Guest View: The next generation of personalized health care (ONLINE EXCLUSIVE)

A recently released national survey shows that many Americans want "personalized medicine" to be a top priority in President Obama's healthcare reform efforts.

A recently released national survey shows that many Americans want "personalized medicine" to be a top priority in President Obama's healthcare reform efforts.

Obama would do well to heed the survey's results. And he can best address voters' desire for more customized medical care by promoting an emerging healthcare model known as "medical homes."

The survey, conducted on behalf of the Patient-Centered Primary Care Collaborative, found that of the respondents open to having their opinions on the then-presidential candidates changed, 75 percent would increase their support for the next President's healthcare platform if it included creating and supporting patient-centered medical homes.

The medical homes model puts a single personal physician as the point of contact between a patient and the medical establishment. The physician coordinates all of the patient's care for the entirety of her life, with particular stress put on preventative medicine and the use of health information technology (HIT).

If enacted nationwide, the medical home model has the potential to create more personalized care for every patient and help prevent chronic illnesses.


Currently, patient care isn't well coordinated among doctors. Different physicians for a single patient often don't communicate with each other about ongoing treatments or drug prescriptions. And many physicians still rely on paper files to track patients' medical history.

The use of HIT in medical homes would make it significantly easier for care givers to access a patient's medical files and coordinate care. And HIT enables patients to receive certain medical services without having to go to the doctor's office.

HIT has been used to great success already. In Massachusetts and Washington, for example, hundreds of thousands of patients use the state-level HIT program to file drug prescriptions and get virtual check-ups.

When I was the medical director of the one of the largest geriatric group practices in the country, HIT allowed us to dramatically improve patient satisfaction with our quality of care. And it allowed the people in our care to become more aware of their health.

Next year, a nationalized HIT system connecting labs, pharmacies, hospitals, doctors, and federal agencies is supposed to go live. What is needed now is the political will to ensure that even the least privileged have access to this technology.

The medical home model would also cut down on soaring health care costs by increasing the use of preventative care.

In 2006, 75 percent of national healthcare spending was on treatments for chronic illnesses. The most common chronic illnesses cost the United States more than $1 trillion annually -- and that number is on the rise.

Small changes in patient lifestyle can ward off future medical catastrophes. Proven preventative medical steps include weight control, improved nutrition, increased exercise, smoking cessation, and early disease detection.


A study by the Milken Institute estimated that a national preventative medicine program could decrease the number of chronic illness cases by 40 million, and that the resulting increases in labor productivity would add $1 trillion to the economy by 2023.

The Tufts Health Plan shows how HIT can be successfully utilized by medical homes to bolster preventative healthcare.

Tufts' staff uses Web-based predictive software to target patients at risk of developing certain diseases. Nurse case managers then follow up with patients to see if they're encountering barriers - such as transportation problems or dietary challenges - that are hindering them from following through on the doctor's preventative medical program.

Other health technology monitors patients' heart rate so that doctors can intervene with non-invasive treatment before a heart attack or stroke occurs. In its first year of operation, this technology prevented 50 percent of patients from having a heart attack.

The medical home model is urgently needed today to ensure all Americans have access to the personalized health care they want. Fortunately, President Obama consistently voiced his support for patient-centered medicine during his campaign. Let's hope he lives up to his promises in office.

Gary Applebaum, M.D., is a senior fellow at the Center for Medicine in the Public Interest. He is the former Executive Vice President and Chief Medical Officer of Erickson Retirement Communities.

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