ensuring that users document the information needed for billing purposes, Greeley says. But he says the tools these companies currently offer “do not neatly support the transition [to value-based care]; you need a more flexible infrastructure.”
With value-based care, the cost of care depends more on factors outside the four walls of a hospital or clinic (we’ll discuss some of those factors shortly). And since the software sold by some of the leading EHR vendors was built with the fee-for-service model in mind, Greeley says, those companies’ products may be less well suited for population health management and other areas of healthcare that have emerged as a result of shifting reimbursement models.
Leaders at Epic say its decades of experience with electronic health records makes the company an ideal provider of population health management tools.
Ryan Bohochik, director of revenue cycle applications at Epic, says that some of the company’s earliest customers were health maintenance organizations (HMOs), which are not fee-for-service healthcare providers.
The HMO model “really in essence is a population health model,” Bohochik says. “For the things that now people generally think of as population health—‘how do we have better outcomes and do it for cheaper?’—we’ve been working with groups that do that since the mid-1990s.”
Epic introduced a population health application, Healthy Planet, about five years ago, says Alan Hutchison, a vice president at the company. He says about 125 of Epic’s clients already have Healthy Planet up and running, while another 130 Epic customers are currently installing the application.
In late 2015, the company did what Hutchison calls “a major refocus” around population health, part of which involved making it easier to bring outside data into clients’ EHR systems.
Besides the information that lives in a hospital’s patient records, data that might be useful for managing patient populations include labs, claims sent to insurers, prescription data, GPS and environmental data, and patient-captured results. That last data source has caught the eye of more providers recently, as the wearable trackers made by FitBit (NYSE: [[ticker:FIT]]) and other Internet-connected devices have proliferated.
Hutchison says Epic’s software is able to exchange data with telehealth monitoring tools so that, for example, providers caring for congestive heart failure patients can monitor fluctuations in their weight and potentially intervene prior to a health crisis. One Epic customer that required its congestive heart failure patients to weigh themselves more frequently and enrolled them in a care management program saw their hospital readmissions decrease by 45 percent, he says.
Providers of value-based care are interested in anything that can affect a patient’s health: where they live, what they eat, how they get from place to place. These factors have become a bigger consideration for providers with the move to value-based care, one of the key objectives of which is to make sure healthy patients stay that way.
“Eighty percent of the population is effectively fine—how do you take everybody else with kind of low-level, non-acute chronic conditions and manage them better in a more cost-efficient way?” asks Greeley, the venture capitalist in Boston. “What’s so exciting as a startup investor is that means there’s a lot of new products and services that have to be created.’’
Cerner, the company many consider Epic’s chief competitor, expects that the ability of providers to manage patient populations effectively will help shape the future of the
