HIMSS 2017: PHM Market Observations

HIMSS 2017: Population Health Management Market Observations

Written by Alex Green

With Population Health Management (PHM) plastered across the majority of exhibitors’ stands at HIMSS last week, it’s hard not to be cynical about the subject and consign it to the list of many other transient themes. However, if you delve underneath the hype there were several serious and well defined solutions on show. Whilst no single vendor yet offers a complete solution, both in terms of technology and services, vendors now have a relatively clear and consistent definition for what needs to be offered to address PHM. One message I thought particularly hit the mark was from Health Catalyst. Their message; PHM is a verb not a noun, and solutions should be designed with this in mind. This certainly resonated and is a message several other vendors would do well to take on board.
Here are our top five PHM market observations from the show:

EHR Vendors Catching Up Fast

EHR vendors have struggled to keep pace with some of the specialist vendors in the PHM market. This has led to companies such as Wellcentive (now part of Philips), IBM (via its ownership of Truven Health, Phytel and Explorys) and Optum taking market leading positions. This is despite the EHR vendors having a significant installed base of customers which should have provided rich pickings for their PHM solutions. Providers and other customer groups have often reported that the PHM solutions offered by EHR vendors are limited in functionality compared to those offered by the specialists. In many cases the solutions are often simple bolt-ons to the EHR offerings, developed largely only to address Meaningful Use, rather than solutions that will drive change as health systems increasingly take on risk.

However, the tide does appear to be turning. Via acquisitions and product development a number of the EHR vendors appear to have caught up and are starting to leverage the advantage that a large installed base of provider customers brings. This was evident from the solutions on show at HIMSS and also if considering the 2016 financial results from a number of the EHR vendors that were announced in the run up to HIMSS. For example, Cerner, reporting $234 million of PHM business in 2016 and Allscripts, reporting $235 million PHM business for the same year. Both are good illustrations that PHM is starting to have positive financial outcomes for some (although not yet all) of the EHR vendors.

Analytics Moving Beyond Claims and Clinical Data

A key focus of many of the PHM and analytics vendors during the show was that PHM platforms require analytics solutions that go well beyond simple claims and clinical data when developing risk stratification. Pooling data from other sources, such a demographic data, social determinants of health, patient generated heath data, geographic information sources and other unstructured sources is now viewed as essential by many (although there is still work to do to convince some physicians). Using this data to develop patient personas will enable providers and payers when implementing stratification processes to better target and communicate with different patient types.

Admittedly, the requirement to aggregate non-clinical/claims data has been the general message for some time, but I certainly witnessed an increased emphasis on this during my meetings last week. This is perhaps a sign that the companies that weren’t doing this well have started to get their act together. This is one part of the PHM market where specialist analytics solution providers still have an advantage to some extent on some of the broader solution providers and some of the EHR vendors. Companies such as SCIO, Lexis Nexis and Health Catalyst certainly exhibited some solutions around this that were particularly compelling.

All or Nothing

Rolling out one element of PHM does not mean you have a PHM solution. From vendor and provider discussions during HIMSS it was clear that in many cases solutions had been rolled out that utilised just one or two elements of PHM. This may be a data analytics or data aggregation tool, or a patient engagement platform.  Stand-alone these components are not addressing the PHM need and will not give the provider the outcomes that are required as they make the transition to value-based care or to taking on risk. Only a complete solution that brings in data aggregation, analytics, risk stratification, care management, care coordination and patient engagement with a results feedback loop will allow providers to obtain the full benefits they’re looking for from PHM. Furthermore, the technology is just the first step; organisational adjustments and infrastructure changes are essential in ensuring that the technology investment pays dividends. My discussions from HIMSS illustrated that in many cases providers and other customer groups that are dipping their toes in PHM are heading for failure as they are not embracing the whole system approach that is required. This does not mean that a vendor needs to offer a complete solution, there is certainly room for best of breed specialists for certain elements of PHM. Rather, the providers need to be taking a whole system approach.

Consumerisation of Healthcare

The modern healthcare consumer in the US is used to having choices. In banking, retail, travel, and most other areas, product or service information is abundant and decisions are made quickly, based on price, convenience, reputation and quality.  Increasingly, consumers are approaching healthcare with a similar attitude. They want to be able to compare the quality of the service they’ll receive, view feedback from other service users, manage appointments online, understand the cost implications of medical procedures, contribute their heath data to the decision-making process and be able to easily communicate electronically with providers. HIMSS demonstrated that technology vendors are now starting to take this on board and are developing patient engagement solutions that address the marketing needs of providers operating in an environment where their customers are increasingly fickle, demanding and where brand loyalty carries a lot less weight. Influence Health has been a long-time player in this space with solutions that have typically been used for marketing purposes. The company is now integrating its solutions with clinical patient engagement functionality to meet this need. SalesForce continued its high profile showing at HIMSS, adding weight to the argument that good CRM is increasingly essential in this more consumer centric healthcare environment. EHR vendors are also developing solutions that better address the marketing needs of providers. For example, Allscripts has a compelling 2017 development plan for its FollowMyHealth solution that will go a long way to addressing the needs of providers that want to execute sophisticated marketing strategies.

It’s Getting Harder to Differentiate

As I toured the booths last week, the constant theme I heard from the vendors was how only they had the right data aggregation tools that blended claims and clinical data from multiple EHR with social determinants of health. How only their analytics solutions gave in-depth actionable solutions for patient stratification. How only their portal went further than meaningful use to offer a truly compelling patient experience. Finally, how only their implementation team could offer the provider support needed to really take advantage of PHM. Unfortunately, the reasons given as to why they were different were more than often than not, very similar. I am being slightly facetious here as there were some that could provide good evidence of solid differentiators. However, most solution providers are now clear on what is needed to offer a comprehensive well-constructed PHM solution, including support services. And although each vendor is at a different point in terms of how far along they are to having a solution that addresses all facets well, they are all moving ever closer. This will ultimately result in differentiation becoming increasingly difficult.

New Market Report from Signify Research Publishing Soon

A full analysis of the population health market will be provided in Signify Research’s upcoming market reports ‘Population Health Management – North America Market Report 2017’, publishing in 1Q 2017, and ‘Population Health Management – EMEA, Asia & Latin America Market Report 2017’, publishing in 2Q 2017. For further details please click here or contact Alex.Green@signifyresearch.net.