In her MedCity News article entitled Achieving the “Holy Grail” of population health management in cancer care, Patricia Goede, VP of Clinical Informatics at XIFIN, make the claim that the key to unlocking the value of population health in cancer care, is to gather clinical information from EHR’s, diagnostic and genomic data from labs and financial data from billing systems – the so-called “holy grail”. Dr. Goede goes on to explain how cancer care is a unique use case for population health. First, multiple medical subspecialties are involved in diagnosis, staging, treatment planning and delivery of care with each subspecialty creating data often in a separate system. Second, the amount of data generated, the complexity of the data, and the fact that the data remained disconnected and siloed makes care team coordination more difficult. The disconnected data makes it difficult to link best treatments to best outcomes and without the financial data nearly impossible to demonstrate value.
Lori Anderson, Product Marketing Manager, XIFIN
Given the history of success that payors have achieved with population health initiatives for chronic diseases, Goede believes that payors may be best equipped to lead the charge of improving population health in cancer care. Payors’ primary driver is the migration to value-based care models of reimbursement, the goal of which is better patient outcomes at lower cost. Moreover, payors understand the delivery of data pathways help physicians order, treat, and care for patients from disease prevention to end-of-life. Payors have a long history of analyzing large data sets including claims data and developing predictive analytics that can benefit patients through screening, access to care, treatment and follow up in addition to improving our understanding of health economics.
In summary, the best practices of population health already used by payors including data integration and analytics can be applied to cancer care. Data integration has the potential to improve coordination of care, better patient outcomes and lower cost, making value-based care quite achievable.