Dr. Nick and the Invisible Patient – Harlow On Healthcare
By David Harlow, JD MPH, Principal, The Harlow Group LLC
Twitter: @healthblawg
Host: Harlow on Healthcare
As Chief Medical Officer at BaseHealth, Dr. Nick van Terheyden (aka Dr. Nick) serves as the voice of the physician at the company. He provides strategic insights in product development and marketing as BaseHealth works to bring to market a predictive, evidence-based and data-driven population health management platform.
Base Health is working from the ground up to build a new approach to population health, focusing on the individual patient, what Base Health calls “the invisible patient.” This is the individual we all know exists who is going to have a catastrophic interaction with the health care system but we don’t yet know who and what – this is the patient who presents in the emergency room with a significant clinical problem leading to costly treatments and significant long term health issues. As Dr. Nick says, “We find the patient before that takes place.”
I spoke with Nick about his new role at Base Health, and he is very excited. Dr. Nick says that the way we practice medicine today is riskier than it needs to be. He likens relying on claims data alone (as he posits many health systems currently do, in their efforts to manage patient health) to driving down the highway while looking in the rear view mirror. Instead he urges that we must Look at the EHR, at Rx data, appointment data, anything that exists about the patient, and assemble it in one place, and examine it carefully. Base Health combines more comprehensive information about individuals and analyzes it using its machine learning knowledgebase including all 150 million-plus medical papers in the PubMed database.
Using these tools, BaseHealth is able in 90% of cases to accurately “risk-adjust” a patient population, thereby enabling the clinical care system to focus its efforts on providing preventive services to those at greatest risk. The system has been implemented at Banner Health, for certain conditions, in the Medicare Advantage population, after Banner tested the BaseHealth algorithms by applying them to old data about patients that had been followed at Banner. BaseHealth predictions based on the old data closely tracked actual experience in the same cohort of patients.
By providing more accurate risk adjustment, Banner Health says it is able to provide a positive ROI for the payor and provider organizations, and benefits to the patients as well. If previously under-reported risk is reported accurately earlier, the Medicare Advantage plan and a risk-bearing provider organization would be paid a higher risk-adjusted capitation rate earlier in time, giving them a longer runway of greater resources to use to address the unmet needs of the invisible patient.
Please have a listen to learn more.
Listen to David Harlow’s interview with Dr. Nick on Harlow on Healthcare. Harlow on Healthcare airs Weekdays at 4:30 pm ET.
This article was originally published on HealthBlawg and is republished here with permission.
