Population Health Management Is No Fad

I have a bone to pick with you, Mr. Paul Cerrato of InformationWeek. Your recent column suggesting that population health management is a fad is well-argued, true. But I think you’re missing the forest for the trees.

In his column, Cerrato argues that population health management (PHM) is a trendy concept which is being pushed down physicians’ throats without docs having the tools to pull it off.

He relies partly on a report from the Institute for Health Technology Transformation, which argues that providers need not only EMRs, but also telehealth platforms, electronic registries, data management software and analytics systems to conduct PHM. There’s some truth to that.

And he notes that even existing tools, like the increasingly ubiquitous EHR, don’t have the ability to interoperate with other systems and so don’t have any information about care outside of a given provider’s practice. Again, that’s true.

But Cerrato seems to think that we’re putting the cart ahead of the horse to engage in PHM until all of that tech is in place.

Here’s where he loses me:

Physicians have been trained to provide individual care, not population care, and while PHM proponents might counter that population care is simply individual care multiplied by X, it’s more complicated than that. Many of the interventions needed to improve the health of a large population fall more into the realm of education and public safety than they do into medical practice.

While physicians may indeed have been trained to provide individual care, it’s time they embrace PHM basics. Simply screening the chronically ill patients get preventive care, if nothing else, isn’t beyond the reach of any practice with an EMR.

And as for fobbing off the population health improvement on public education, well, just tell me this: just how successful was Nancy Reagan’s “Just say no to drugs” campaign? (That one was about as hip as your grandmother’s nightgown, wasn’t it?)  While some interventions may work from a governmental level, there’s a graveyard of others that never even enter the consciousness of individuals.

No, I refuse to believe that doctors can’t look at their patients as a population until they can do big-time data aggregation and the like. They need to think about their patients as a population now, especially PCPs, not only because it’s the right thing to do, but because it feeds back into daily practice to know what common patterns emerge.

The new, emerging emphasis on population health may challenge physicians, but I think they’re up to it, especially if hospitals support them in their efforts. Even if what we do now is a pale shadow of what we can do over time, there’s no excuse not to get started.  PHM will be a critical part of medicine’s future, so let’s step to it.