Population Health, Value-Based Care, and Existential Annihilation

Another blog about population health? Yes, but wait… there’s a plot twist:

‍

Most of my pop health colleagues are (appropriately) focused on broader access, prevention, and wellness initiatives - knowing that they will positively impact their population's health over time. But many do not recognize the very real, very pervasive, very large problem they have today within their population – the growing number of patients in which cancer is missed.

‍

The good news is there’s a plug-and-play solution that reliably identifies patients at risk for cancer and facilitates diagnosis at an earlier stage. So you can move from palliation to cure, without lifting a finger. It just works.

‍

Population Health is facing a 3-pronged problem:

‍

1. Growth pressures: cancer care expenditures are projected to increase 30% by 2030 - to more than $245 billion. These costs put tremendous pressure on health systems with value-based or ACO contracts, especially when patients leave their systems to get care.
2. Late diagnoses: cancer rates are on the rise in patients outside of screening eligibility, and the majority of cases are still diagnosed in late stages.
3. Avoidable costs: stage IV lung or breast cancer costs 10 times more than stage I during the first year of treatment.

‍

You can effectively manage what you know, but what you don’t know can kill your patients.

‍

So, what report do you get on a regular basis that summarizes:

‍

• The # of abnormal findings identified on radiology studies
• The # of patients with abnormal findings that follow through with a guideline-driven care plan
• The # of cancers missed until it’s too late

‍

If you don’t get such a report (and you are not alone), you likely have no idea how pervasive this problem is or the dire outcomes your patients are facing. Most patients with abnormal radiology findings are not traditionally managed in a pop health sense, but rather subject to the vagaries, faults, and failures of the traditional “one patient at a time” health care process. They are not on your radar. But they damn well should be – if not you, then who?

‍

So, as a public service, let me provide you with the results of the report at your health system:

‍

• The # of abnormal findings identified on radiology studies: a zillion
• The # of patients that follow through with a guideline-driven care plan: a handful
• The # of cancers ultimately missed until it’s too late: way too many

‍

Most health systems have no ability to reliably identify important findings, no system in place to track them, and no dedicated staff to assure that the right thing happens the first time, every time. And it’s not a one-off problem, it’s a recursive need. Right now, the words “oh crap” should be forming in your brain.

‍

You can’t do things differently until you see things differently.

‍

Now that I’ve piqued your interest, it should be obvious that you have a problem. A problem that exists not because of bad people, but bad processes. Or more commonly, no processes. Either way, the solution is not to patch your broken system, but rather plug in a new system – one that integrates seamlessly with your EHR and is designed to do exactly what’s needed:

‍

• Identify - reliably identify abnormal findings in any body system on any study
• Plan – set a guideline-driven care plan
• Track – longitudinally track that care plan until it’s completed
• Rinse and Repeat - set the new plan and track that one, and the next…
• Report – report on your success, highlighting the earlier diagnosis of cancer, lives saved, and reduction in cancer costs

A child of five could understand this. Fetch me a child of five (Groucho Marx). 

‍

The nice thing about this diatribe is that, unlike most things in healthcare, there is a solution that works and makes sense - a solution that will save you, your institution, and your patients. The company is Eon, and their solution is a combination of software and care management staff.

‍

Eon works with population health leaders to catch and treat catastrophic illnesses in their earliest stages. By using advanced AI to analyze existing EHR records, they help organizations:

‍

1. Support growth: their system identifies patients at risk for lung cancer, pancreatic cancer, breast cancer, liver disease, cardiovascular disease, and more - proactively directing them to in-house services for care.
2. Manage late diagnoses: their clients consistently move from 20-30% of cancer patients diagnosed in early stages to 50-70%.
3. Reduce costs: over 75% of patients return for in-network treatment in the early stages of disease. The net result is not only thousands of saved lives, but a reduction in the overall cost of care.

‍

UCHealth, a leading academic medical center in the Rocky Mountain region, diagnosed 263 patients with cancer in the first seven months of their partnership with Eon. Their ‘safety net’ approach ensured patients were not being overlooked, and today, more than 50% of lung cancers diagnosed at UCHealth are diagnosed in early stages (compared to the 27% national average).

‍

At the end of the day, population health teams have a duty to manage and improve the health of the patients in their region. But most are letting patients slip through the cracks - patients whose abnormalities are mentioned, but not followed-up on appropriately. It’s time to start detecting disease early to improve patient health and reduce the cost of care - at scale.

‍

Let me help you solve this: 

Click here: www.eonhealth.com 

Intelligent care saves lives.

You’re welcome.

‍

Eric Newman MD

Former Director of Clinical Innovation, Medicine Institute, Geisinger

President, ELAN Consulting Company