The healthcare industry’s recent shift towards value-based care pushed population health into the spotlight, but medicine at its core has always focused on individualizing care for each unique patient. In the age of population health, how can we maintain the personalized nature of healthcare?
CipherHealth’s Chief Nursing Officer (CNO) Lisa Romano, RN, MSN, and Chief Medical Officer (CMO) Brad Miller, MD, MBA share their clinical and operational perspectives on the interplay of priorities between personalized medicine and population health. In the context of this conversation, personalized medicine is defined as an individualized course of treatment that is developed for each patient. Population health is defined as caring for groups of patients that are clinically and financially aligned in terms of conditions, diagnoses, comorbidities, clinical courses, and payer types.
If personalized medical care is the goal, how does that fit with the concept of population health?
Romano: Personalized medicine is equivalent to a personalized plan of care that understands and anticipates the individual patient’s needs throughout the duration of the healthcare episode and as he or she transitions into the community. Providers need to integrate the social determinants of health into the patient’s plan of care, as healthcare literacy, socioeconomic status, and level of education shape an individual’s ability to follow the plan of care and achieve optimal health outcomes. Developing a partnership with the patient’s primary caregivers is a top priority. Ultimately, a robust population health approach must be patient-centered. For any particular disease or diagnosis, patients in the community may fall anywhere along the full spectrum of recovery, with patient needs evolving at different stages of the healing process. Effective population health management cannot be achieved without personalized medicine; we need to do one in order to achieve the other.
Miller: The interesting thing about population health is that it’s really about the individual. How can we increase the quality of each individual’s health while developing better clinical outcomes across the community and lowering the total cost of care? I believe clinical execution on a population health perspective requires a truly personalized view of each patient.
What challenges do you anticipate for healthcare organizations that are navigating this evolving regulatory environment?
Romano: With the shift in value-based care, providers are assuming increased responsibility for patients after they are discharged from the four walls of the hospital. We worry about our patients’ recovery once they leave our care. Providers need to arm their patients with educational resources, but more importantly, collaborate closely with the entire team across healthcare settings so that patients receive the highest quality of care. Since lives are at stake, it is important to ensure that care is accessible with meaningful touchpoints throughout each patient’s journey.
Miller: Population health management is driven by the shift towards value-based care, which creates the momentum to coordinate care across the healthcare continuum. Since healthcare systems carry increasing financial responsibility for patient outcomes outside the four walls of the hospital, they need to determine how far to extend care outside the traditional healthcare setting. Although home-based interventions (such as installing shower safety bars or front door ramps) may be outside the traditional realm of medicine, they are critical components of the patient’s plan of care if they can prevent costly emergency department readmissions.
How can technology improve health at the population level as well as a population of one?
Romano: With the large diversity in clinical and reimbursement priorities driven by these value-based models, providers need technology to serve as a source of navigation. As the sands continue to shift, technology gives providers the ability to adapt in the continually evolving healthcare ecosystem. Patient-centered, data-driven technology can help healthcare systems lead the way in the era of value-based care.
Miller: Healthcare systems are facing a constellation of business models. We’ve moved from fairly straightforward but non-sustainable fee-for-service (FFS) models to complex value-based models that remain relatively nascent and require refinement. Each value-based model is different, creating a complex clinical and financial environment for providers, physicians, and payers. To successfully keep track of and manage the competing demands created by different reimbursement models, healthcare organizations need to leverage technology to execute both clinically and operationally.
With value-based care programs in full swing, understanding the relationship between personalized medicine and population health is paramount. At each touchpoint, there are opportunities to personalize care processes and streamline patient experiences. As Romano and Miller outline, long-term success depends on clinical and resource alignment. To learn how CipherHealth empowers multidisciplinary teams across the care continuum to effectively coordinate care for complex populations and manage high patient volumes, please visit www.cipherhealth.com.
As CipherHealth’s CNO, Lisa Romano, RN, MSN is passionate about improving the health of patients across the healthcare continuum. Romano brings more than 25 years of clinical practice, healthcare IT strategy, and healthcare operations experience to her current role. Prior to previous CNO roles, Romano spent 19 years as a nurse and hospital administrator at Lehigh Valley Hospital and Health Network in Allentown, PA, where she was responsible for all patient flow and transfer center operations as well as numerous quality and patient satisfaction initiatives.
Brad Miller, MD, MBA serves as CMO at CipherHealth. Passionate about driving value in healthcare through technology, data, and biomedicine, Miller has more than 15 years of experience working alongside healthcare providers, payers, and vendors on developing data-driven, patient-centered strategies.