January 27, 2010

Improving Health by Taking It Personally

Author Affiliations

Author Affiliations: Center for Research on Prospective Health Care, Duke University Medical Center, Durham, North Carolina.

JAMA. 2010;303(4):363-364. doi:10.1001/jama.2010.34

To resolve the nation's health care dilemma and tackle exploding costs, the current sporadic and reactive focus on treating episodes of disease must be transformed into one that is coordinated to improve health and minimize the consequences of chronic diseases.

Because care is more effective when services are coordinated,1 there are mounting efforts to spur greater integration of delivery systems. What is missing is an approach that aligns the patient's individual needs with health services tailored to meet those needs. Coordination of services will be insufficient unless they are driven by plans designed to anticipate the health needs of the patient over time. A proposal to do this is “prospective care,” a strategic approach that combines personalized health planning with integrated care services to focus on individualized health promotion, disease prevention, monitoring, and early intervention.2 Personalized health planning has the potential to effectively engage individuals with any aligned delivery system and serve as a foundation for payment models for valued outcomes.3 To deliver prospective care, 3 interrelated elements are essential: (1) a care model that uses personalized and predictive health planning, patient engagement, and processes to track health status, anticipate events, and personalize care when disease occurs; (2) care delivery systems to support the patient's strategic health plan and medical needs in a coordinated, integrated fashion; and (3) a reimbursement system that supports prospective approaches and provides incentives for effective interventions.

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