Q&A with AT&T ForHealth’s Andrew Biviano

Andrew Biviano is a Director of Product Marketing at AT&T’s ForHealth Solutions. In this role, Biviano tracks trends and happenings in the healthcare market. As the industry moves toward value-based care, population health management is becoming a topic of great interest. Recently, Biviano shared his views on the benefits and challenges associated with population health management.

HIMSSwire: How can population health management programs support value-based purchasing initiatives?

Andrew Biviano:  Once you understand the ‘so what’ of value based purchasing programs – that is, the fact that providers take on financial responsibility for an entire population of patients and, therefore, take on a considerable amount of risk, then population health management just makes a lot of practical sense. 

Population health management can help providers become more efficient in the way that they care for a specific population.  For example, providers can identify which patients to focus on, which are most in need of care.  In addition, they can continually assess what they are doing to ensure that the services and treatments they are providing are having the desired effect.  In essence, they can analyze the impact they are having on a population along the way – and that is really important as organizations strive to succeed under reimbursement models that reward quality care.

HIMSSwire: Overall, what are the advantages or benefits that various stakeholders will realize from population health management programs?

Andrew Biviano: When I think of the advantages of population health for patients, providers and clinicians, I think of two dimensions: better health outcomes and reduced costs. And clearly those two dimensions work together in that a healthier population costs less.  Those benefits are universal – and they can have a positive impact on everyone involved. The beauty of it is that all the stakeholders in the healthcare industry have wanted the same thing for so long and now they have a way to achieve it.

HIMSSwire: What are the main challenges for provider organizations that are trying to implement population health initiatives?

Andrew Biviano:  Many providers are not yet using all the right tools. Providers are focused on implementing their electronic health records, which is a great start. But the typical EHR, in and of itself, is not equipped to handle population health management. The software programs just don’t have the interoperability and the analytics capabilities needed.

When conducting population health management programs, providers need to aggregate a lot of data – and that means getting more data than just what is produced within their own four walls. Quite simply, organizations need to have the ability to exchange data.  That’s what is most important.  They don’t necessarily have to be involved in a full-blown HIE until they’re ready for that level of connectivity.  They could use a variety of clinical messaging tools to share data.  For example, the ONC’s Direct Project has developed standards designed to support secure exchange of basic clinical information and public health data. 

Exchanging data is just part of the challenge.  Once providers get access to each others’ data, they then need to normalize the data, store it, and then apply the analytics that makes it possible to turn the information into intelligence.

HIMSSwire: How do population health initiatives differ from the managed care programs of the 1980s and 1990s?

Andrew Biviano: Philosophically, they’re similar in a lot of respects. The biggest difference between the managed care programs and population health is that healthcare organizations are now in a better position to actually implement the strategies. Clinical research and advances made in terms of quality measures are much more accurate and robust.  Plus, the technologies available today, specifically interoperability and analytics capabilities, are better able to accommodate the demands associated with managing the health and care of an entire population.

HIMSSwire: What tools are currently being used and what are some tools of the future?

Andrew Biviano: Well, EHRs are the primary tools, even though they have many shortcomings surrounding the interoperability issues. Some analytics tools and disease registries are also being utilized. 

As we move forward, the analytics will broaden.  We won’t just be using claims data but we will start to combine it with clinical data to get a much broader view of the patient.  You will see biometric and behavioral data being used as well. So, healthcare providers will know so much more about the patients they are serving.  They’ll know if they smoke or drink and have an idea of what their diet consists of. 

In addition, we are starting to see a huge increase in the use of mobile technologies.  And consumers will continue to use all kinds of mobile applications to monitor their conditions or simply to monitor their diet and fitness to keep well.  That data can be tracked in near real-time by their providers, allowing them to identify relevant concerns.     

HIMSSwire: What specifically does AT&T bring to population health management efforts?

Andrew Biviano: AT&T provides an end-to-end population health management strategy. First, we make it possible to aggregate and normalize data from different sources. So, providers can assess information beyond the data that is developed within their four walls. 

Then we apply a couple of layers of analytics to all this data. The first layer is geared toward identifying gaps in care. With this type of analytics, healthcare organizations can identify which patients are due for certain tests or are testing out of range for a particular measure.  The second layer of analytics allows healthcare organizations to perform better on the financial side by stratifying risk. With this layer, they can predict which patients are at higher risk to incur more costs based on the volatility in their claims.  Both components provide insight on how best to utilize limited resources to care for the population. Finally, we offer tools for patient engagement and care coordination to allow providers to execute on the care plans that were derived from the analytics.