Collaborating to Manage Populations

Partners HealthCare and HealthCatalyst create a novel strategic alliance to enhance Population Health Management.

If payment weren't an issue, how would top clinicians organize health care to best serve the needs of their patients? This question is at the center of a $30 million strategic alliance between Partners HealthCare and data analytics firm Health Catalyst, announced September 9. A system-wide technology subscription agreement will apply Health Catalyst's suite of technologies to intellectual property developed at Partners. Through this agreement, the team will bring innovative strategies for population health management to other institutions around the nation. “Health care delivery has developed in response to a fee-for-service payment system. And while that has produced really amazing benefits, over time what's happened is that the types of care that aren't paid for under a fee-for-service system have really atrophied,” says Timothy Ferris, MD, Partners' Senior Vice President of Population Health Management. That's where the collaboration come in. Under the new arrangement, Health Catalyst will license Partners-derived technology, content and analytics innovations. These innovations aim to realign health care delivery, allowing clinicians the freedom to provide extra support to patients with complex medical needs. The ultimate goal is to help patients live healthier, more independent lives. “What's exciting about working within Partners is that our clinicians have tons of ideas about how they could make care better if they weren't constrained by the payment system,” notes Ferris. “And so our job, in population health management, is to vet these ideas and test these ideas. And if they work out, we adopt them throughout the whole system.” Relations with Health Catalyst began in 2013 when Partners first invested in the company and commited to co-develop technology. The recent agreement expands this relationship and will allow Partners to launch a new HealthCare Center for Population Health. Led by Ferris, the Center will facilitate the market application of intellectual property generated by Partners to other health care providers around the globe, expanding access to an array of innovative health care solutions, products and services. “The new Center will be the locus of the interface between Partners and Health Catalyst,” Ferris says. “We get a lot of calls from other parts of the country, and frankly the world, asking us how we're doing what we're doing. The Center is going to be an incubator and tester of ideas, a gathering place for people interested in transformation, and a place to train people from outside the system in the methods that we have developed.” Since 2006, Partners HealthCare has explored a number of strategies to fill the gaps left by traditional fee-for-service health care models. From the initial Medicare Demonstration Project – which significantly reduced emergency room and hospital readmission visits among the elderly by assigning each patient to a nurse care manager – emerged the Integrated Care Management Program, giving patients with complex, chronic illnesses 24/7 access to nurse care managers familiar with their medical conditions. In the past 3 years, Partners has explored more than 20 individual programs spanning primary, specialty and post-acute care. Some programs encourage patient engagement through electronic media; others determine how to structure incentives, or use data and analytics to improve care. An e-consult program, for example, allows primary care doctors to query specialists by email. “It turns out that in ambulatory primary care, about 20% of referrals that a primary doctor makes to a specialist could have been answered by a simple email,” Ferris notes. “The patient didn't need to make another appointment, didn't need to park their car and pay for parking, didn't need to pay another copay – all the specialist had to do was look at an x-ray or answer a simple question. But because that's not paid for under a fee-for-service model, specialists don't do it.” The program has greatly exceeded expectations. “It's making our doctors feel great because they're not wasting their patients' time. And they're getting great answers from world-class specialists right away. It's just better care,” says Ferris. These and similar changes have produced significant benefits across Partners' institutions. The Medicare program alone boasts a total savings of $40 million. More than 10,000 high-risk patients now have a personal care manager. And there's significantly reduced mortality among the system's sickest patients. The new arrangement with Health Catalyst will bring these strategies to a larger market, drawing from talent from across the Partners system. “Unlike classical innovation, which often comes out of the lab, this is the aggregation of hundreds of people's work, which is a novel way for Partners to go to market,” Ferris says. Comparatively robust programs across the nation primarily take the form of integrated delivery systems, such as Kaiser Permanente. “Just about everyone is doing something – one, two or three of the things we're doing,” Ferris notes. “A few institutions are doing many of the things we're doing. But what makes Partners different is the breadth and depth of our programs, and the inclusion of academic health centers. That combination is possibly unique.” “Health transformation is going to require the ability to guide large populations of patients in a coordinated, efficient manner that moves the needle in their overall health,” says Health Catalyst CEO Dan Burton. “Our collaboration with Partners HealthCare is going to put state-of-the-art tools and capabilities in the hands of hundreds of systems throughout the U.S. and overseas. It has the potential to bring enduring benefits to millions of patients.”