Population Health for Europe - Why not?

Posted on: 25.08.2017

The term Population Health amongst European circles is not really a popular term as much as our US Counterparts. Yet the work which is involved is very much alive, and it’s better known as Public Health.

The European Public Health scene is incredibly active yet, we have still have a lot of work when it comes to developing and implementing technological solutions related to Population Health.

What is exactly Population Health and why isn’t it just called Public Health?

Many times, the distinction between population and public health has been confusing and even slightly divisive. It is a term which is widely used in healthcare, but not universally understood. Population health is inherently defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group (Kindig, 2017).

This easily explains why it is such an important theme within the American Health I.T communities and why it is quite the buzz word. Public Health, especially for the American health community, is focused more on the approaches that we use to improve the public’s health. The difference between Population Health and Public Health within the European community, doesn’t seem to be the case as they rather fall under the same umbrella of terms.

Are we doing enough when it comes to Population Health or Public Health and I.T within the European Community? We can do much more than we are doing today.

Population Health Information Technology and Public Health Informatics

Within the European Community we refer to Population Health I.T as Public Health Informatics. Here in Europe, it’s in the infancy stage and it’s interesting to note that developments are taking place slowly in places like Sweden (European Commission, 2017) and the European Centre for Disease Prevention and Control (ECDC, 2011) are also taking initiatives in this regard. In fact, the finest and most practical definition of Public Health Informatics that I have found is the “systematic application of information and computer science and technology to public health practice, research and learning”.

But what’s happening outside of Europe? The John Hopkins Bloomberg School of Public Health has a Centre for Population Health Information Technology (John Hopkins Bloomberg School of Public Health, 2017) and the CDC offer Public Health Informatics Fellowship (CDC, 2017) with yearly intakes. I also got to find out that Walgreens, one of the US’s retail leaders has even launched a ‘Health and Wellbeing’ Research Centre focused on Population Health Management (Wahlgreens, 2017). This Centre has focus areas such as “Access to Care & Patient Experience”, “Common Chronic Conditions” and “Digital Health and Member Engagement” offering relevant research papers and posters.

Yet another definition - Population Health Management

Population Health Management is a discipline within the healthcare industry that analyses and simplifies care delivery across the general population or a group of individuals. Technology comes into the equation with the possibility of creating solutions that support data aggregation, data governance and data analytics. In the US, this is even more important as it is tied to incentives that request that a health care provider to statistically prove a significant increase in a given population’s health. Business Intelligence (or what I would rather call ‘health intelligence’), data analytics and the crucial element of predictive analytics are part of the game.

Like everything else, we simply love objectives and goal, population health management is focused on three main goals:

-       Financial Improvement

-       Clinical Proficiency

-       Better Patient Engagement

These goals are proving to be essential in the shift of American healthcare towards value-based care (or rather value-based reimbursement).

Is this happening in Europe? Through initiatives such as the European Health Information Gateway, were you can access relevant health information databases such as the European Health for All Database and the Health Behaviour in School-aged children. Then again, are we applying this to a health system level with the possibility of optimising the healthcare pathways of a specific target population? We’re not quite there yet and even though we’re heading towards a future where Public Health has publicly embraced the role of eHealth (WHO Regional Office Europe, 2017), we still have got a lot of work to do.

At times, it’s easier to outline problems and challenges, so this time round I will offer some solutions. How can Europe get closer to providing European Citizens with better health outcomes using technology?

-       Empower the Healthcare I.T Industry, government, start-ups to create an ecosystem which provides the right population health management solutions

-       Ensure that all these solutions are designed with privacy and security being of the highest priority.

-       Heavily invest in a Public Health Workforce which knows how to use these technologies, and even more importantly correctly interprets and implements the insights.

The potential for Public Health and Information Technology to improve patient’s lives and provide value-based care through risk stratification, complete and comprehensive patients’ profiles with socioeconomic characteristics, is definitely something to look forward to.

 

Sources

  1. CDC. (2017). Public Health Informatics Fellowship Program (PHIFP)|CDC. Retrieved August 25, 2017, from https://www.cdc.gov/phifp/ 
  2. ECDC. (2011). Field Epidemiology Manual - FEM Wiki - Public Health Informatics. Retrieved August 25, 2017, from https://wiki.ecdc.europa.eu/fem/w/wiki/public-health-informatics
  3. European Commission. (2017). Learning Opportunity: Public health informatics - European Commission. Retrieved August 25, 2017, from https://ec.europa.eu/ploteus/en/content/public-health-informatics
  4. John Hopkins Bloomberg School of Public Health. (2017). The Johns Hopkins Center for Population Health Information Technology - Centers & Institutes - Research - Johns Hopkins Bloomberg School of Public Health. Retrieved August 25, 2017, from http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-cente...
  5. Kindig, D. A. (2017). What Is Population Health? - Improving Population Health. Retrieved August 25, 2017, from http://www.improvingpopulationhealth.org/blog/what-is-population-health....
  6. Wahlgreens. (2017). The Walgreens Center for Health & Wellbeing Research. Retrieved August 25, 2017, from https://www.walgreens.com/businesssolutions/research/research.jsp
  7. WHO Regional Office Europe. (2017). eHealth and public health – a beautiful marriage. Retrieved from http://www.euro.who.int/en/data-and-evidence/news/news/2017/05/ehealth-a...

Stefan Buttigieg

Specialist Trainee in Public Health Medicine, Malta