Why Emphasize social Determinants when we can Embrace Personal Determinants?
Originally Published By illumination on Medium
Most leading healthcare institutions strive to impact patient compliance by improving the population health within their neighborhoods. Not surprisingly enough, they do not go far in their mission without facing resistance- even though their utmost intention is to personalize medical care. However, within the logical sense, personalization should not propagate resistance and or failure for specific groups within the same community while benefiting the rest. Then again — despite the rhetoric of the intention conveyed by a few personalized care advocates, not every patient in their model would be regarded as a valid beneficiary.
The reason for such a flaw is as; One- they feel that engaging patients in their care are needed for personalization. Two — utilizing the social determinants of health and disease solely is enough to engage everyone in their wellbeing. Or they see personalized healthcare as equal to Personalized Medicine and the latter in turn the same as Precision medicine such as Genomics. In reality, once we pay close attention- it will be hard not to realize what the everyday personalized healthcare advocates are perpetuating is nothing but the archetypal two-century-old population health. It is the same collective approach with a touch of patient engagement and more comprehensive artificial guidelines outlining a profile of social factors determining what is healthy and what is not!
A survey administered by modernized healthcare media, sponsored by Envolve Healthcare, attested that virtually all modern healthcare delivery practices lack sufficient health determinants. They further endure intricacy engaging patients in wellness programs- a component of a personalized approach in their health model. For instance, within the three years of operation, a German polyclinic, Gesundheit für Billstedt/Horn, has cared for over 3,500 patients in the two neighborhoods it serves. But only 50% of the people who show up for a first visit routinely return for a follow-up.
The city health officials in Hamburg, where the clinic is located and meant to serve two of the most diverse neighborhoods in the state, have implemented comprehensive patient engagement programs, such as diabetes prevention and treatment. While trying to engage, the value-based reimbursement model is put in place to engage physicians and care providers towards better medical service.
It is crucial to recognize the meaning of value, health, and quality of medical care to imagine why those administrators are striving with optimal patient engagement.
The Quality of Medical Service is Personal too!
The quality of service provided in medicine is the measure caught by objective and subjective attributes of how it is offered at the Point of Medical Care and not merely based on the predetermined deliverables. That is mere rest on patient concerns at a provided physician facility visit at a particular time, scenario, and place.
Quality is the whip of value during a substantive encounter, hence dubbed as the efficiency and precision of undertaking “Individual determinants” in contrast to the social elements. Accordingly, leaders’ failure to adhere to their principal mission is incongruous with a significant lapse on determinants that may be otherwise vital in the case of an individual. Likewise, We will effectively achieve educated Patient engagement through the Doctor-patient relationship, not within the protocol-driven handover.
Modern population health has downshifted its locus from a nationwide or statewide target group to smaller population subgroups such as counties and cities. The betterment intention was to maximize patient engagement and minimize the minority well-being's marginalization who did not benefit from the recommended recommendations.
The unprecedented hurdles that prevailing administrators face today presumably stewards a light of the diversity within constituency in almost every community and they're distinctive social and individual determinants. Under the covers, all societies may share the related general principle of “patient resisting to engage” in his or -her medical care. Still, when crumbled, each leader will face their unique contentions.
Preparing for a value-based recompense — artificially manufactured determinants will hardly produce “one hundred percent everyday “ social wellness. Instead, we will require a perception of what an issue means for individual patients within the context of their particular existence environment.
To appraise a quality compels a point of reference or association. A typical aspect of the text in population health is more plausible than not underrepresented for many patients in a given profile. All individuals hold their private personal determinants as well as point of comparison to quality and value. These include improving the Lifestyle program, Care coordination for chronic disease, and after hospital release, Medication compliance, which, if broken down, can represent hundreds of more inequitable individual circumstances. Or, for instance- Telehealth, Mental health, 24/7 nurse lines are nonspecific and broad issues. It by no means can be regarded as specific for any particular physician-patient encounter and more so for someone who is not at the first-hand character of the patient appointment to observe particulars of a given personal determinant.
It is time to reform Healthcare Delivery Model.
Population health is failing to address 21st-century healthcare demands. That is the upshot of the increased knowledge base and access to information.
The Millennials have the liberty of individual expectations. Therefore, it’s time to accept the heartbreaking honesty of outmoded population health.
Population health has run reasonably well since its inception in the 1900s. It is inexpensive as long as the citizens follow the One-Size-Fits-All pattern of the scheme. But on the downside — Population health tends to leave out the minority crowd and the vulnerable at exile.
The enthusiasts of population health are professedly unwilling to recognize the current needs. And to improve by the so-called presumptuousness of utility challenges linked with personalized healthcare. Yet, they are radically executing value-based models and patient engagement programs that are merely the composite of population and “personalized” healthcare concepts. Such a system may indeed attend well in the short run for a healthcare system in transition to personalized healthcare, but if the development halts at some point, it will also falter in the long term.