Originally Published by Illumination Curated on Medium
Hippocrates once said: “It is more important to know what sort of person has a disease than what sort of disease a person has.”
After 20 Centuries from when Hippocrates quoted the phrase, most of us physicians are still unable to implement it in our practice genuinely. Some may argue- the 1st-century concept is probably outdated in our technologically savvy era. Others may even take it further and assert that the definitions of disease and health perhaps may have shifted over time. Although there are many prevailing arguments about health, disease, and remedies around the last two, maybe one thing could not have changed much.
Every medical care's quality and value are unique for every individual at a given point in time and place. And that no two clinical scenarios are identical because circumstances and individual variables are and will always be different. Therefore, whether a medical treatment is rendered twenty centuries ago or today, the definition shall not be varied unless intended for deliberate social engineering.
Personalized Healthcare Pertains to Individual Experience
The individual’s understanding makes medical care personalized, something not particularly experienced today by the patients, expected by physicians, and defined by 3rd party entities, including the payers. A personal opinion of quality and value of service and commodity bears or correlates only to one singular personage rather than to a profile of people as a group.
Personalized Healthcare utilizes the latter concept top to transform patients’ experiences by delivering medical care tailored to the individual, whereby bettering to circumvent, diagnose, and doctor diseases more efficiently and expeditiously.
The conventional population-focused Healthcare is characterized as a passageway to providing patient care that concentrates on an entire community with a particular predetermined profile, rather than solely centering on individualized patient care.
Personalized Healthcare is beyond Precision
Amid the modern-day terminologies, the buzzwords like “Personalized Healthcare,” Personalized Medicine,” and “Precision Medicine” have been heedlessly yet exchangeably utilized within the common vocabulary. The latter phrases are currently undergoing semantic shifts through indiscriminate social engineering.
It seems essential for us to recognize the significance of this trend to make better use of the meaning and protect patients from the impending prejudice associated with its deviation. For instance, if one performs a Google search can find that Personalized Healthcare or Personalized healthcare is being conveyed as Genomics and its utility in cancer treatment. It is conceivable that Genomics is a subordinate of the former two but never equal.
Like many other scientifically backed instruments and technologies, Genomics refers to the quality, status, or fact of being precise and specific. But it only applies to the instrumentality of the latter phenomenon. In contrast, Personalized Healthcare is a complete term that refers to the conveyance of medical service- be it curing or preserving health.
Personalization of Healthcare pertains to rendered services between a patient by a physician and anything in between from reimbursements, conditions of doctor-patient interaction (virtual or physical), to socioeconomic factors. Personalized medicine, along with its sub-domain, Precision Medicine, only comes under such environments.
Precision Medicine is merely a Targeted-Medicine.
Precision medicine denotes the application of tools, strategies, and science, be it alone or in collaboration, toward enhancing personalized medical treatments. Genomics, along with the other technologies, can be classified under the class, as mentioned earlier.
Some other precedents of engines used or having the potential for the utilization of personalized medicine combine one or more of Big data, Machine Learning (ML) / Artificial Intelligence (AI), Deep Learning (DL), the Blockchain, Mixed reality, Software-as-a-service (SaaS), Wearable Technologies, Immunotherapy, and many other systems.
Personalized Medicine is about Patient Experience
Personalized medicine is the subordinate of customized Healthcare and constitutes the core of every doctor-patient interplay. It comprises anything from screening the patient, chatting, evaluation, and interpretation of clinical judgment by an individual physician at a particular place and time. The interaction is based on socioeconomic, psychological, physiological, genetic, environmental, and familial factors, complemented by the utility of Precision Medicine to enhance such interplay.
Determinants of Health are Personal
In a typical population health scenario, certain factors are commonly used as a point of reference to establish the quality and value of medical care. These factors are also known as “Social Determinants of Health; such as the circumstances in which people are born, grow, live, work, and age. Other factors such as the complex, interrelated social arrangements and economic systems shape the conditions mentioned above.
Social determinants of health incorporate aspects of the social scene discernment, income, education level, marital status, the physical environment like residence, crowding conditions, built environment, and health services.
In contrast to the population health-based attitude, Personalized Healthcare takes the quality and value estimation of Healthcare one step forward by adding personal determinants of health to social factors. The latter pertains to the internal or personal determinants, including personality, health beliefs, health perspectives, and any unique manifestation of an individual’s trait at a given time and place. Personal health determinants provide the flexibility of medical care to be customized to the individual patient instead of being tailored to the majority in a population.
Quality is the Personal Trait
Generally speaking, the quality of a product or a service defines how beneficial or displeasing is that particular deliverable. Quality means social acceptance and maximum benefit in care delivery that matches the patient and the physician’s expectations and abilities, given the available options.
Every quality possesses subjective and objective components. Concerning Healthcare and medical service, patients see the “Quality” through their peculiar “subjective” glasses, whereas physicians or other healthcare stakeholders know the quality of care from their objective impressionism. To extract the most value from a particular patient clinic encounter, patient experience and expectation must ideally be in parity with physician “Objective” intent. Unfortunately, despite the pretentious efforts of the current system by pushing for a merit-based reimbursement model, the actual quality does not meet the criteria described above.
Today, the common designation of value and quality of medical service is primarily the derivative of combined social determinants and risk assumption profiles, leaving out the minority of populations who don’t necessarily fit those criteria. For example, not all white males in Hamburg, Germany, belonging to a high socioeconomic class share the same risk factors and attitudes towards cancer and smoking. But, indeed, they are considered within the same profile under the population health model.
Value is an Independent Appraisal
The quality is the product of doctor and patient collaboration, defined by the services rendered between them. Medicine is the science of infinite variabilities; hence We must apply it differently to every individual scenario. Although quality drives the value of medical care or service, quality in Healthcare is no mathematical equation. It can’t be guided by orders, policies, or even distinct business principles. The value set by corporations and other third parties fails to account for social variables. Therefore, the assignment of value-based criteria on population health is a dropout and a loser.
Personalized Healthcare is the Service, Science, and Process behind satisfying Quality Care.
Personalized Healthcare is primarily defined in multiple ways depending on the circumstances and intentions. It is a means that encourages people to gain a handle over their own experiences and grow their potential to act on matters that they determine as relevant.
The environment a patient finds themselves in plays a crucial part. Aspects of empowerment include health literacy, shared decision-making, and self-management.
In conjunction with empowering patients through personalization, it is also necessary to help physicians sustain their independent practices.
An Independent Physician is the one who owns a preponderance of their practice and has fundamental decision-making rights for the method. By doing so, physicians will have the ability to practice medicine and run a practice, all on their terms, custom to patient needs, hence laying the foundation to become personalized. An independent doctor has complete control over their practice's management and financial health and can thrive and compete in the local healthcare market. Concomitantly, Independent physicians can make informed, strategic decisions, as well as shine through industry changes. Last but not least, by staying independent and personalization, they will be in a better position to stay connected and integrated with hospitals and other organizations while remaining autonomous.
Current Strategies to Healthcare Delivery issues have been compromised by Hypocrisy.
Today, we offer medical care to patients according to the population healthcare scheme, yet we compensate for clinic visits based on the personalized concept. We invest in therapies that science provides, but we can’t deliver them to the appropriate self at the right point. We are frequently extending death for the reason that we cannot maintain a quality life. We believe in the Hippocratic oath but turn a blind eye to the deception in our healthcare system. We encourage our patients to engage them in their personal healthcare decisions, but we utterly take away their options. Patients have digital medical records but are not in control of them. Instead, third parties’ entities can earn billions of dollars by merely having access to and working the information. Concomitantly, we advise patients of their need for specific treatment but can’t because their insurance carriers do not cover it.
As physicians, we apprehend what patients need, but our hands are often bound; yet we still get paid based on value and performance.
There is neither a single formula nor a policy or mandate that will serve as a silver bullet salvaging today’s healthcare mess and restoring quality care for all because there are many variables.
“Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.” — William Osler.
We can never achieve the value-based reimbursement ideal without petitioning certain matters. Only then will we have the real value in medical care.
As Hippocrates said over 20 centuries ago- “Cure sometimes, treat often, comfort always.”
The true Definition of Personalized Healthcare
Personalized Healthcare is merely nothing short of balancing the physician's objective mission and patients’ subjective expectations with sustained focus, the highest quality, value care available, and affordable to the patient. In other words, personalized Healthcare is about balancing the options, quality, patient satisfaction, and efficiency.
To achieve the maximum result, personalized Healthcare must be ideally in the open market setting as stringent over-regulation would yield counterproductive ends. Only then, through patient education, engagement, and feedback, can we present personalized medical treatments (Personalized Medicine) to the right person at the appropriate time.
Precision medicine is the base of any personalized healthcare system.
Health is an individual right; nonetheless, it can only exclusively be achieved adequately through personal empowerment.
Everyone is a patient, while only a few are physicians too, and every case is novel. The latter demands an innovative healthcare tone, one that balances technology, strategy, and innovation.