Magazine article Drug Topics

Walgreens Model Takes Aim at Population Health

Magazine article Drug Topics

Walgreens Model Takes Aim at Population Health

Article excerpt

How can health systems sin simultaneously improve population health and patient satisfaction, yet reduce per capita was - the thme goals of the Triple Aim"?

The Institute for Healthcare impmvement a nonprofit center based in Cambridge, Mass., has been working on this question with oiganizations around the world since 2008, when Don Berwick, former president and CEO of the Institute, and his colleagues first introduced the Triple Aim concept.

At a population level, the Institute has encouraged organizations to explore interventions such as the promotion of greater use of primary care, enhanced communication between datai and ~deu1s thivugh e-mail wimspondence, and self-management of disease. Some organizations have tried a targeted approach, going after specific groups of patients with limited means, those without insurance, or those who have chmnic medk~l wnditions.

However health-system success may require both population strategies and more targeted strategies at the individual leveL according to Ian Dunon, vice piSdent clinical outcomes and analyiks, Walgreens. DunQn and his former Walgreens' colleague, Genint Lewis, outlined a new appmach for health systems flying to achieve the rnple Aim in their artide, "How health systems wuld avert tiple Fail' events that are harmfuL are wstly, and result in poor patient satisfaction," in the April issue of Health Affairs.

The Waigreens executives suggest that a stratified approach should be used to identify subpopulations of patients who are at risk of health events - described as "triple fail" events - and who could possibly benefit from preventive measures. A triple fail event is defined as a suboptimal health outcome that is too expensive and resuits in patient dissatisfaction. Some examples include unplanned hospital readmission within 30 days, untimely nursing home admission, and overmedicalization at the end of life,

While many organizations have relied on predictive modeling to identify individuals at high risk for one of these events, they have not stratified the population to determine which subset of patients to put their resources behind. A stratified approach not only identifies individuals who are at high risk; it identifies those who represent an opportunity for improved care and lowered healthcare costs, Duncan said,

"Our findings suggest that if [health systems] expand their thinking around how to classify patients in order to take a more predictive approach aimed at preventing triple fail events before they occur, the potential benefits for all stakeholders would be significant," said Duncan. …

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