Population Health Management | Philips Healthcare

An innovative and cross-continuum approach to care management redesign

AMITA Health, one of the largest health systems in the Midwest, was looking to redesign its Care Management program in preparation for their transition to value-based care.

They had engaged other consulting firms but those initiatives had not achieved the cultural shift needed. AMITA Health challenged Philips to transform their system – as well as their own mindset - to provide strong, patient-centric population health management aligned with their vision of delivering efficient, high-quality, faith-based care.

Philips collaborated with AMITA Health to deliver a new Care Management platform supporting improved communication and coordination of care for high risk patients across the AMITA Health continuum.

amita cs an innovative crosscontinuum approach

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Who/where: AMITA Health, Midwest, USA.

Challenge: Redesign the Care Management Program and instill a cultural shift to be supported by all levels of the organization and which provides strong, patient-centric population health management.

Solution: Philips provided an innovative, collaborative, and phased approach to Care Management Redesign which aligned with AMITA Health’s vision of delivering high-quality, faith-based care.

Results: Our consultants helped AMITA Health build a common Vision of Care Coordination across its diverse care settings, engaged the frontline staff and physicians in designing and testing a human-centric Care Management program prototype, and delivered a platform to support improved communication and coordination of care for high risk patients.

A strategic framework

Our consultants recommended a phased process of vision building, rapid prototyping, and implementation support to provide a smooth transition to a sustainable, value-based care delivery model.

We believe the pillars of quality Care Management are:

Governance: Focusing on clinical, quality, and financial structures.
People and processes: Identification of patients through risk stratification, intervention to address specific unmet needs, coordination across varied teams and care settings, and close engagement with patients, care givers, and physicians.
Measurements: Relevant and timely feedback on the interim progress and overall program outcomes.
Technology: Enabling an efficient and effective new care management program through automation and data analytics.

A collaborative and innovative process

Specific attention was given to the human and cultural factors in setting out to redesign AMITA Health’s Care Management program. Frontline staff, system leadership, and other stakeholders across the organization were engaged to help develop a common vision and create and implement new care management processes.

Visioning

An enterprise-wide assessment was completed to review associated functions and processes. Insights from data analysis and stakeholder interviews, workshops, and site observations helped develop an understanding of existing practices and identify opportunities for improvement.

Cultural changes were implemented through empathic design focusing on the needs of eight unique population cohorts in the community. A vision was developed and agreed via collaboration of multidisciplinary AMITA Health teams and Philips consultants.

Prototyping and planning

A co-create workshop was held to identify key care management processes: Identification, Intervention, Coordination, and Engagement. Detailed workflows, tools, process, and key performance indicators (KPIs) were identified with staff and leadership input.

A practical program was built and tested in an “innovation sandbox” - a live operational environment with limited scale for rapid learning and improvement.

Our consultants provided rapid rounds of on-site support and huddle calls and evolved the program through facilitated learning, sharing, and program adjustment during the testing period.

During a final co-create workshop, the team reviewed lessons learned, finalized program design, and identified key considerations for systematic enterprise expansion.

Enterprise expansion

Philips helped AMITA Health embed the new program into daily operations and enable the cultural and operational changes with leadership and frontline staff.

A train-the-trainer approach helped educate frontline staff, support internal capabilities, and sustain program ownership of the operational leaders.

Sustainable results

Through strong stakeholder engagement and human-centric design, Philips helped AMITA Health redesign their Care Management program prototype that improved communication and coordination of care for high risk patients across the AMITA Health continuum.

Results of this engagement included:

Development of a common vision of care coordination supported by all levels of the organization.
Designed and tested a human-centric care management program prototype that engaged the frontline staff and physicians to improve communication and coordination of care for high risk patients.

Philips and AMITA Health will continue to leverage the high level of engagement from staff and stakeholders to expand the program across the entire AMITA Health continuum.