Redefining Population Health to Deliver Health+Care at the N of 1: Part 3

Experts consider population health the next revolution in healthcare, but before data, analytics, and statistical patterns give up the secrets that will improve patient outcomes, the industry must create a framework of standards, guidelines, and measures that focus on individual impacts to health.

Any conversation about population health starts with definitions: what is health; what are suitable patient groups; what treatments do we measure; do we measure episodes or illness; what is the unit of measurement; what are the expectations. These initial steps will allow healthcare organisations and systems develop and personalise the revolutionary prevention, diagnosis, and treatment programs that will allow for improved patient care and help prevent further cost explosion.

A results-based population health model is a first step to reforming treatment and payer models, and incorporates new variables such as community and environmental factors, and social determinants. It also sets the premise that by using digital technologies and expanded data sets to stratify, follow, treat, and engage sub-populations, providers will be able to influence improved patient health outcomes and achieve a high value-for- cost ratio at the N of 1.

The American Journal of Preventive Medicine proposes (2012) another lens for population health-precision medicine. Hood’s P4 medicine (2010) describes an evolving perspective for medicine based on systems biology and information technology to enhance wellness (instead of treating disease) [9]. The four P’s describe a predictive, preventive, personalised, and participatory approach to medicine. Researchers have proposed adding a fifth P — population [10].

When we integrate this population perspective, it enables providers, institutions, and regional healthcare systems to prescribe health approaches that reflect the community and its surrounding social structure. Moreover, it allows them to use population screening for prevention, enables evidence-based practice to become personalised medicine, and assures alignment of participatory medicine and public health. More research will demonstrate the value of P4 or P5 medicine.

In the end, only person-centered care — those individual-level interventions — will provide the health benefits we are all seeking, improve patient/consumer experiences, and improve the value-to-cost ratio.

While the defining population health continues to be dynamic, it may be that utilising this evolution will unlock a few of the secrets to disease prevention, early detection, and more inclusive management. With the dawn of social media, patient’s lives are more public than ever with menial tasks and daily routines giving information to individual health status [11]. The consulting and research firm Frost & Sullivan has even suggested that tracking consumer spending will give the healthcare industry yet another significant source of information as it relates to such things as a patient’s dietary and exercise habits [12].

The capture of this information and then integration into the clinician-patient relationship opens doors to communication about lifestyle modifications, disease prevention, and management. Furthering innovation in information collection and analysis begins by integrating data to from alternative healthcare sources to create cohesive data sets that will become useful in disease prevention and reduce healthcare costs by improving health outcomes for individual patients at the N of 1, as well as populations.

This the final part of an abbreviated three-part series. Part one of the series can be read here. Part two can be read here.

[9] E. Singer, “A Vision for Personalized Medicine,” 9 March 2010. [Online]. Available: https://www.technologyreview.com/s/417929/a-vision-for-personalized-medicine/.

[10] R. E. Glasgow, M. L. Gwinn, M. J. Khoury and B. S. Kramer, “A Population Approach to Precision Medicine,” American Journal of Preventive Medicine, vol. 42, no. 6, p. 639–645, 2012.

[11] Wharton School of the University of Pennsylvania, “What Do Your Social Media Posts Reveal About

Your Health?,” 25 April 2016. [Online]. Available: http://knowledge.wharton.upenn.edu/article/whatdo-your-social-media-posts-reveal-about-your-health/.

[12] R. Das, “Five Ways Walmart And CVS Will Change Your Healthcare Experienc,” 6 June 2016. [Online]. Available: http://www.forbes.com/sites/reenitadas/2016/06/06/five-ways-walmart-and-cvswill-change-your-healthcare-experience/#407d89bc4604.