Population health management systems and methods for clinical and operational programs

Abstract

Methods, systems, computer storage media, and graphical user interfaces for population health management are disclosed. The population health management system may allow for cross-continuum tracking and subsequent interactions with transactional systems, providers, and/or patients. The population health management system may include utilizing clinically relevant algorithms to populate registries to enable healthcare providers to better facilitate care for a population of patients. The population health management system may consolidate and provide comprehensive condition-specific and/or patient situation specific information that is accessible and updatable across venues. The population health management system may create cross venue antibiograms based on medications information and susceptibility results which can be filtered for selected demographics. The population health management system may be utilized to provide multiple medication options including dosing, generic alternatives, cost, availability, and susceptibility information. Inappropriate trends may be flagged and monitored and medication stewards may be alerted or notified to intervene.

Having thus described the invention, what is claimed is: 
     
         1 . One or more computer storage media storing computer-executable instructions that, when executed by one or more computing devices, cause the one or more computing devices to perform a method that facilitates designing and utilizing population health programs, the method comprising:
 receiving, at a population health server, healthcare data from disparate sources;   utilizing the population health server to identify a population of patients based on a set of criteria;   utilizing the population health server to stratify the population of patients based on one or more algorithms to create one or more groups of patients, wherein at least one group of the one or more groups of patients comprises a plurality of patients having at least one substantially similar attribute; and   utilizing the population health server to create at least one registry, the at least one registry comprising at least a portion of the one or more groups.   
     
     
         2 . The media of  claim 1 , wherein the disparate sources include a plurality of EMRs, and wherein at least a portion of the plurality of EMRs is associated with the same patient. 
     
     
         3 . The media of  claim 2 , wherein the plurality of EMRs are associated with at least one of: a plurality of healthcare providers, a plurality of patients, a plurality of medical conditions, a plurality of healthcare venues and/or facilities, a plurality of organizations, and a plurality of communities. 
     
     
         4 . The media of  claim 1 , wherein the set of criteria comprises one or more medical conditions. 
     
     
         5 . The media of  claim 1 , wherein the healthcare data comprises one or more of clinical data, healthcare-related financial data, and patient sensor and/or patient device data. 
     
     
         6 . The media of  claim 1 , wherein the at least one substantially similar attribute comprises one or more disease risk levels and/or scores, one or more disease stages, and/or one or more healthcare objective. 
     
     
         7 . The media of  claim 1 , wherein the method further comprises providing a notification to one or more healthcare providers that one or more patients have been added to the at least one registry. 
     
     
         8 . The media of  claim 1 , wherein the method further comprises providing a worklist, the worklist comprising a list of one or more patients from the at least a portion of the one or more groups, the one or more patients associated with a substantially similar medical condition, wherein the worklist supports, across multiple venues, multiple providers, and multiple conditions, providing actionable decision support tools and interventions, wherein the worklist is configured to be parsed based on healthcare providers, venues, and/or one or more medical conditions. 
     
     
         9 . The media of  claim 1 , wherein the method further comprises providing information for display, the information comprising a timeline of events related to the one or more medical conditions for at least one patient, the timeline of events including laboratory results, medications, diagnostics, and/or interventions derived from the healthcare data from multiple venues and/or multiple providers. 
     
     
         10 . A computer system that facilitates designing and utilizing population health programs, the computer system comprising a processor coupled to a computer storage medium, the computer storage medium having stored thereon a plurality of computer software components executable by the processor, the computer software components comprising:
 a receiving component that receives healthcare data from disparate sources;   an identifying component that identifies a population of patients based on a set of criteria;   a stratifying component that stratifies the population of patients based on one or more algorithms; and   a creating component that creates a registry for at least a portion of the population of patients, wherein the registry accounts for one or more of: resources available to a patient; lifestyle and prognostic assets that can be used for prediction; and assets necessary for attribution, allocation, or measurement.   
     
     
         11 . The computer system of  claim 10 , wherein the disparate sources include a plurality of EMRs, and wherein at least a portion of the plurality of EMRs is associated with the same patient. 
     
     
         12 . The computer system of  claim 10 , wherein the healthcare data comprises one or more of clinical data, healthcare-related financial data, and patient sensor and/or patient device data. 
     
     
         13 . The computer system of  claim 10 , further comprising a management component that is configured to provide a proposed plan to allocate healthcare resources to the least a portion of the population of patients. 
     
     
         14 . The computer system of  claim 10 , further comprising a worklist component that provides a worklist that comprises a list of one or more patients from the at least a portion of the one or more groups, the one or more patients associated with a substantially similar medical condition, wherein the worklist supports, across multiple venues, multiple providers, and multiple conditions, providing actionable decision support tools and interventions. 
     
     
         15 . The computer system of  claim 10 , further comprising a condition component that provides information for display, the information comprising a timeline of events related to the one or more medical conditions for at least one patient, the timeline of events including laboratory results, medications, diagnostics, and/or interventions derived from the healthcare data from multiple venues and/or multiple providers 
     
     
         16 . One or more computer storage media storing computer-executable instructions that, when executed by one or more computing devices, cause the one or more computing devices to perform a method that facilitates designing and utilizing population health programs:
 receiving, at a population health server, healthcare data from disparate sources, the healthcare data comprising one or more of clinical data, healthcare-related financial data, and patient sensor and/or patient device data;   utilizing the population health server to identify a population of patients based on one or more medical conditions;   utilizing the population health server to stratify the population of patients into one or more groups based on at least one algorithm, wherein each group of the one or more groups comprises one or more patients having a substantially similar medical condition;   providing an opportunity for a clinician to confirm an output of the at least one algorithm; and   utilizing the population health server to create at least one registry for the population of patients based on at least a portion of the output of the at least one algorithm.   
     
     
         17 . The media of  claim 16 , wherein the method further comprises providing a worklist, the worklist comprising a list of one or more patients from the at least a portion of the one or more groups, the one or more patients associated with a substantially similar medical condition, wherein the worklist supports, across multiple venues, multiple providers, and multiple conditions, providing actionable decision support tools and interventions, wherein the worklist is configured to be parsed based on healthcare providers, venues, and/or one or more medical conditions. 
     
     
         18 . The media of  claim 16 , wherein the disparate sources include a plurality of EMRs, wherein at least a portion of the plurality of EMRs is associated with the same patient, and wherein the at least a portion of the plurality of EMRS are associated with at least one of: a plurality of healthcare providers, a plurality of patients, a plurality of medical conditions, a plurality of healthcare venues and/or facilities, a plurality of organizations, and a plurality of communities. 
     
     
         19 . The media of  claim 16 , wherein the method further comprises providing a notification to one or more healthcare providers that one or more patients have been added to the at least one registry. 
     
     
         20 . The media of  claim 16 , wherein method further comprises providing information for display, the information comprising a timeline of events related to the one or more medical conditions for at least one patient, the timeline of events including laboratory results, medications, diagnostics, and/or interventions derived from the healthcare data from multiple venues and/or multiple providers.