Population Health Management 2.0

Population Health Management 2.0: It's a Verb

Published by Amy Mosher-Garvey on Jun 5, 2021 9:51:17 AM

In 2015, 30+ healthcare leaders were interviewed for an article on how they defined Population Health (Pizzi, 2015). Though much has changed in these past six years, including the need for a more granular understanding of patient needs in a pandemic-ravaged world, what has not changed are the limitations of traditional definition of population health nor the solutions offered when it comes to directly creating improvement in outcomes.

The definition of population health has been overly narrow since it was coined by Kindig and Stoddart in 2003. Sadly, nearly twenty years later, we are still stuck serving the original definition: “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.”


Five years ago, ~85% of respondents neglected to mention anything about taking the necessary action to change the outcomes that were being measured and displayed (Pizzi, 2015). This shouldn’t surprise anyone, population health is, after all, a buzzword, a noun. To drive improvement we must engage in action, a verb.


“Population Health is, after all, a buzzword, a noun. To drive improvement we must engage in action, a verb.”


Most advancements in population health have focused on better reporting. Large Electronic Health Record (EHR) companies like Epic and Cerner, owners of much of the clinical data that feed population health systems, have built their own platforms and applications. These applications are purpose-built to position data to help providers identify patients in need of an intervention and to reflect back the results of such efforts. There are many other independent population health companies doing the same, and a whole industry of newer tech companies that exist solely to plumb the myriad of available data sources to create a more comprehensive understanding of the patient’s data story.

The ability to aggregate and easily interpret the growing list of available healthcare data sources has been the holy grail of popu
lation health. This includes integration of clinical, operational, financial, claims, social determinants of health, genomic, digital device and web application sources (and others). It also requires the ability to filter and group episodes of care, create accurate numerators and denominators for disease registries, develop vaccination registries as well as public health and geo-centric databases.

To all of our colleagues that have contributed to this great effort this far, we are grateful. When it comes to population health, it’s clear that the winners will be those who have the most data. With the explosion of digital devices, smartphones, electronic medical records and virtual visits, we have access to more health-related datapoints than ever before.

...So now what?  Read Arine's White Paper to Learn Our Point of View...

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