The start of a Population Health Management Maturity Index: an international Delphi round

Summary: This workshop focusses on the international validation of items relating to context, mechanisms and outcomes to implement a Population Health Management (PHM) approach in order to reach a health system change. Based on two previous Dutch Delphi rounds, RAND UCLA appropriateness method, that will take place in 2022 with patient representatives as experts among others, participants are encouraged to reach consensus on relevance and importance of the context, mechanisms and outcomes provisionally divided into 6 PHM elements: Accountable regional organization, co-designing workforce and community, cross domain business model, emergent implementation strategy, integrated data infrastructure and population health data analysis. With the outcomes of these Delphi rounds, a first model is constructed that can support practice in the process and evaluation of implementing PHM.

Background: More and more initiatives around the world are implementing a PHM approach. However, there is no clear consensus on when to focus on certain facilitators or barriers, no blueprint exists. Therefore, a realist scoping review that created an overview of the existing knowledge in the field was used as basis for the first Delphi round.

Aims and Objectives: Internationally validating context, mechanisms and outcomes that were used to describe facilitators to implement a PHM approach to a whole system transformation.

Enable the participants to discuss and reflect upon the context, mechanisms and outcomes in the process of implementing PHM.

Identify and fill the gaps, which may still persist because of underrepresentation in the published literature.

Discuss with participants the practical application of the PHM Maturity Index.

Target audience: We aim for an audience of diverse stakeholders that have experience with implementing Population Health Management into practice – international practice leaders, researchers, policy makers, patient representatives and people with lived experience. In the months prior to the workshop, potential participants will be invited and asked to fill in a questionnaire that will form the basis for discussion.

Facilitators: The workshop will be led by the research team. Viktoria Stein will chair the workshop and the discussion, Annefrans van Ede will present the background of the research and the results so far, and Nick Goodwin and Marc Bruijnzeels will be present as discussants. A 2nd PhD student will take notes of the workshop.

Format: Prior to the workshop all participants fill in the questionnaire to score the items on a 9 point Likert scale on relevance, importance and occurrence. The answers are presented and discussed during the workshop.

Introduction. 5 min.

Presentation: Background of the research and the results so far, including the results of the questionnaire. 15 min.

Discussion: Depending on the outcomes of the questionnaire, all items that did not reach agreement (<.70) on relevance and importance are discussed and re-scored by the participants. 60 min.

Closing. 10 min.

Key Learnings: The participants have reached agreement about the context, mechanisms and outcomes that influence the implementation of a PHM approach. Through this workshop first steps are taken in understanding which factors matters most in disentangling the complexity of a complex adaptive health system change.