Table Of ContentContents Contents
Orchestrating Value
Population Health in the Digital Age
Orchestrating Value
Population Health in the Digital Age
Pam W. Arlotto, MBA, FHIMSS
Susan P. Irby, MSHS
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Library of Congress Cataloging‑in‑Publication Data
Names: Arlotto, Pam, author. | Irby, Susan P., author.
Title: Orchestrating value : population health in the digital age / Pam W.
Arlotto, Susan P. Irby.
Other titles: Rethinking return on investment.
Description: 2 edition. | Boca Raton, FL : CRC Press, Taylor & Francis
Group, 2020. | Preceded by Rethinking return on investment / Pam
Arlotto, editor ; with Susan Irby, associate editor. c2012. | Includes
bibliographical references and index.
Identifiers: LCCN 2019046127 (print) | LCCN 2019046128 (ebook) | ISBN
9781138367340 (paperback) | ISBN 9781138367913 (hardback) | ISBN
9780429429507 (ebook)
Subjects: MESH: Medical Informatics--economics | Investments--economics |
Health Information Management--economics | Population Health Management
Classification: LCC R858 (print) | LCC R858 (ebook) | NLM W 26.5 | DDC
610.285--dc23
LC record available at https://lccn.loc.gov/2019046127
LC ebook record available at https://lccn.loc.gov/2019046128
Visit the Taylor & Francis Web site at
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Contents
List of Figures .....................................................................xi
List of Tables ...................................................................... xv
Foreword ...........................................................................xvii
Preface ................................................................................ xxi
Acknowledgments ..........................................................xxiii
About the Authors ........................................................... xxv
SeCtion i SettinG tHe StAGe
A New Cadence of Change ................................................ 1
Bonus Materials ................................................................... 2
Note ..................................................................................... 3
1 Orchestrating Value in the Digital Age ...................5
Purpose ............................................................................... 5
Introduction ......................................................................... 6
Defining Value .................................................................... 8
The Next-Generation Value Management Strategy ...........10
Conclusion ..........................................................................17
Notes ...................................................................................17
2 The Journey to High-Value Healthcare:
A Framework .........................................................19
Purpose ..............................................................................19
The Transition from Volume to Value ..............................20
The Journey to High-Value Healthcare—A Framework ....21
1.0: Brick and Mortar Healthcare .............................23
v
vi ◾ Contents
2.0: Transition ............................................................25
3.0: Digital Health and Connected Health ...............30
Conclusion .........................................................................31
Notes ..................................................................................34
3 Digital Health and the Fourth Industrial
Revolution ..............................................................37
Purpose ..............................................................................37
The Coming Tsunami of Change ......................................38
Looking Back to Look Forward.........................................40
The First Industrial Revolution and the Growth of
the Hospital ....................................................................40
The Second Industrial Revolution and the
Industrialization of Healthcare ......................................42
The Third Industrial Revolution and the Electronic
Health Record .................................................................45
The Next Great Revolution—Healthcare Is Primed for
Disruption .......................................................................... 46
Enter Big Tech ................................................................49
Conclusion ..........................................................................50
Notes ...................................................................................50
SeCtion ii LeADeRSHiP tHinKinG,
MinDSetS, AnD CULtURe
Change Is Not the Enemy, Rather the Only Path to
the Future ...........................................................................53
Notes ...................................................................................55
4 The CEO and the Orchestra Conductor .................57
Purpose ..............................................................................57
The New Role of the CEO .................................................58
Orchestrating Leadership Thinking, Mindsets, and
Culture ................................................................................62
Mission and Future Purpose ..............................................63
Change the Vision—Articulate the Value That Change
Will Bring and Invest Accordingly ................................... 64
Change the Leadership—Get the Right People
on the Bus ..........................................................................66
Contents ◾ vii
Change Planning Methods—Cultivate a Culture of
Experimentation .................................................................67
Conclusion ..........................................................................69
Notes ...................................................................................69
5 Healthcare Silos and the Leadership Pivot in
Decision Making ....................................................73
Purpose ..............................................................................73
The Leadership Pivot .........................................................74
The Impact of 1.0 Silos on Decision Making ....................75
Organization Charts and the Silo Mentality ......................76
The Pivot to Next-Generation Decision-Making
Models ................................................................................79
Conclusion ..........................................................................83
Notes .................................................................................. 84
6 Collaborate, Create, and Innovate: Platform
Thinking ................................................................85
Platform Thinking: A New Mental Model .........................85
Role of the Platform Players...............................................91
Platform Innovation and Design Techniques ....................94
Product Management .....................................................94
Design Thinking ............................................................94
Jobs-to-be-Done Framework ........................................ 96
Conclusion ..........................................................................97
Notes .................................................................................. 98
SeCtion iii tHe CARe MAnAGeMent PLAtFoRM
New Platforms, New Services ..........................................101
Notes .................................................................................104
7 The Care Management Platform, Its Layers
and Hubs .............................................................. 105
Purpose ............................................................................105
Defining the Care Management Platform ........................106
The Hubs That Help Define the CMP .............................111
Care Team Hub ............................................................111
The Consumer and Patient Hub ..................................113
viii ◾ Contents
The Hubs Combine to Create the
Next-Generation Platform ............................................116
Conclusion ........................................................................ 117
Notes .................................................................................118
8 The Value of EHRs as Foundational Systems ....... 119
Purpose ............................................................................ 119
The Clinical Information System and EHR Journey .......120
EHRs as the Foundation of the Care Management
Platform ............................................................................121
Value of the EHR .............................................................122
Challenges with Today’s Foundational Systems ..............125
The Next-Generation EHR ...............................................128
Conclusion ........................................................................129
Notes .................................................................................130
9 Interoperability and High-Performing
Networks..............................................................131
Purpose ............................................................................131
Definition of Interoperability ...........................................132
Interoperability—A Short History ....................................133
Standards for Interoperability ..........................................136
Key Components of the Interoperability Layer of the
CMP ..................................................................................138
Interoperability Challenges ..............................................140
Future of Interoperability ................................................142
Conclusion ........................................................................143
Notes .................................................................................144
10 Knowledge Management and Analytics ...............147
Purpose ............................................................................147
Data and Analytics for Population Health ......................148
The Knowledge Management and Analytics Layer of
the CMP ............................................................................153
Challenges and Critical Success Factors ..........................159
The Future of Analytics in Health and Healthcare .........162
Conclusion ........................................................................165
Notes .................................................................................166
Contents ◾ ix
11 Advanced Care Management ................................167
Purpose ............................................................................ 167
Advanced Care Management Concepts and
Framework .......................................................................168
Key Components of the Advanced Care Management
Layer of the CMP .............................................................170
The Future of Advanced Care Management ................... 174
Conclusion ........................................................................ 174
Notes .................................................................................175
12 Consumer and Patient Engagement .....................177
Purpose ............................................................................177
Consumer and Patient Engagement—Population
Health’s Missing Piece ......................................................178
The Consumer and Patient Engagement Layer
of the CMP .......................................................................181
The Future of Consumer and Patient Engagement .........186
Conclusion ........................................................................186
Notes .................................................................................187
SeCtion iV MAKinG VALUe ACtionABLe
Next Steps ........................................................................189
13 The Population Health Services Organization.....191
Purpose ............................................................................191
The Population Health Services Organization ................192
Founded in the Tradition of the Management
Services Organization ......................................................194
A Case for Digital Health—Diabetes .............................. 200
Conclusion ........................................................................204
Notes .................................................................................204
14 Final Thoughts .....................................................207
Purpose ............................................................................207
Mindset Shift Redux .........................................................208
Moving the Needle While the Needle Moves .................208
Notes .................................................................................213
Index .......................................................................... 215
