How do you define your population health framework?

[clairebonaci]

Claire Bonaci 

You're watching the Microsoft U.S. health and life sciences, confessions of health geeks podcast, a show that offers Industry Insight from the health geeks and data freaks of the US health and life sciences industry team. I'm your host Claire Bonaci. Today we begin a health plan series on population health with guest host Amy Berk. Amy welcomes Dr. Joel Shu, the chief medical and quality officer at Emory healthcare network to discuss the future of Population Health Management.

Amy Berk 

Welcome to a series of podcasts the first of many around population health. We have today, the chief medical and chief quality officer at Emory health care network, Dr. Joel Shu. Dr. Shu, thank you so much for joining us. We really appreciate you being one of our experts and the opportunity to discuss population health and the future population health management and its trends for both payers and providers.

Dr. Joel Shu 

Well, thank you. I've been at Emory healthcare network for about three years. And prior to that, I served as vice president of population health, and a chief medical officer and some other roles for Catholic health services of Long Island. That was a six hospital system about similar in revenue to Emory healthcare. And prior to that started my career as an anesthesiologist. And I'd say I got into the role by kind of opportunity that presented themselves, I was part of one of the first ACOs in New Jersey, and started that without even knowing at that time what an ACO was. So I've learned a lot along the way. And at this point, it's been about 10 years now in this space.

Amy Berk 

Wonderful. Well, we share some similarities as I to remember the development of the ACO myself and as the director of population health here at Microsoft, I'd be very interested to hear, you know, what your thoughts are on, you know, priority focus of Population Health Management. So what is it that, you know, top of mind, if you will, around the population health management framework for you What, what do you think about when you think about population health management?

Dr. Joel Shu 

Well, the nuts and bolts are first gathering the data, and that's a lot harder than it sounds. If all of our patients came to only our systems for care, then it would be a little bit easier. But of course, patients go everywhere, and they get their services that the doctors that are most convenient or most helpful to them. And then we're trying to aggregate data across a lot of different sources to understand how that patients do it. Once we have some data, then it's a matter of creating workflows that make sense for the physician. And right now, physicians still build in two different kinds of systems, one being the traditional fee for service billing system, and the other being some type of value based vehicle. And we have to create a workflow that makes sense in both billing contexts.

Amy Berk 

No, that definitely resonates and with the growth of value based frameworks, and how payers and providers are going to be communicating and exchanging that data becomes even more important. Any thoughts on the differences in how a payer versus a provider might approach the data, and even collaborate on the data?

Dr. Joel Shu 

No, here at Emory healthcare, we have a lot of collaborations with our payer partners, especially in the value based vehicles. Now, many people think that if they're the payer, you're gonna have all the data and it's gonna be perfect. But even for them, it's not as easy as it sounds. So we take all of our payer partner data and feed it through a common platform to make it easier for us to analyze and our providers to use. That's been a challenge that we've been working through with each of our partners. And luckily, through value based vehicles that allows a healthcare system and insurer to have a lot of the same align goals, and therefore partner together as opposed to the, you know, the historical adversarial relationship.

Amy Berk 

That's really great to hear and definitely a step in the right direction. I'm moving on to, you know, question number two, what technology do you think optimizes population health management and and of those technologies of that technology or technologies how do you think that technology can help optimize population health management?

Dr. Joel Shu 

Sure, well, the first technology goes back to the first point, which is the data aggregation. Now any technology that allows us to capture how our patients are doing and be able to integrate that with where we normally look at data that's to everyone's advantage. And the second technology is the workflow piece. So I always kind of orient us back to there's the data piece, and there's the workflow piece. So each technology has to help in one of those two arenas to make it easier for us to help our patients and understand how they're doing.

amy 

That's really great to hear. And, you know, we at Microsoft, really do believe that technology can optimize the population health framework and data is at the core of our solution, if you will, around, you know, what we can glean insights from the data, how we act on the data, being more predictive with our data, all of these technical solutions really help to cast that net forward, you know, as to how we harness and leverage the data, so can definitely rely on that point around data. Next question, then is, you know, I think you answered this, but I'll explore it even further. What then does the data tell us about effective interventions? So, you know, once we harness the data and leverage that data, how we act on that data? And what that data can tell us? Can you expand your thoughts on that question, please?

Dr. Joel Shu 

Sure. Well, here at Emory healthcare, we are a top 20 research institution. And that doesn't mean that everything we do is research, but it does kind of guide how we think of a pre and post approach. So when there's a particular issue that we're trying to solve or patient outcome that we're trying to improve, we will think, okay, what's been the historical performance, what have we been doing, after we implement a solution, then we'll give it enough time and effort enough patients to enroll to see how that program is performing? Often it's not the technology but the execution of the process. So that's our typical framework to understand our interventions and how we performed and

amy 

so a lot then tied to performance improvement, if you will, on quality measures that really then circumvent around the success of your programs. Yes. Very good. All right. And then final question is, what do you think is next for population health management, as you think about the framework today, at your organization? What's next at Emory healthcare, and even broadly, more broadly, pardon me? What is next for population health overall? What would you say to that?

Dr. Joel Shu 

Okay, well, a lot of population health or, you know, risk based contracting, or value based contracting, does depend upon the local politics or government. So you see certain states that are maybe more blue leaning and have the highest Medicaid populations, no surprise, they have large Medicaid redesign projects that I participated in New York to kind of drive value based care with it. States, such as Texas, or Georgia, for that matter, that have more red leaning, governments tend to have less involvement in their Medicaid redesign. and that in turn drives the rest of value based contracting. So government policies are a big part of it, and politics are a big part of it. But outside of that, I would say, this is a space that's ripe for disruption. And you see lots and lots of venture capital and other money coming into the space to take shots at what they think could be the next area to disrupt the way that we provide care and make it better.

That's really interesting. You know, the interesting point around the politics of it all and how that plays into the population health framework is definitely something to think about. Tell me this, then Dr. Shu any final thoughts or recommendations that you might have around population health management as we think of it?

Dr. Joel Shu 

Well, I think the next magic solution as it pertains to the data space will be to make it easier for systems to integrate other systems. And it's right now the standard is, let's say, a community physician, we bring it into our network, or another healthcare system. It's a one to two month project to integrate their data and a lot of dedicated effort to that, you know, so someone who makes it an easier system to bring that data together. Now, that's the first step in making sure that our population has all the information it needs to drive good performance.

Amy Berk 

That's wonderful. And I think that aligns with the space of interoperability and, you know, our FHIR solutions to bring that data together to be able to exchange the data and as we've seen in the 21st Century Cures Act, the opportunity to exchange data between payers and between providers and patients and payers and their members. So definitely becoming that much more important in this space of Population Health Management. Well Thank you so much Dr. Shu. Really appreciate your thoughts on the topic of Population Health Management. I really wish you all the best at Emory healthcare. I know the system is doing wonderful things. And it sounds like you're very innovative in your approach to population health management and definitely very interesting to hear your thoughts. So I thank you for your time today and I look forward to furthering the discussion. Thank you.

Dr. Joel Shu 

Thanks for having me.

Claire Bonaci 

Thank you all for watching. Please feel free to leave us questions or comments below and check back soon for more content from the HLS industry team.