How to Create a Data Driven Population Health Program

June 11, 2019
September 16, 2022

With the healthcare industry shifting from the fee-for-service model toward pay-for-performance value-based care, it is critical to begin understanding patients, the care they receive from your organization, and the social determinants they face at a deeper level than ever.

But how exactly do providers work to deliver more preventative and cost-effective care? How do you collaborate to assess risk and analyze spending? How do you stay connected with discharged patients and prevent future hospitalizations? How do you monitor and treat chronic diseases? You already know that data insight is the key, but you need a roadmap.

Below we have prepared a few tips for enabling a data-driven population health program. 


1. Consider the needs of your clinicians. The first thing to remember is that clinicians are not data practitioners—nor should they be. If you are designing a data driven program to support clinicians, always begin your project with the understanding that they will need visualizations that offer quick and easy to understand insights into patient care.

US Health Trends Map by County
County Health Trends Map

The availability of technology to gather and analyze data is critical, but it’s even more important to ensure that data is available to physicians at the point of care in a format they can use. Check out for examples of great health visualizations, like this map of the U.S. that shows health trends at the county level for both sexes for cancer, 21 major causes of death, life expectancy, alcohol, smoking, hypertension, obesity, physical activity, and diabetes.

2. Connect your data. While many healthcare organizations face the challenge of data siloed in various systems across the care network, the ability to aggregate and use this data is your foundation for a data driven population health program. You must be able to share patient data across your network to improve outcomes.

3. Develop a strategy to turn information into insight. Once your data is connected across systems, it’s important to begin turning that data into a usable asset. This often requires combining data sets to create a more holistic view of the care continuum. Tableau is a great platform for analyzing data and transforming it into actionable insights through simple but powerful visualizations.

4. Set yourself up to turn insight into immediate action. This is where you begin designing the program to offer personalized care that allows patients to become more proactive partners in their health. Data analysis can be used to identify members of the population who need intervention—the high-risk population. Methods of intervention should be tailored to the needs and abilities of the patients involved. For example, offering multiple communications options to cover those who don’t have access to text messaging or the Internet. This requires clinician buy-in and alignment with key metrics and organizational objectives. Easy to use workflows also make a big difference in adoption rates of programs like these among clinicians.

5. Make sure you have adequate support. Finally, services like strategy design, practice transformation, and staff augmentation can support the creation of your population health management program. This can be achieved by working with a service that understands not only the healthcare industry but also the role data analytics plays in supporting your organization. As a data analytics provider in the Midwest, Onebridge offers healthcare data expertise as well as insight into a provider’s various departments like finance, IT and human resources.


Onebridge is uniquely positioned as both a Tableau and Power BI partner, serving as an extension to those teams to enable you to achieve better insights from your data. Tableau is an expert in healthcare data and its potential to reduce healthcare costs, enhance care quality and improve the patient experience -- click here to view Tableau's 5 best practices to enable population health. Together, we recognize the challenge that every healthcare organization faces: getting from information to insight to action. We know how to connect your data, visualize and analyze it to provide quick answers to your most important questions.

We understand the challenges you face and the opportunities you have available. Contact us to find out how you can give your care delivery and population health program a major advantage with data.

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