To create new sustainable models of care will require real-time capacity to monitor and understand the health needs of communities, including understanding how our interventions are making improvements in the lives of families and in neighborhoods we serve. New tools, and a different lens to look at community health are essential in developing the missing analytical capacity that health systems need, such as examining geographic variability, location analytics, or predictive modeling.
Some steps health systems executives will need to take include:
- Higher quality patient addresses in their patient registration systems and clinical data repositories (e.g. point-of-service address verification), for higher confidence in analysis and interventions using sound best practices,
- Adding new types of highly localized information to manage the new healthcare environment, such as more accurate physician supply information, neighborhood characteristics, lifestyle characteristics, environmental hazards and exposures, and estimated demand for healthcare services.
Most health systems have never incorporated this type of information into their automated systems. For example, most hospitals do not have geographic Information Systems (GIS) capacity and electronic medical records with address validation as a standard feature. Such new technologies would give us the ability to invest strategically in prevention with a focus on areas of greatest need in our communities. They would also allow us to facilitate data and intelligence from other community partners (emergency workers/paramedics, etc.).
Critical needs going forward therefore include:
- Common community metrics to connect community prevention to clinical prevention (e.g. Prevention Quality Indicators),
- Shared information systems or ‘common versions of the truth’ within communities,
- GIS technology relevant to health systems,
- Predictive modeling,
- Address validation features as a standard feature for electronic medical records,
- The use of hot-spotting tools along with the intelligence of emergency workers/paramedics, etc. (what Methodist Le Bonheur healthcare calls ‘participatory hot-spotting’).
Health systems will nedd to change the way they view their investments in information technology, from valuing only systems that improve clincial efficiencies and patient care to investing in systems that deliver a continuous flow of clinically and community relevant information to caregivers to support desirable lifetime outcomes.