What is Health Status?
The healthcare industry is one that is no stranger to jargon; possessing so many specialized terms and acronyms it can almost be said the industry has its own vernacular. So, when an industry outsider hears the term “health status” for the first time, it can be difficult to understand exactly what is being referred to despite the deceptively simplistic nature of the expression. This is not anything extraordinary, though, as many in the industry itself get mixed up over the true definition of the term. This is due to the fact that simply put, it’s a complex and ever-evolving topic. It is used in two contexts: for potentially fatal acute illnesses, and for chronic illnesses. When discussed in the context of the former, the term is easy to understand; it refers to the expected length of life for a patient who has developed a sudden, severe, acute illness. When discussed in the latter, things get complicated.
Health status for chronic illnesses, in general, is designed as a means to measure the overall wellbeing and welfare of hospital patients. The issue in defining health status arises when you must include measurement domains other than the length of life for these chronic illnesses that are long-lasting and recurring. This begs the question, then, “well how do you measure it?” Before we expand further, this chart below should help you visualize such a concept.
How do you Measure Health Status?
Depending on what professionals you ask, and what hospitals you ask at, you’re likely to get a hundred different answers. This is merely because experts disagree on what factors weigh more in defining a patient’s overall health status. A psychologist would weigh mental status more in a health status measurement than say a physician. Furthermore, a dietician might give a patient’s overall nutrition more weight in a measurement than say a surgeon. Even in closely related healthcare positions disagreements surface frequently. A pediatrician may delegate more weight to social factors in determining a patient’s health status than an adult primary care physician would. These disagreements are what make it difficult to measure the health status of large populations, as you can imagine.
Any decently clever person immediately would say the easy solution to this problem is standardization of the term health status; “why not just create a standardized measurement for every hospital to base off of?” While such a solution sounds textbook, the same issues arise once again. You must now get industry experts and academia to all agree, and such a task is insurmountable… especially when academia can’t even agree on why we sleep, why we yawn, or how many planets there really are in our solar system. What instead has occurred in lieu of an academician enlightenment, is hospitals and health organizations have created their own systems for measurement; and the industry has found some are better than others. Johns Hopkins health status measurement system has come to be frequently cited as best-in-class and is often emulated by other healthcare institutions.
Johns Hopkins University was the United States’ first-ever research university, and today spends a whopping $2.5 billion in research expenditure annually. Circa 1989 Johns Hopkins University created a clinician view of health status, including predictability, when it launched its ACG health status model. This model was created by clinicians, for clinicians, and has been highly effective in achieving the goals any health status system seeks to achieve; as well as being rated one of the top health systems in the world. Top clinicians throughout the USA, UK, and many other high-tier Western healthcare systems all emulate or directly use this model, allowing providers to properly and quickly identify an illness’s root causes; and also assists providers in giving proper diagnoses and being able to more accurately predict patient outcomes. The exact needs of a patient are now able to be met once root causes are determined, and the ACG model developed by Johns Hopkins immensely limits the influence of subjectivity and the bickerings of academia. But in considering how you measure and what’s the best way to do so, you are once again led down a thought path that begs another question, why do you measure health status in the first place? Before we touch on that, this graphic below provides a visualization of the Johns Hopkins Health Status Model.
Why Measure?
While many answers are available to choose from, no answer is as absolute and all-encompassing as this: to offer healthcare providers a degree of predictability, however volatile it may be. If a hospital can look at past patient outcomes with the same diagnosis codes that resulted in improvements in health status, it is now able to determine the absolute best method of treatment for said current patient; with the ultimate goal of keeping that patient out of the hospital. It’s an inimitable measurement tool that identifies patients risk level, identifies the proper resources needed, and is a good way of analyzing health-providers altogether performance. In simpler terms it accomplishes many useful things: it increases treatment effectiveness leading to better patient wellbeing and outcomes, saves hospitals and insurers money due to fewer admits; and it increases hospital efficiency as patients are being more speedily and proficiently treated, ultimately leaving everyone more satisfied with the healthcare system. So, the key then, is that health status must be used first and foremost as a tool to predict patient outcomes with the data available from tracking past patient’s health status. It’s a concept that by now you must see is indispensable, and it is important it gets implemented into as many systems possible, as standardized and efficiently as possible. This has never been easier in today’s world with the advent of ever-improving complex and valuable computer software. But, once again a clever thinker might be left with another question just begging to be answered: “well what if you as an institution has never tracked health status before and don’t have past data to point to?”
You Don’t Have the Data, So What do you Do?
The first logical error is in thinking you don’t have the necessary data to either point to past health statuses or to start tracking health status. One thing a hospital always has, barring any freak circumstances, is visit records. From such data, one could see how many times a patient was admitted, what they were treated for each visit, and for what conditions. From there you can now logically determine what treatment was given and if the results were desirable. Moreover, hospitals can contact their regional HIE (Health Information’s Exchange) to acquire more useful and relevant information if they are truly starting from nothing data-wise. HIE’s allow healthcare data and records to be moved across different systems and locations, to the healthcare providers benefit; it allows for hospitals to see what testing and treatment has already been administered, what diagnostic codes a patient has already received, important information regarding allergies and past conditions, et. al. By taking such action, efficiency is once again increased, and patient outcomes are by extension more likely to be positive. Health status can now begin to be tracked from this starting point, or it can be more easily implemented within a system already beginning to track health statuses.
In finality, it can be said health status tracking should be, if not already, a top priority for any healthcare provider. It saves money, it saves time and resources, increases patient’s overall health, and generally puts less strain on the system as a whole. So, for any clever thinkers, this is your cue to take health status tracking seriously.
Written By:
Shane Andrews
Chase Group Ltd.
Written by:
Robert Bonhag
Chase Group Ltd.
