Population Health Starts At Home

Population health programs start with a key consideration: which patient population with a particular need or condition should be a focus? For Novant Health, where 90% of its 25,000 team members also receive care at their workplace, treating team members as a distinct patient population was a no-brainer. Care coordinators monitor team members’ preventive care in Epic and target outreach in ways that are convenient for them, such as by making resources available at company events.

Care coordinators can see details like whether a patient is a Novant Health team member from the chart, and from there can customize outreach to a patient’s needs. For example, care coordinators can schedule follow-up visits in Epic during a post-operative outreach call, and specialists are available by phone 24/7 to answer questions after patients leave the hospital. Team members might even see a preventive care reminder on their paycheck or schedule a visit while signing up for health insurance.

Novant Health plans to continue making resources easy for patients to find and use, such as by expanding e-visit hours to better serve patients who might otherwise visit an urgent care clinic. This patient-oriented approach starts from within, according to Terri Cardwell, PharmD, Novant Health’s VP of clinical operations and value-based care. “What better way to start than with our own team members?” she notes. “They’re our family. Starting with your family first is a case study to prove that you can take care of others.”

Epic community members can learn more about Novant Health’s work in population health here.