CKD PHM Model Cases

These model cases provide pragmatic examples of various chronic kidney disease (CKD) population health management (PHM) efforts implemented at different institutions. The cases provide detailed information about how the effort was implemented, including barriers and solutions related to privacy, technology, and administration.

CKD Identification, Phenotyping and Registries

• Cleveland Clinic: Development of an EHR-based CKD Registry for Use in Clinical Research and Improvement of Patient Outcomes (PDF, 254.6 KB)
• Alberta Kidney Disease Network: A Province-wide Central Repository of Laboratory and Administrative Data to Support CKD Research (PDF, 88.84 KB)
• Kaiser Permanente Southern California: Managing Chronic Kidney Disease Populations within an Integrated Health Management Organization (PDF, 293.24 KB)

CKD Analytics & Data Warehousing

• Institute for Clinical Evaluation Science, Kidney, Dialysis, and Transplant Program (ICES KDT): A Renal Program Nested in a Larger Population Health Management (PHM) Program (PDF, 333.94 KB)

Intervening for Improved Health

• Mayo Clinic: Project RED: Quality and Design-Method Approach to Improving ESRD Outcomes (PDF, 239.4 KB)
• Indian Health Service: A Strategic Plan for Population Health and Analytics (PDF, 369.77 KB)