Key Elements: Improving Population Health

Improving Population Health Principles

Leveraging Electronic Clinical Data

One of modern medicine’s greatest accomplishments has been the development of programs that monitor and improve the public’s health. Vaccines, improved sanitation and hygiene, safer workplaces, enhanced food and drug safety, illness and injury prevention, and improved drug and alcohol abuse programs have led to improvements in the health and well-being of people of all ages and backgrounds.²²

In the broadest sense, improving population health is about “what we as a society do collectively to assure the conditions in which people can be healthy.”²³ Effective efforts in this area often stem from coordination between healthcare organizations, governmental agencies, the scientific community and others to monitor, measure and promote healthy behaviors and disease prevention.

Because of the Blueprint’s overall goal of improving health and healthcare through information and information technology, this section focuses on one aspect of improving population health that is directly linked to health information technology and information exchange– leveraging electronic clinical data to support improving health at the population level. Electronic clinical data can help support health and healthcare improvements including public health interventions, disease management, quality improvement, provider performance measurement, epidemiologic surveillance, research, and more.

Data describing the process of healthcare and the health of individual patients is generated from many sources. The process of collating, analyzing, and using this and other data to benefit the entire population can support improvements in the way we prevent illness and injury, provide patient care, and manage care systems – important areas of focus if we are to assure the conditions in which people can be healthy.

In most cases, patient data is recorded in their chart using pen and paper. As electronic clinical data systems become more widespread and more patient data is recorded electronically during the process of care delivery, we must give careful consideration to the opportunities and challenges of using electronic clinical data for population health purposes.

Policies for how these data should be used and shared are still in an early developmental stage, though they are emerging rapidly. In particular, important work remains to be done to build consensus around privacy issues, consent, data control, and who can profit from the use of such data. Understanding and agreement must be developed to define the appropriate uses of both identified and de-identified data. The public does not fully understand the value of using personally identifiable data for the purposes of population health improvement. Thus it is difficult to have an informed debate around the trade-offs between individual privacy and the benefit of using health information to improve the health of all individuals (i.e., the public).

The principles for Improving Population Health lay the groundwork for the policy development that must be undertaken. The strategies and actions directly support engagement of multiple stakeholders to develop and implement those policies, as well as to create the resources, tools and data to support the use of electronic clinical data to improve the health of a population. With these policies, resources and tools in place, electronic clinical data can be used to enrich population health improvement functions, including disease management and wellness programs, quality improvement of healthcare delivery, disease surveillance, and research. Phase II of the Blueprint should help develop action plans for accelerating progress in these areas.

PRINCIPLES

1. The Use of Electronic Clinical Data is Beneficial and Necessary to Improve Population Health
   
   The use of electronic clinical data that is derived from the care delivery process is both beneficial and necessary for improving population health, including but not limited to the following critical areas:
   
   
   • Improving the quality, safety, efficiency and effectiveness of healthcare
   • Monitoring, detecting and responding to hazards and threats, to protect the public’s health
   • Expanding knowledge about disease, diagnosis and appropriate treatments and services
     
     
2. Everyone Who Uses Clinical Data for Population Health Purposes Should Abide by a Common Set of Principles and Policies
   
   Everyone who utilizes clinical data derived from the care delivery process for population health purposes should, in addition to abiding by current federal and state laws, rules and regulations, agree to and comply with a common set of principles and policies developed through a transparent, open process involving multiple stakeholders, including but not limited to consumers, providers, payers, purchasers, and researchers to build trust and confidence in the use of such data.
   
   
3. Those Who Use Clinical Data for Population Health Purposes Should be Transparent About Their Principles, Policies and Practices
   
   Those who utilize clinical data derived from the care delivery process for population health purposes should clearly disclose, in a transparent, easily accessible and understandable way, how the data is being used, as well as the principles and policies by which they abide.
   
   
4. Healthcare Organizations Should Support the Use of a Common Set of Data Derived Directly From Care Delivery Processes for Multiple Purposes
   
   Healthcare organizations should seek to use the clinical data derived from electronic clinical data systems as well as other sources to support population health improvement in a “one data source, multiple uses” approach. Agreement on and widespread implementation of a set of common data elements, standards for interoperability, policies for data sharing that build trust, and agreed upon business models will accelerate the use of data to support population health and other purposes.
   
   
5. Financial or Other Incentives Will be Required to Accelerate the Use of Clinical Data for Population Health Purposes
   
   While the results of improving population health include increases in healthcare quality, efficiency, and safety, such benefits do not always translate to financial benefits to the healthcare organizations that capture the data. Therefore, widespread use of clinical data will not occur without the creation and implementation of financial or other incentives.