Defining Value in Population Health: Evaluating Program Impact and Outcomes

The University of Virginia (UVA) Health’s Population Health Department advances health equity by expanding access to patient-centered care and improving health outcomes. One of their programs, Interactive Home Monitoring (IHM), provides follow-up care for patients discharged from the UVA Medical Center through remote patient monitoring protocols, proactive care coordination strategies, and patient engagement practices. This paper aims to inform quality improvement for IHM by understanding the value of the program through currently collected metrics (e.g. readmissions, emergency department visits, length of stay) and through creating a more holistic understanding of value from multiple stakeholder perspectives. Defining and demonstrating the value of IHM is currently challenging due to the ambiguous nature of value and limitations in data collection and reporting, including data integration and capturing patient perspectives. This paper evaluates IHM’s effectiveness using statistical methods to compare outcomes between enrolled patients and those eligible but not enrolled. This addresses the challenges posed by limited data collection and reporting in defining and demonstrating program value. Through qualitative content analysis of interview notes and Mann-Whitney tests of datasets on the Locus platform, we define value for IHM. The findings aim to establish a framework for defining and assessing value in population health programs, aligning stakeholder priorities with program outcomes. This analysis provides actionable insights to enhance program effectiveness and measure value and could be used as a framework for similar population health programs.