Certified Case Manager Education: What is Population Health?

Population Health Management

Today’s Certified Case Manager is becoming more involved in assessing and working with information on population health. Population health looks at the data of an entire group instead of an individual patient and considers not only the general state of health of the population but typical outcomes as well.  “Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” (1)

 The term “population health” is a broad one and the group examined can be defined in a variety of ways; your chosen population could be a specific town or city, race or even age group. Viewing data across a broad population can help determine the best practices of care for that particular group and allow for that group’s needs to be anticipated and met. A definition of population health is: “The inherent value of a population health perspective is that it facilitates integration of knowledge across the many factors that influence health and health outcomes.” (1).    “The CDC, which has a Division of Population Health, is far wordier and gives more of a functional definition. Population health is interdisciplinary, according to the CDC website, and an approach that uses “nontraditional partnerships” among different sectors of the community — public health, industry, academia, healthcare, local government entities — to achieve positive health outcomes.” (2)  We see more content being added today to Case Manager Certification education curriculums on this interesting and important practice topic.

William Edwards Deming was a scientist and engineer and is best known for his principles of productivity; his approaches are often modeled by organizations looking to boost efficiency and quality while lowering costs. Deming’s involvement was a key component of Japan’s recovery after WWII; he also brought his unique take on the tie between quality and productivity to corporations in the US, including the Ford Motor company. This attention to quality helped Japan rebound after WWII and become a booming economy just a decade later; it also helped Ford and other US car makers understand why Japanese motors were outperforming homegrown products year after year. Applying these same principles to population health can help improve outcomes and as a natural byproduct of that improved care, reduce costs as well.

 

The Deming Philosophy and Healthcare

The Deming philosophy or approach at its most basic states that when an organization focuses on improving quality, costs will naturally fall over time. Case managers work with this philosophy everyday and are at the forefront of guiding quality, cost-effective care.  Conversely, an organization that is focused on costs will find their quality dwindling over time. This philosophy can be applied to a variety of industries – including healthcare. When we focus on improving care and outcomes, we can expect costs to drop; focus too much on costs and the quality of care can easily slip. Case managers know this well and serve as educators today to teach this to others on the health care team.

 

Applying Deming Principles to Healthcare

Managed Care = Managed Processes

The concept of managed care is less about planning the daily work of individual providers and more about the way that the entire process works. The broad approach that is taken to care will have a larger impact on the health of specific populations; engaging and including physicians and providers in the planning process is a must. These providers are the clinicians dealing with clients on a regular basis, and their insight could hold the key to improved overall process and better levels of care.

 

Engaging Physicians in the Process of Care

Including working physicians in the conversation will greatly improve both the approach to care and the outcomes. Doctors, nurses certified case managers and other providers are working “in the trenches” daily and already have the skills and knowledge to predict what methods will work and what will not. Incorporating frontline care providers in conversations about population health is a must if we are going to properly serve that population and understand what will work (and what won’t).

 

Accurate and Timely Data is a Must

“In God we trust…and all others must bring data.”
William Edwards Deming

This Deming quote is at the heart of why data is so important. If we can’t measure population health data, there is no way to tell if measures are resulting in improved outcomes, worsened outcomes or having no impact at all. The ability to measure and compare data from a specified population is a must; without accurate data and the ability to analyze it, there is no way to determine if measures designed to improve care have any actual impact at all.

The quality-based approach outlined by Deming offers many advantages and possibilities for population health and for healthcare in general.  For true gains to be made, the right data must be collected and accessible, front-line caregivers need to be involved in the planning process, and a broad approach to care for a specific population needs to be implemented. We need to continue to provide continuing education for our case managers and others on the health care team in the quality improvement process, including the use of quality improvement tools, data collection and appropriate interpretation of data.

Some reasons we should care about population health include; 1) it is people focused, 2) it seeks to improve the health of our society, 3) it helps to reduce costs as society becomes healthier, 4) it promotes medical science to deliver better care, 5) it leads to the ability to provide better access to care, and 6) it promotes better patient engagement (3). As such it fits very well into the role of todays certified case manager. It would be most advantageous if we provide our case managers more continuing education and opportunities to become involved in this area of practice. Becoming more intimately involved in population health will assist case management profession in its ultimate growth and expansion of specialized professional practice.

Are you a licensed health care professional who is interested in becoming a Certified Case Manager? If so, you may want to preview information on our Certification and Fellowship program at the American Academy of Case Management. You may access information here.

References:

  1. David A. Kingdig (Ed.) What is Population Health? Improving Population Health: Policy, Practice, Research. University of Wisconsin. Population Health Sciences.
  2. Karen Appold. Confused About Population Health? You’ve Come to the Right Place. Managed Healthcare Executive. Vol. 30, Issue 10. October 2020.
  3. Christina Rosario. Why is Population Health Important? Advanced Data Systems Corporation. July 8, 2020.

What are the Biggest Data Security Risks in the Healthcare Industry?

Padlock and keyhole in a printed circuit. Digital illustration.Written By Lucy Peters

The current global health crisis is doing more than wreaking physical havoc; it is also affecting data security, exposing potentially sensitive patient data and putting the efficient functioning of healthcare organizations at risk. In some parts of the world, there has been a 150% increase in cyber attacks in recent months, with the stress of the pandemic causing many organizations to lose sight of cyber security at a time in which it is most under threat from new advancements in AI and other technologies that make attacks swifter and wider in scope. What are the main threats to data security in the healthcare sector and what steps can be taken to reduce them?

Phishing Attacks

Prior to the COVID-19 outbreak, many organizations – including the Oregon Department of Human (ODHS) Services – fell prey to phishing attacks. Indeed, the latter suffered a breach affecting some 645,000 patients, compromising over two million emails after just nine employees responded to a phishing email. In order to counter this threat, organizations need to rely on technology such as multi-factor authentication to prevent malicious emails from making it to employees’ inboxes. Employee training is equally important in preventing cyber attacks; in some organizations, simulated phishing software is being used to train and test employees’ abilities to respond to such a threat. Investing in training is a highly efficient way to combat a problem that is costing companies hundreds of billions of dollars every year.

Insider Breaches

Research by Egress has found that about 63% of healthcare data breaches are caused by human error, while around 20% are caused by sending information to the wrong recipient. The famous UW Medicine breach (which exposed the data of around 947,000 patients) was caused by a misconfigured server that made private documents accessible to the public. Healthcare organizations should set up identity access management rules to be followed strictly by staff. They should also implement controls covering the printing of sensitive documents. New content aware print management tech tracks information on who printed a document, where it was printed, and the contents of a document. This can boost compliance and minimize security breaches.

Cloud Security

Research by MarketsandMarkets indicates that the cloud model is increasingly appealing for healthcare decision makers, as most organizations need solutions to deal with an exponential growth of patient data. The benefits of the cloud are indubitable, yet alongside them comes a host of new threats — including malware and ransom attacks. Solutions to the problem include performing regular backups (these should be stored offline or in a separate network from the main one), encryption, and the conduction of a full cyber risk assessment on all third party vendors and contractors.

The healthcare industry is increasingly relying on digital sources for the storing of sensitive data. Some of the main threats it faces include phishing, insider breaches, and cloud security issues. These can be tackled both through education of personnel and through the adoption of effective solutions such as efficient IT management services, a regular backup system, encryption, and the reliance on a professional IT team that is on the beat when it comes to new developments in cybersecurity threats – including AI-based threats.

 

 

 

Please also review AIHCP’s Case Management program and see if it matches your academic and professional goals.  The program in online and independent study and open to qualified professionals seeking a Case Management Program

Risk Management: Keeping Diseases Out of Healthcare Facilities

When healthcare facilities’ staff and vendor employees are aware of infection problems and take specific steps to prevent them, healthcare-acquired infection rates can decrease by more than 70 percent.

Sourced through Scoop.it from: ehstoday.com

Case management and risk management of disease is critical in hospitals.  Please review our program to see if you would like to become a certified case manager
Case management and risk management of disease is critical in hospitals. Please review our program to see if you would like to become a certified case manager

There are huge risks with disease and it spreading in healthcare facilities.  Case management and risk management look to contain these issues

If you would like to become a certified case manager then please review the program and see if it matches your academic and professional needs.

#casemanager

Become a Certified Case Manager and Help Hospitals.

The article, “6 ways hospitals can reduce length of stays”, by Katie Sullivan states

“As hospitals and healthcare systems pinch pennies and look for ways to operate more efficiently,  a new CentralLogic report reveals six simple steps they can take to reduce length of stay and increase on-time discharge.”

American Institute Health Care Professionals‘s insight:

Case Management is about quality for the patient but also reduction of price for both the institution as well as the patient.

This article looks over some simple steps to help hospitals run more financially smooth. This is very important because good case management can help hospitals and patients save funds and also improve quality assurance.

If you are someone looking to become a certified case manager, then please review our program.  If our program matches your professional and academic needs, you could become a certified case manager.

#howtobecomeacasemanager

See on www.fiercehealthcare.com

Become a certified case manager

Become a certified case manager
Become a certified case manager and enter into the field of health care reform

The article, “What Healthcare Reform Means for Providers”, by BHM Marketing states

“Healthcare Reform has brought about many changes, especially for providers. Failure to comply can result in substantial penalties. Are you ready? Are you complying 100%?”

American Institute Health Care Professionals‘s insight:

Certified case managers should have a strong understanding of how the new health care law will effect providers.

Dealing with providers and patients and how payments are given under health care is an everyday affair for health care managers.  Hence, this article will be of some use for those who have not investigated many of the new issues.  This article  looks at regulatory and cost issues that health care providers will have to deal with in the new future.

If you are interested in case management or would like to learn how to become a certified case manager, then please review the program.

See on www.bhmpc.com