Population Health and Precision Medicine

September 14, 2016 DREW IVAN, DIRECTOR OF BUSINESS TECHNOLOGY

Among the consensus predictions for 2016 was a two-part forecast related to population health and precision medicine. First, population health would move from a buzzword to mainstream practice. Second, precision medicine will emerge as the new frontier for proactive patient care.

In July, I provided an update on the progress toward part two of this prediction, noting that precision medicine still seemed a long way off. However, a new HIMSS Analytics poll seems to paint a somewhat more optimistic picture. A poll of 137 hospitals reveals that 29% of providers are currently using some form of precision medicine. This survey defined precision medicine as "treatment and prevention that takes into account individual variability in genes, environment and lifestyle."

Although 29% of providers are using precision medicine, that does not mean that 29% of all patient encounters involve a precision medicine component. The use of precision medicine techniques is unevenly distributed. Specialties like oncology, neurology, cardiology, and prenatal screening most commonly use precision medicine.

While less than one third of providers are using precision medicine, the HIMSS Analytics report states that two thirds of healthcare organizations are using population health initiatives. As predicted, population health has become mainstream, and precision medicine is beginning to enter the picture.

This doesn’t mean that precision medicine is replacing population health. On the contrary, precision medicine will play a supporting role to population health management.

Both care models can work together to manage risk. A key element of population health management is to stratify patients based on risk scores that are determined by a multitude of considerations. Elements of precision medicine like genetic test results, environmental factors, and lifestyle can contribute to the risk score calculations and provide a more sophisticated, accurate, and predictive score.

Two rapidly advancing technologies—EHR functionality and big data—will continue to improve clinicians’ abilities to incorporate precision medicine into their population health initiatives. In fact, big data is already linking EHR data to genetic variations as a way of predicting disease before the symptoms manifest. As it becomes easier and cheaper to integrate precision medicine into everyday practice, the industry will realize better outcomes and higher rates of return.

Precision medicine is the next initiative to follow population health, but it is not the end of the road. The Journal of the American Medical Association explains why precision medicine may not improve population health.

It’s difficult to say what will replace precision medicine at the frontier of improving healthcare. JAMA suggests it might be addressing social determinants of health such as reducing poverty, improving education, and focusing on access to resources. And that’s high-hanging fruit not easily within reach.

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