There have been a number of recent policy initiatives at the state and federal levels aimed at accelerating the nation’s shift to a patient-centric health care system.
While public policy will undoubtedly help spur this transition, the role of behavior should not be underestimated. Stakeholders in the health care system – a group that includes patients, providers, payers, health science professionals, and life scientists – are also changing the landscape of health care by how they are approaching and solving health problems.
In a patient-centric world, medicine will be tailored to an individual’s genetic makeup.
Schools of pharmacy and health sciences should be included among these stakeholders. All of which makes this the ideal time to step back and ask the question: What will a patient-centric world look like? Below are some of the key components and implications for schools and graduates.
Value based services – Up until now, the health care system has been driven by the provision of services, e.g., the number of tests ordered, the amount of prescriptions filled, etc. In a value-based system, graduates will need to understand how value is defined and be capable of delivering a measure of this value to the patient. This means not only having a working knowledge of areas such as health outcomes research, but also an ability to advocate for one’s profession in the shaping of public policy.
Personalized medicine – We are beginning slowly moving from a one-size-fits-all approach to medicine to one that is tailored to an individual’s genetic makeup. As personalized medicine segments the population into “genetic strata,” providers and payers must have a deeper understanding of areas such as genomics, biomarkers, and molecular diagnostics. There will also be a corresponding impact on the drug development process as big pharma will need to develop new business models that allow them to profitably develop drugs for smaller, stratified populations.
Screening and physiologic monitors – In his book The Creative Destruction of Medicine, author and physician Eric Topol shares an account of an 83-year old patient who every two weeks e-mails him data with his blood pressure, heart rate, blood oxygen levels, and even how many steps he takes each day. Through cell phone apps and wearable devices, patients will increasingly share data with their providers with a frequency and sophistication once unimaginable. For providers, this means they will need to be able to organize, assess, and act on this information in a timely and effective manner.
Electronic Health Records – The Electronic Health Record will dwarf the information once housed in paper folders. From the annotation of one’s genome sequence to results of every diagnostics test a person has had, this resource will contain a staggering amount of patient information. Who is going to analyze all of this data? Who is going to oversee and organize it? Who is going to develop a therapy management strategy to meet the patient’s needs? Graduates must be prepared for these types of roles by possessing the informatics skills to manage this knowledge and the ability to help inform a course of treatment.
Self-diagnosis and medical literacy – Not long ago the patient would never question providers such as physicians and pharmacists. With the birth of the internet and the explosion of easily accessible information, that is no longer the case. Patients are better educated about health matters in general – which is good – but many also now feel qualified to self-diagnose and treat, which can be problematic. The expectations and demands of the 21st century patient underscores the need for providers to possess strong communications skills – skills that balance respect for a patient’s opinions while also being able to guide them towards the most effective treatments.
The advent of a new type of health care system will require a new type of health care professional. Colleges and universities must not only provide their graduates with the skills to operate in this complex, technical world, but as importantly, equip them to do so in a caring and compassionate manner that places the patient’s best interests above all else.