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Yet Another Meaning of “P” in PHM

by Scott MacStravic

It seems almost as if authors have taken as a wordsmith challenge the creation of new and different meanings for the first word in the initials “PHM”.  The “HM” always means “health management”, but the “P” may stand for any one of the following adjectives:

  •     Performance – when HM is used to improve this among employees
  •     Personal – when HM is provided to self-paying consumers
  •     Personalized – when tailored to individuals vs. one-size-fits-all, or segment-differentiated
  •     Pervasive – when disease management becomes a continuous and deliberately intrusive, constant element in patients’ lives
  •     Population – when it is applied across populations such as insurance plan members or employees
  •     Predictive – when it focuses on altering predictions about individuals’ or populations’ health
  •     Pre-emptive – when it aims to replace sickness with health
  •     Preventive – when it employs primary, secondary or tertiary prevention methods
  •     Proactive – to distinguish it from reactive sickness care
  •     Productivity – when it aims to improve employee performance
  •     Prospective – when it is based on what is foreseen otherwise

This widely varied use of different adjectives to precede “Health Management” is not a serious problem, since the varied meanings are all embraced in what most of us think about and do when thinking about or applying PHM.  On my own part, I file articles under the generic initials “PHM” rather than worrying about what the “P” is said to stand for.  There are more similarities across all the different labels than differences.

And just to add to the list, it occurred to me this morning that there is still another “P” that can apply, though it would involve a number of specific elements that would distinguish it from a number of other PHM examples.  It would be called “Precision Health Management”, and would roughly correspond to “precision marketing” as defined and applied by a research and consulting firm. [“Precision Marketing Solutions” Aberdeen Consulting Group Aug 1, 2006 (www.mycustomerl.com)]

Precision health management would be like precision marketing in that it would rely on predictive modeling and analytics to identify and grade the risks of individual HM prospects, and particularly the different potential value of each to sponsors of PHM, as well as the idiosyncratic personality factors of each relative to selecting the most cost-effective PHM interventions.  Its use in marketing is a sound basis for application to PHM, since both aim to understand, predict, and influence consumer behavior.

Just as marketing is increasingly moving toward customization of relationships, interactions, transactions, and customer experiences in general with customers, so Precision HM would strive for a similar degree and kind of individualized approaches to managing individuals’ and populations’ health.  This would include, for example, choices to consciously avoid “acquiring” some consumers, and even “firing” some already acquired, when their predicted or actual value is less than their predicted or actual costs.

It would include precision choices of communications channels, frequency, and content, involving whatever mix of channels and messages is predicted to be most cost-effective.  It could easily involve the use of the same kinds of software (e.g. SSP and SAS) and contact center strategies currently used in marketing applications designed to improve customer lifetime value (CLV).  It would alter this common set of initials to “PLV” for participant lifetime value, but would otherwise involve similar content and analytic as well as communications technologies.

As with its marketing applications, users of precision HM could choose to adopt internal, on-demand, or outsourced analytic, process, and communications, in whatever mix over time proves most cost-effective.  And as with precision marketing, this approach to PHM would strive for, and should achieve similarly higher levels of ROI for its adopters.  The use of predictive metrics in rules-based application to individuals or segments, where appropriate, should ensure that the value proposition offered and delivered to each individual will optimize the value that both participants and PHM sponsors gain, in both the short and long run.

It is unfortunate that so far, the healthcare industry has been significantly behind the curve in terms of taking advantage of emerging and constantly innovating computer analytics and communications technologies.  Precision HM represents a challenge to all who are or might consider being involved in PHM to ride the “breaking wave” of such innovations in pursuit of the most mutually valuable results possible for all stakeholders concerned.