Is There Conflict between Precision Medicine, Population Health?

If there’s one thing that all healthcare stakeholders can agree upon, it’s that there’s never enough time, money, or manpower to do everything that needs to be done.  Whether electronic health records, novel care delivery frameworks, or emerging payment reforms help or hurt this fundamental truth may be up for debate, but even the most efficient and tech-savvy organizations are unlikely to argue that the healthcare system is as good as it needs to be right now.

Ask a group of providers how to make patient care better, and you’re likely to get twice as many opinions as people in the room.  They are likely to volunteer buzzwords like “accountable care,” “chronic disease management,” “genomics,” “the Internet of Things,” and “big data analytics.” ... Population health management has more potential to make an immediate impact on the largest number of patients, argue the researchers from Columbia University and Boston University in a New England Journal of Medicine op-ed, and the hype around precision medicine is distractingly “premature.”

ACOs and the PCMH model encourage cooperation and coordination with community health organizations that are often doing the heavy lifting for vulnerable patients in underserved communities, and these non-clinical reform efforts may be the key to wiping out avoidable disparities in access, care, and outcomes, Bayer and Galea write.

“Yet seemingly willfully blind to this evidence, the United States continues to spend its health dollars overwhelmingly on clinical care,” they said. “It is therefore not surprising that even as we far outpace all other countries in spending on health, we have poorer health indicators than many countries, some of them far less wealthy than ours.”