Health Management

The growing importance of population health management


Greg White, Vice President & Managing Director, Cerner Middle East and Africa and Mike Pomerance, General Manager and Managing Director, Cerner Middle East, discuss the growth of healthcare spend and projects in the Middle East and the rising importance of ‘population health management’ to proactively keep communities healthy.

The Middle East healthcare industry has shown record growth over the past few years and is expected to continue growing in the future for reasons that include increasing population and the rising prevalence of lifestyle diseases such as those related to obesity, smoking or lack of exercise. This has led to a boost in the demand for better healthcare services. As a result, an estimated US$10 billion worth of healthcare projects are planned or underway in the GCC. The Middle East healthcare sector is expected to be worth US$60 billion by 2025 as the need for investment in facilities and services continues to escalate.

The outlook for healthcare technology adoption in the region is promising due to factors such as increasing population, rising income levels of residents, increased penetration of insurance, etc. With the adoption of new technologies, as well as the support lent by authorities, it is expected that healthcare standards in GCC will match or even surpass those in developed countries of the world. High investment projects and new regulations to ensure international healthcare standards are also other contributing factors to this positive outlook.

According to estimates from the World Health Organisation, the average human lifespan increased to 68 years in 2009 from 64 in 1990 with advances in healthcare facilities. Consequently, the annual growth rate of the aged population (60 years or older) surged to twice that of the overall population; this is expected to continue over the next few decades.

At Cerner, we believe that older patients need to have greater access and control over their care. Just as the banking and travel industries have taken a lead in their own respective sectors, Cerner makes the case that the same thing needs to happen in health care. For example, we have a personal health record (PHR), Cerner Health, which allows users to access their medical records online and input data such as diet, exercise and other personal and lifestyle information. This will help doctors better understand the lifestyle of their older patients, thereby delivering more efficient quality of care.

In addition, the electronic health record (EHR) within Cerner Millennium allows for an integrated approach to health and care so that different care settings are joined together to treat the patient throughout the care pathway in order to deliver better outcomes. This is particularly important, considering the increase in the average human lifespan.

We have used individual and team-based programmes, supported by information technology, to help people address the self-inflicted causes of ill health such as lack of exercise, poor diet and smoking. We emphasise the importance of managing one’s own health, and aim to place the power and responsibility back in the hands of individuals.

Our Cerner Health PHR also houses a set of personally-controlled health management tools and capabilities that allow people to connect with their health information.

One of the most attractive features of this is the personalized messages it sends including recommendations, alerts and education to help better manage one’s own health. Cerner Health also enables people to connect devices to their PHR. Cerner currently has three in use by the company’s staff: the Fitbit; Withings scale; and a glucometer. All of these devices automatically upload information to the employee’s PHR and in turn, with their permission, enables the information to be shared with the employee’s care team.

We are engaging people and giving them a reason to interact with their PHR whilst at the same time automating the process to make it easy and effective.

Our initiatives have yielded strong results. In 2010 we had 96% employee completion rate of their Personal Health Assessment. Our employees now actively managing their health; in the period from 2007 to 2010, 80% of a consistent cohort of over 2,800 employees maintained or reduced their number of health risk factors.

Slimdown throwdown

In 2011, Cerner staff competed in a global weight loss challenge called the ‘Slimdown-Throwdown’. Employees from around the globe formed teams of between four and six staff members and attempted to reach a percentage target weight loss; this was a great success and produced some interesting results. The analysis showed that between the 1,865 participants over 10 tons in weight were collectively lost. Our competition winners were awarded with an all-expenses paid Caribbean holiday.

At an individual level, there have been some rewarding stories of how employees’ lives have been changed for the better as a direct result of our initiatives. One employee said in an interview: “It’s really helped putting a number to it. It’s more concrete than just ‘oh, I need to lose weight.”

By setting her targets, sticking to a rigid plan of exercise and maintaining a healthy diet, this employee won our February Fit Challenge competition by losing more than 11% of her body weight. She went on to say: “I used to get out of breath walking down the hallway to conference rooms. Now I can walk anywhere. I can even run a little bit, and I can do stairs. I don’t get out of breath.”

Healthy M.E. Steps Challenge

Earlier this year, Cerner’s Middle East office developed the Healthy M.E. Steps Challenge for all its clients and employees in the region to help them lose weight and improve fitness by motivating each other. This was Cerner’s first health competition involving clients in the Middle East.

The Healthy M.E. Steps Challenge was a nine-week competition in which Cerner Middle East employees and client employees formed separate teams competing on the number of steps taken, using a Fitbit to help track their steps. Cerner created an interactive website, called Cerner Health Wins, to help client employees and employees set up teams, configure their individual profiles and manage the competition online by tracking their progress and the progress of others using a real-time scoreboard.

The winning team of the Healthy M.E. Steps Challenge with the highest average steps per participant was from Children’s Cancer Hospital – Egypt. The fourmember team lost more than 34 kilogrammes collectively during the competition.

Ahmed Badrawy, a member of the winning team called it an unforgettable experience for the organisation, emphasising the importance of leading a healthy lifestyle. He said that the team spirit, daily workouts and tracking of steps on a regular basis using Cerner’s competition website provided the boost and motivation needed to win this fun challenge.

Cerner received a lot of positive feedback from participants on how this competition effectively improved their health. For example, a participant in the Kingdom of Saudi Arabia reduced his Hb1AC (blood glucose level) from 0.64 to 0.58 (normal) and, after consulting with his physician, was able to stop taking his regular medication to control his sugar level before breakfast and supper.

Many employees already know what they need to do – lose weight, be more active, improve cardiovascular health, etc. but they may find it hard to get started. Our Middle East health competition provided a kick-start and improved overall determination. People are more engaged and motivated when opportunities to improve their health are competitive and social. This is evidenced by the amount of positive feedback we received from our clients and other heath associations asking Cerner to arrange similar competitions in the future to include participants who did not get a chance to be part of this year’s competition.

It is through initiatives and incentives such as these which have made wellness and exercise a huge part of the Cerner culture.

We are continuing the momentum with new competitions and incentives all the time, such as our current ‘Stay Slim’ weight loss competition. We continue to analyse the outcomes of our initiatives in order to make adjustments to achieve optimal engagement and results. This, in turn, further enables us to better understand our population and its health needs.

Date of upload: 22nd Jan 2013


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