PHM is a systematic way of gathering, analysing and managing at-risk patients’ data through tools such as Utilization Management, Case Management, Disease Management, Portals etc. Healthcare organizations need to have technological capabilities within their care delivery processes to effectively use data to manage the cost and quality of care. To pursue more aggressive risk-based reimbursement models, these capabilities need to be expanded strategically and proportionately.

1. Technology Components
of a Complete
Population Health
Management System
Shridhar Purohit is a Healthcare IT consultant with extensive experience in devel-
oping product strategy, consulting and implementation of health care business
solutions. He has worked in delivering multiple life-cycle engagements from
concept to solutions across all product lines such as EMR, EHR ,Population Health
Management Solutions (Utilization Management and Care Management Applica-
tions) ,Life Sciences application CTMS (Clinical Trial Management System).
Shridhar Purohit

2. What is PHM and Why is it Required?
Population Health Management is the systematic process of patient data gathering, analyzing and managing patient’s data in the
health care system. It starts with identifying the population, condition-based stratification and engaging patients with respective
providers based on their needs.
The changes in healthcare industry are impacting traditional
hospital reimbursement models. Before the introduction of
Patient Protection and Affordable Care Act, hospitals were
reimbursed based on the volume of procedures, through
models like fee-for-service.
With PPACA, reimbursement models are shifting from
volume to value.
Along with the focus on improving patient experience of
care and reducing costs, hospitals should also focus on
improving the health of populations (IHI Triple Aim).
PHM initiatives will improve, if participation in
value-based reimbursement models such as account-
able care organizations (ACOs) increases.
The solution is to create a centralized entity from which
providers get shared services such as analytics, quality moni-
toring, and contracting resources. The centralized entity has
the operational benefits of scale—like a Management
Services Organization (MSO)—but supports population risk
management, instead of back-office functions.
Below are a few facts that highlight the need to enable
cost-effective quality healthcare in the US. The U.S. spends
more on healthcare, yet Americans have a lower life expec-
tancy and worse health outcomes than any other high-in-
come nation according to a 2015 study from the Common-
wealth Fund.
SOURCE: CTG Health Solutions and Clinovations. “Population Health Management: Leveraging Data and Analytics to Achieve Value.”
Population
HealthManagement
Shared
Vision
Leadership
Governance
Culture
Innovation
Subpopulation
identification
&
description
Predictive
analytics&
riskstratification
Provider
engagem
ent
CDS&guidanceDesign
Perfomancetracking
Patient EngagementDataSharing
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3. Conclusion
PHM provides the ability to build a consolidated view of each patients including demographics,
eligibility, claims, medical history, care plans, lab history, diagnostic information, communication
preferences, and privacy preferences. The aggregation of this information helps build the com-
plete picture. A PHM solution helps realize this and create workflows that make use of this infor-
mation to optimize care, improve quality and lower costs.
If you would like to bounce off your thoughts on this, let’s have a
conversation.
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engaging user experiences that reduce organizational cost and risk. Our healthcare and technology expertise, along with our flexible
engagement models, make us a great fit for developing the quality technology while reducing time to market and engineering costs.
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