Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

How to aggressively pursue population health

David B. Nash, MD, MBA
Policy
July 27, 2013
Share
Tweet
Share

A good recipe is one that combines high-quality ingredients in appropriate quantities to produce a savory main course or a decadent dessert.

It strikes me that, in order to answer the Affordable Care Act’s call for us to aggressively pursue population health, we must first understand what the recipe calls for.

Dichotomous as it may seem, the primary ingredient for population health is accurate, comprehensive data on the individuals who comprise the population.

In our radically changing industry, where health systems and academic medical centers are increasingly rewarded on the value achieved (i.e., appropriateness of tests and therapies ordered and the health outcomes achieved), the synergy between individual data (e.g., clinical, socioeconomic, genetic, environmental) and population health is key.

With the science and business of genomics moving forward at breakneck speed, and the digital technology industry keeping pace, we are rapidly approaching a time when gene sequencing performed in a physician’s office will inform the choice of therapy for each patient — and every patient will have a Web-enabled cell phone where such medical information can be stored and health behaviors can be tracked.

Here are a few more essential ingredients in the recipe:

Evidence. We must replace the “art” of medicine with medical practice based upon a robust body of evidence — a feat requiring dramatic change in current practice, wherein a mere 20% of clinical decisions made at the bedside are evidence-based.

Such evidence is being accrued by means of global clinical trials involving tens of thousands of patients.

Electronic systems. We must retool our electronic systems to provide the data we need to optimize patient treatment. For example, we need to create registries with collective data on target populations (e.g., patients with chronic conditions such as diabetes and hypertension) to better understand which therapies and interventions are most appropriate for which patients.

Population-based “big data.” Today, private industry is developing sophisticated health and fitness applications that deliver behavioral messaging and interventions to large targeted groups at a relatively low cost.

We must harness this “big data” input by millions of people who are beginning to track their own health status and manage their own conditions and organize it to help deliver care at the individual patient level.

Medical education. We must shift the medical education paradigm away from the traditional approach (a single patient with a single problem for whom treatment is determined by “guesswork” based on the clinician’s experience) toward a model that incorporates population-based data and research evidence as well as “personalized” information to better understand and treat each patient.

Obviously, the recipe for population health is fraught with complexity and will likely take time and effort on the part of the healthcare industry’s “top chefs.”

ADVERTISEMENT

Nevertheless, for those of us who practice medicine, positive change will come when we are able to reconcile population-wide, evidence-based recommendations with individualized care that is guided by each patient’s unique genetic makeup.

David B. Nash is founding dean, Jefferson School of Population Health, Thomas Jefferson University and blogs at Nash on Health Policy and Focus on Health Policy.

Prev

Patients and clinicians don't have the same goals in mind

July 27, 2013 Kevin 1
…
Next

Suicide in female physicians: Recognize, respond, reconsider

July 28, 2013 Kevin 49
…

Tagged as: Primary Care, Public Health & Policy

Post navigation

< Previous Post
Patients and clinicians don't have the same goals in mind
Next Post >
Suicide in female physicians: Recognize, respond, reconsider

ADVERTISEMENT

More by David B. Nash, MD, MBA

  • Does the House of God stand the test of time?

    David B. Nash, MD, MBA
  • a desk with keyboard and ipad with the kevinmd logo

    Nonprofit hospitals: The potential for conflict of interest is huge

    David B. Nash, MD, MBA
  • a desk with keyboard and ipad with the kevinmd logo

    Quality measures benefit from quality improvement

    David B. Nash, MD, MBA

More in Policy

  • Understanding alternative drug funding programs

    Martha Rosenberg
  • The impact of policy cuts on ableism in health care

    Ahna Shome, MD
  • Accountable care cooperatives: a community-owned health care fix

    David K. Cundiff, MD
  • Why U.S. health care costs so much

    Ruhi Saldanha
  • Why the expiration of ACA enhanced subsidies threatens health care access

    Sandya Venugopal, MD and Tina Bharani, MD
  • Why extending ACA subsidies is crucial for health care access

    Curt Dill, MD
  • Most Popular

  • Past Week

    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • The loss of community pharmacy expertise

      Muhammad Abdullah Khan | Conditions
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • How should kratom be regulated? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why senior-friendly health materials are essential for access

      Gerald Kuo | Conditions
    • Why humanity in medicine requires peace with a spine

      Kathleen Muldoon, PhD | Conditions
  • Past 6 Months

    • Direct primary care in low-income markets

      Dana Y. Lujan, MBA | Policy
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • Patient modesty in health care matters

      Misty Roberts | Conditions
    • The U.S. gastroenterologist shortage explained

      Brian Hudes, MD | Physician
    • The Silicon Valley primary care doctor shortage

      George F. Smith, MD | Physician
    • California’s opioid policy hypocrisy

      Kayvan Haddadan, MD | Conditions
  • Recent Posts

    • What to do if your lab results are borderline

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Direct primary care limitations for complex patients

      Zoe M. Crawford, LCSW | Conditions
    • Understanding the unseen role of back-to-school diagnostics [PODCAST]

      The Podcast by KevinMD | Podcast
    • Public violence as a health system failure and mental health signal

      Gerald Kuo | Conditions
    • Physician asset protection: a guide to entity strategy

      Clint Coons, Esq | Finance
    • Understanding factitious disorder imposed on another and child safety

      Timothy Lesaca, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • The loss of community pharmacy expertise

      Muhammad Abdullah Khan | Conditions
    • Is primary care becoming a triage station?

      J. Leonard Lichtenfeld, MD | Physician
    • How should kratom be regulated? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why senior-friendly health materials are essential for access

      Gerald Kuo | Conditions
    • Why humanity in medicine requires peace with a spine

      Kathleen Muldoon, PhD | Conditions
  • Past 6 Months

    • Direct primary care in low-income markets

      Dana Y. Lujan, MBA | Policy
    • Psychiatrists are physicians: a key distinction

      Farid Sabet-Sharghi, MD | Physician
    • Patient modesty in health care matters

      Misty Roberts | Conditions
    • The U.S. gastroenterologist shortage explained

      Brian Hudes, MD | Physician
    • The Silicon Valley primary care doctor shortage

      George F. Smith, MD | Physician
    • California’s opioid policy hypocrisy

      Kayvan Haddadan, MD | Conditions
  • Recent Posts

    • What to do if your lab results are borderline

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Direct primary care limitations for complex patients

      Zoe M. Crawford, LCSW | Conditions
    • Understanding the unseen role of back-to-school diagnostics [PODCAST]

      The Podcast by KevinMD | Podcast
    • Public violence as a health system failure and mental health signal

      Gerald Kuo | Conditions
    • Physician asset protection: a guide to entity strategy

      Clint Coons, Esq | Finance
    • Understanding factitious disorder imposed on another and child safety

      Timothy Lesaca, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

How to aggressively pursue population health
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...