COLUMBIA, MD – Johns Hopkins Medicine will apply its expertise in 23 clinical specialties and subspecialties of Resolution Health’s data analytics-driven rule sets used for identifying actionable opportunities for care intervention.
The relationship will enable Resolution Health to go beyond evidence-based medicine and get better at identifying opportunities accurately based on existing guidelines, said Earl Steinberg, MD, president and CEO.
He said candidates need to be identified early enough to provide them with alternative care strategies and balanced information of their benefits and risks so that physicians and patients can make informed decisions.
Steinberg noted that employer groups have focused on disease management for the top one-half of 1 percent that consume the most healthcare dollars but have not “bent the trend cost.”
“Employers are looking for something else,” he said, referring to the other two populations – those with multiple chronic conditions and everybody else.
Through controlled studies, Resolution Health has been able to prove ROI in the identification for care intervention, he said. For example, in the area of high-cost, discretionary surgical procedures, there is no evidence to support the use of surgeries over other less-than-evasive procedures for low back pain.
Predictive modeling is used to identify which patients have a high likelihood of having surgery within four to 12 months by looking at the escalation of service use such as back X-ray, pain medication prescriptions, steroid injections and MRI.
The key is identifying near at-risk members, said Lynne Dunbrack, program director for Health Industry Insights, an IDC company. Identification of members in the early stages of chronic conditions and getting them into a program and engaging them early delivers a two-fold benefit – improving the quality of their lives and reducing healthcare costs.
“We need the expert guidance from a variety of clinicians in several specialties,” Steinberg said, to be able to expand the ability to deliver targeted interventions.
Eric Bass, MD, professor of medicine, epidemiology and health policy and management at Johns Hopkins University, said one challenge the partnership will be addressing is the rapid technology changes that require updating rules every year.
Bass, who is part of the team at JHM working with Revolution Health, said that with so many changes in evidence-based medicine, physicians welcome the revisions that would help them keep up to date with best practice standards.