Data-Driven Population Health Management in Asia-Pacific


In conversation with Farhana Nakhooda, Senior Vice President, Asia Pacific, Health Catalyst

Asia-Pacific faces an increasing prevalence of chronic diseases or non-communicable diseases (NCDs), caused by the increasing aging of the population. In fact, 55% of all deaths in Southeast Asia are due to NCDs. In addition to having to fight infectious diseases such as Covid-19, NCDs represent a significant burden on the region’s health systems.

A data-driven approach to managing the health of patient populations with NCDs can significantly alleviate this burden. Biospectrum Asia spoke with Farhana Nakhooda, Senior Vice President, Asia Pacific at Health Catalyst, who shared additional information on the importance of population health management in Asia-Pacific, the challenges health systems face in managing population health and the possibility for data and analytics to improve population health management, improve patient outcomes and reduce health care costs.

Chronic disease is one of the biggest health problems in the world, killing an estimated 40 million each year, of which 8.5 million reside in Asia. In Asia-Pacific, cardiovascular disease, diabetes, cancer and chronic respiratory conditions are among the most common chronic diseases. This is mainly due to the aging of the population and poor lifestyle choices such as lack of physical activity and the consumption of tobacco and alcohol.

Healthcare spending generally follows the 80/20 rule, whereby 80% of healthcare spending is incurred by 20% of the population, usually made up of cohorts with complex chronic conditions. The growing incidence of chronic disease is straining the region’s health systems, especially for developing countries which already struggle with inadequate financial and human resources, poor service delivery and information systems. weak. A well-thought-out population health management strategy can help alleviate some of these burdens by actively identifying, enrolling, managing and monitoring those who may be in that 20% of the population. It also involves examining high-risk patients who tend to and are at risk for chronic disease and enrolling them in prevention programs. Finally, the rest of the population that is healthy today should make sure to undergo regular health examinations to minimize the risk of ending up in the high risk group. This holistic approach to population health management ensures that the health of the entire population is assured, while programs are tailored according to individual health care needs.

Consider the example of a group of diabetic patients from diverse socio-economic backgrounds: providing a single care management approach may not effectively improve health outcomes for this group, as individuals may require different levels of attention. and care. For example, accessibility to healthy food, stable employment, adequate housing and family support are just some of the key social factors that can affect the improvement or health status of patients. Being able to expertly manage these nuances is essential for both improving health outcomes and reducing health care costs.

Population health management takes into account the factors that make up the complete picture of individual and collective health, including demographics, lifestyle and social background, among others. This leads to more responsive care delivery, which improves patient outcomes and enables more efficient allocation of health resources.

  • How do you define effective management of the health of populations and the struggles associated with it?

The biggest challenge is to provide and improve care for people with chronic diseases, while remaining vigilant against infectious diseases. Many healthcare providers are already under immense pressure today to fight infectious diseases, such as Covid-19, which has severely disrupted the treatment of chronic diseases.

A significant amount of health resources are required for the effective management of chronic diseases, including detection, screening, treatment and access to palliative care. Many healthcare systems lack the resources to meet these demands – in Asia-Pacific, for example, there are not enough physicians to meet this demand, with many patients learning to manage the conditions themselves and learn to manage the conditions themselves. minimize hospital visits.

Another major challenge is cost and affordability. Managing chronic disease is costly for both health care providers and patients. Take the case of diabetes: the cost of care for a single patient averages US $ 16,752 per year. This can have an impact on livelihoods. A study in Southeast Asia found that 48% of cancer patients experienced financial disaster, due to the out-of-pocket expenses for treatment. In countries where access to health care funding is limited, long-term treatment can even push people above the poverty line.

In addition, one of the most important aspects of effective preventive and proactive health care is understanding the science of behavior. Most overweight people know that they need to lose weight and that their weight can lead to diabetes and other chronic diseases. Likewise, most smokers know that smoking will shorten life expectancy. However, many continue to eat poorly and smoke. This can be attributed to a number of reasons including stressful lifestyles, depression, loneliness, among others, all of which have an impact on mental state. The ability to understand and influence people to change their behavior is a science and an art in itself.

Finally, the lack of timely access to precise data in near real time makes it difficult to actively identify cohorts at risk and manage populations. Healthcare teams often make decisions based on outdated data and have limited means to measure the effectiveness of their programs. Building the foundation for healthcare teams so that they can access the right data at the right time is essential to measure the success of their population health strategies.

  • How can data and analytics address these challenges and create a more sustainable approach to population health management?

There is a huge opportunity for data and analytics to ease the burden of chronic disease on Asia-Pacific health systems and also prevent the rest of the population from becoming chronically ill. With access to accurate, real-time data, healthcare providers will be better equipped to plan, allocate resources, and implement appropriate intervention strategies for patient populations.

Data and analytics can provide greater transparency into the population health journey by understanding what is happening beyond the four walls of a hospital. For example, in the case of diabetes, social determinants such as economic stability, education, social and community context, all have an impact on the effectiveness of diabetes self-management. Access to this data can enable health care providers to identify barriers to diabetes care and then design a program that is appropriate for the social background of patients. This approach helped a healthcare provider in the United States reduce patient follow-up visits by 19% because patients feel more confident and better equipped to manage their diabetes. Drawing on the data and analysis, the hospital was able to understand individual barriers, such as lack of knowledge, poor transportation, or affordability of medications, and worked to make diabetes care more accessible to each patient. The same approach can be applied to most types of chronic disease.

Data can provide a more complete view of the continuum of patient care inside and outside the healthcare system, providing a better understanding of the environments in which patients live, work and play. It helps providers prevent chronic disease, personalize care, and help patients successfully manage their own chronic diseases. This is extremely important as healthcare systems in Asia Pacific begin to consider a transition to value-based care, where success depends on improving patient outcomes rather than just the volume of patients treated. As Asia-Pacific continues to grapple with an aging population and high incidence of chronic disease, this data-driven approach can create a more sustainable path to managing population health.

Hihaishi C Bhaskar

[email protected]


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