Developing Population Health Management in Ireland-Challenges and Opportunities

Population Health Management (PHM) is the concept of aggregating population data with data from multiple care and service settings, the analysis of that data into a single, actionable patient record, and using the insights gained to identify that population's specific healthcare needs and develop a tailored response to them. This is achieved through the use of data analytics, artificial intelligence, and digital technologies, by stratifying populations according to the risk of deterioration in health. This stratification allows the development of early personalised interventions with an emphasis on prevention, which are key to better outcomes. The overall aims of PHM are to improve the health and well-being of the population, and the patient experience of care, to reduce healthcare costs, to improve workforce well-being and engagement, and to address inequalities in health and care. This discussion paper will cover the core building blocks for PHN, the tools required to carry out population health needs assessment; population segmentation, and risk stratification. The development of PHM and its use internationally will be discussed together with developments and opportunities provided in the context of the Irish healthcare system. It will discuss the current status of PHM development in Ireland using a population health maturity matrix. Evidence and examples of impact will be provided and recommendations to advance its progression within the Irish healthcare system. Challenges for the future advancement of PHM include a better definition of the content of the segmentation analysis and the intervention steps, demonstration of its added value, in particular its cost-effectiveness, and aligning the rationale for action that underpins current customization efforts. Regarding programme implementation, those programmes that are well-supported, funded, and given sufficient time to develop are most likely to demonstrate impact. KEY MESSAGES: • Future advancement of PHM requires a better definition of the content of the segmentation analysis and the intervention steps, and demonstration of its effectiveness and cost-effectiveness. • Programmes that are well-supported, funded, and given sufficient time to develop are most likely to demonstrate impact.