Monday, April 28, 2014

Person-Centricity: A New Paradigm to Bend the Sickness Curve and Make Health Personal

By Dennis A. Robbins Ph.D., M.P.H.
CINA and The PEARL Translational Network

The transition from healthcare to health requires a dramatic shift from patients/consumers to persons. This transition supersedes suggested antidotes, tourniquets and temporary fixes that have included a plethora of consumer/ patient involvement initiatives. While well intended, those initiatives pretty much miss the boat in terms of activating the person to change the trajectory of health and healthy behaviors and making health personal. The prescription for health centers on meaningful changes in behavior in concert with person- centric solutions, rather than impersonal ones.

Person-centricity moves beyond models of consumer/patient empowerment, centeredness, engagement, and activation and is reflective of how individuals make health and healthcare decisions within the broader context of their lives. This distinction is not a facile shift in semantics but offers a fresh paradigm that accounts for the complexity and comprehensiveness of who we are. A person is always a person; that is the default. The individual is the regulating fulcrum to evaluate and filter information based on evidence, and best practices and personal preferences.

As persons, we are not be defined by the functions or circumstances we assume temporarily, those contingencies of human existence. The person-centric focus is not a gratuitous semantic distinction but cuts to the core of who we are and who and what we are not. The recognition of the person as the dynamic fulcrum of his or her life and destiny is a critical reminder of how we need to get back on track to navigate our lives and futures.

Moreover, the changes required to create a healthier America and lower the costs associated with lifestyle-related diseases need to happen on a personal level coupled with a supportive infrastructure and public policies that promote and sustain them. This shift is critical and a necessary part of every aspect of our transition from healthcare to health and to bending the sickness curve to better curb and control avoidable costs.

Person-centricity accommodates the shift from passive patients (or any externally derived designation) to active persons in an ongoing continuous, dynamic process in which all constructs and actions revolve around each of us. It profoundly transforms how all our decisions (including those related to health and healthcare) are made and who has the authority and ability to make them in a way that is consistent with our values, priorities, preferences, beliefs, and aspirations in the context of our broader life experiences.

The relationship between the notion of person-centricity and the transition from healthcare to health is symbiotic. The concept of person-centricity functions as both the missing link and the common thread that weaves together the needs, choices, and aspirations of people throughout their health journey and is absolutely crucial in addressing the mind, body, and spirit triad required to support and inspire all individuals to reach higher levels of health, self-actualization, resilience, and well-being. In a person-centric system, the frame of reference is personal health.  

We have improved tools at our disposal to support autonomous person-centric decision-making through mobile health, and comparative effectiveness. Mobile technology, through high-speed networks and smartphones, has transformed the ways we work, learn, communicate, and play. Instant access to information on the web and the ability to contact anyone wherever they may be has changed the world forever. Mobile technology can help address this issue through easily accessible, real-time, continuous data for current status updates. The autonomy that is so critical to person-centricity is further enhanced by improved health literacy. Decision-making should pivot on what the person determines is best rather than where care or services are sought.

When the focus shifts to the person and personal health, even prevention looks different. The focus shifts from preventing sickness and disease to the readiness, resilience and endurance of the individual person. Then and only then can we begin to address and reduce the unwanted sequelae of lifestyle-related disease and illness. By bending the sickness curve and offering prescriptions for health we can make an immense difference. By shifting our focus from the patient back to the person and supporting the person in embracing healthy living and making prudent proactive choices, we adopt an approach that is more reflective of the manner in which people change the trajectory of their lives. By engaging a mix of readiness, resilience and endurance we can not only bend the sickness curve but also have dramatic impact on the health of the person and well-being of our society.

About the Author

Dennis A. Robbins is a health and healthcare thought leader and steward. His career spans multiple sectors of the health and health care system including serving as an advisor to the President’s Commission on Ethical Issues in Biomedicine, Biomedical and Behavioral Research, the White House Educational Advisory Committee on Complementary and Alternative Medicine, and the National Endowment for the Humanities and co-editor of The White House Monograph on Healthcare to Health. He has worked in the device industry in various capacities over the past 20 years dealing with product approval, research, adoption, and payment.

Dr. Robbins received his postdoctoral MPH from Harvard and Ph.D. from Boston College. He serves on the boards of companies in the U.S., U.K, and Australia, and is an Adjunct Professor/Director of Health Policy at the PEARL Translational Network at NYU and Pepperdine, and advisor to CINA-QED Clinical, KPN, Heartmath, National Research Network, DARTNet, and the Ultimate Human Foundation. Dr. Robbins has written 9 books on healthcare and lectures and publishes extensively.

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