S.A.C. Halvorson is associate professor of medicine and chief, Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, Portland, Oregon. M. Tanski is associate professor of medicine, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon. L. Milligan is chief medical information officer, Information Technology Services, Asante Health System, Medford, Oregon. T. Yackel is professor of medicine, Virginia Commonwealth University, Richmond, Virginia.
Acad Med. 2019 Sep;94(9):1305-1309. doi: 10.1097/ACM.0000000000002614.
In 2017, the authors published an article describing the experiences of Oregon Health & Science University (OHSU) as it adapted to new challenges of changing payment models, the imperative to manage the health of populations, and the desire to compete for statewide contracts. The authors described Propel Health, a multi-institution partnership created in 2013 to deliver the tools, methods, and support necessary for population health management. In the ensuing two years there were considerable changes to the structure and mission of Propel Health, ultimately resulting in its dissolution in January 2018. Using the organizational framework from the original publication, this article shares a number of lessons learned with other academic medical centers as they make the journey toward value-based care and population health management. Examples of lessons learned include ensuring that clinical and administrative leadership are aligned and that shared partnership goals are not eclipsed by local strategic needs. The potential for shared data remains a powerful motivation to partner; however, technology integration can be costly and complex. Once data are available, the ability to respond quickly is a key competency. Understanding individual sites' needs and capabilities is critical before embarking on shared clinical programs. Best practices from industry-specific experts should be employed. Lastly, it is essential for partners to determine how shared gains/losses will be attributed, and how aggressively risk should be required. Next steps for OHSU, including new, local partnerships, are shared.
2017 年,作者发表了一篇文章,描述了俄勒冈健康与科学大学(OHSU)在适应新的支付模式挑战、管理人群健康的必要性以及争夺全州合同的愿望时所经历的转变。作者描述了 Propel Health,这是一个多机构合作伙伴关系,成立于 2013 年,旨在提供人口健康管理所需的工具、方法和支持。在随后的两年中,Propel Health 的结构和使命发生了重大变化,最终导致其于 2018 年 1 月解散。本文沿用了最初出版物中的组织框架,与其他学术医疗中心分享了许多经验教训,这些中心正在向基于价值的护理和人口健康管理转型。所吸取的经验教训包括确保临床和行政领导层保持一致,以及共同的伙伴关系目标不会被地方战略需求所掩盖。共享数据的潜力仍然是合作的强大动力;然而,技术整合可能既昂贵又复杂。一旦有了数据,快速响应的能力是一项关键能力。在开展共享临床项目之前,了解各个站点的需求和能力至关重要。应采用特定行业专家的最佳实践。最后,合作伙伴必须确定如何分配共享收益/损失,以及应如何积极要求承担风险。作者还分享了 OHSU 的下一步计划,包括新的本地合作伙伴关系。