telehealth.”
In this era, there will be more of an emphasis on secure, HIPPA-compliant apps and wearables to support population health management and proactive care. Of course, any connected health reading will require a physician visit to confirm diagnosis, whether the device is a Class 2 medical device or a wellness app.
Although these three terms are overused and commonly misunderstood, they are at the heart of the industry’s movement toward improved quality care, better patient outcomes and lower costs — the coveted Triple Aim. The challenge for health care vendors and organizations is to identify real solutions that truly advance these initiatives rather than simply rebranding IT offerings or antiquated models of care using the right buzzwords. Only then can real progress be made, and change achieved.