Chapter 6: Developing and Gaining Support for a PHM IT Investment Road Map - Step 6
Excerpted from original article published by Population Health Management, copyright Mary Ann Liebert, Inc.
Guide for Developing an Information Technology Investment Road Map for Population Health Management
Jacquelyn Hunt, PharmD, MS, Richard Gibson, MD, PhD, John Whittington, MD, Kitty Powell, Brad Wozney, MD, Susan Knudson, MA
Many health systems recovering from a massive investment in electronic health records are now faced with the prospect of maturing into accountable care organizations. This maturation includes the need to cooperate with new partners, involve substantially new data sources, require investment in additional information technology (IT) solutions, and become proficient in managing care from a new perspective. This seven-part series, with excerpts drawn from the article originally composed by leading authorities on population health management and enabling IT, will help organizations chart their position on the population health readiness spectrum and enhance their chances for a successful transition from volume-based to value-based care.
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Developing and Gaining Supportfor a PHM IT Investment Road Map
Step 6. Analyze external alternatives to fulfill unmet PHM business requirements
The unmet PHM IT needs of burgeoning ACOs and health delivery systems have spurred the rapid entrance, adaption, and/or evolution of multiple IT market alternatives. To assess IT market maturity, we start by defining ‘‘mature.’’ Classically, a mature market is defined as one that has passed the emerging and growth phases of industry development.45 More specifically, we believe that the characteristics of a mature PHM IT market will include products that cover all or most JTBD, assimilate multiple data types, contain preconfigured evidence-based decision support for all stakeholders, enable plug-and-play installation, and provide easy access for all stakeholders with seamless integration across users. By this definition, the PHM IT market is decidedly immature, although rapidly evolving. Companies with historical roots in the insurance industry and disease management are working to develop more integrated platforms to cover a broader spectrum of PHM IT capabilities. However, at the present time, no single platform covers the breadth and depth of the PHM IT requirements represented in Table 3.
An organization that has clearly articulated its PHM business requirements, understands current state IT capabilities, prioritized unfilled PHM business needs, and determined budget and time line is well prepared to make discerning PHM IT investments. At this point, the organization should appoint a person or small team, under the guidance of an executive sponsor or committee, to conduct an analysis of alternatives. Given the complexity of the topic and overlap in solutions, we have found the following process to be expedient while yielding a robust outcome.
We suggest sending a request-for-proposal (RFP) composed of the organization’s PMH business requirements to a narrowed field of vendors. It is helpful to vendors when background information on the organization (eg, PHM goals, number and type of providers, number of covered lives, time line for decision making) is included in the RFP. We found that it is essential to provide mandatory self-scoring instructions with clear, distinguishable scoring definitions in order to optimize the chances of receiving standardized vendor responses.
To validate the extent to which a product’s suggested capabilities match the reality of the offering currently available in the market, we suggest a ‘‘deep-dive’’ assessment of viable alternatives. The deep-dive assessment, which differs dramatically from the typical vendor-driven demonstration, is conducted with a select few team members. In preparation for the deep-dive reviews, the team should create role-based use-case scenarios. The scenarios should consider the user perspectives that the business requirements must ultimately serve (Table 2). This provides a practical approach for the vendor to illustrate current product capabilities and/or acknowledge shortcomings.
We have found that deep-dive assessments are conducted successfully in person or remotely and typically require 3 to 5 hours per vendor product, depending on the breadth of solution capabilities. The deliverable from the deep-dive assessment and vendor interview is an internally validated rating of each product’s capabilities against the organization’s specific requirements. Additional time is required to complete product license and services quotes, estimate internal resource requirements, and interview existing customers for the final list of vendor alternatives.
Product demonstrations for all relevant stakeholders involved in investment decisions should be reserved for comparison of the final alternatives once all product information is gathered, compiled, and analyzed by the appointed clinical and technical team. Creating a visual display of the results aids decision makers by distilling complex criteria across multiple vendors into a color graphic that incorporates both functionality and cost. Our experience is that this methodology is efficient, maintains the governance process, and generates confidence-inspiring results that enable fact-based decision making.
45. Investing Answers, Inc. Mature industry. http://www.investinganswers.com/financial-dictionary/economics/mature-industry-1478. Accessed July 7, 2014.