What are Geneia’s key population health initiatives?
Geneia is a population health analytics and care management company. We help clients across the healthcare ecosystem: payers, providers, hospitals and employer groups. Our ultimate goal is to help improve patients’ health outcomes while allocating resources wisely. Our flagship analytics product helps clients derive clinical and operational insights via flexible utilization and clinical quality analytics. In addition to retrospective analytics, we have built and continue to build predictive modeling capabilities.
In terms of key initiatives at Geneia, I would name our efforts to advance our analytical capabilities pertaining to operational and clinical insights. We have continued to enhance our utilization and quality metric portfolio, and are adding insights pertaining to social determinants of health (SDoH) and AI-driven capabilities. For example, being able to predict and intervene to preempt hospital stays for diabetes complications is one area of interest. Ultimately, we would like to expand this approach to other disease areas such as heart failure, COPD, asthma and behavioral health.
We are continuing to enhance our retrospective and prospective medication adherence algorithms. It’s estimated that the U.S. healthcare system loses $300 billion every year due to medication non-adherence not to mention the impact on patients in the form of preventable emergency department visits and hospitalizations.
Another area of interest to us at Geneia pertains to adverse drug events (ADE). While we have incorporated industry-standard retrospective quality measures, for instance addressing compliance with monitoring tests for patients on persistent medications, we have also begun working on predictive models to preempt the development of adverse drug events before they actually occur. One example here would be prediction of bleeding events for patients on anticoagulant medications.
Are there are any lessons learned you can share?
Collaboration and engagement of all stakeholders across the board is key. For example, adoption by medical professionals and practitioners is key to the success of any analytics platform, including ours. On that note, we have designed a measurement tool and plan to survey care givers periodically to assess their satisfaction with our product and address pain points.
Provider adoption is of particular importance when it comes to AI-driven analytics. Since this is a relatively new approach in healthcare we need to work on enhancing the explainability of AI models. For example, an AI model predicting adverse drug events would be more valuable if a care giver could determine which modifiable risk factors drove the model to conclude the patient is at high risk to develop an ADE.
In terms of the role of technology in population health management and system transformation, where are the health IT gaps and unmet needs?
Broadly speaking, technology has the potential to transform clinical care and population health management. Digital assistants, the Internet of Things, coupled with the upcoming 5G cellular wireless networks, will increase patient engagement and change the way we communicate with patients and monitor and treat disease, in my view. Some of the gaps I see are integrating different data sources, incorporating AI to automate and increase efficiencies, patient privacy and data security.
What is the role of social determinants of health (SDoH) in population health?
At Geneia, we are developing capabilities to incorporate SDoH data into our analytical insights. Imagine a population health analytics platform that is able to tell the physician the patient is at risk to miss the next appointment because of a transportation barrier. There have been recent efforts reported in the media to meaningfully connect patients, care givers and payers with service providers that address social determinants.
SDoH will have great value, in my view, when aiming to predict which patients will develop a quality care gap, and what will be the best way to engage the patient (communication channel, type of message, etc.) to help them adhere to a care plan. Closing care gaps is critical to preempting more serious events such as emergency department visits and hospital stays.
Do you have any other thoughts on the role of technology in healthcare transformation?
I believe technology will be key to our efforts to transform healthcare and population health. It has been said that it takes 17 years, on average, for a new discovery to translate from bench to bedside. Technology has moved faster in the recent past – the iPod, for example, was launched 17 years ago and is already obsolete – and can help healthcare move faster as well.
Remote patient monitoring will transform how and where we provide care. As monitoring devices become less and less expensive at the same time the technology improves, it will become more worthwhile to move patient care, as well as population health, from hospital to homes and communities. That is often a patient’s preference as well.
Stakeholder alignment, collaborative platforms and data integration from multiple sources to support care coordination also are essential.