Why Do We Need Patient-Specific Care Plans?

Abhinav Shashank
Fri 23 Dec 2016
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The population in the United States is extremely diverse – people from different communities, countries, ages and socioeconomic backgrounds are all living there – diversity is everywhere. This composition is going to defines how U.S. healthcare is and the way people are covered under it. The notion of a single-mold health plan has been all but rendered moot. Hospitals and other healthcare required to constantly assess the changing population and their changing needs to deliver the best care.


Understanding the Need for Specific Care Plans – One Size Does Not Fit All

The healthcare system is already witnessing major shifts. Combine those with the changes in population structure, and health care requires to undergo a transformation. Disparities in various social determinants could lead to gaps in care, and consequently poor health outcomes and lower quality of care.

  • In a quickly-aging population, 80% of people over the age of 65 have at least one chronic illness.
  • Variation in drug metabolism among ethnic groups – According to a report, there is major difference in therapeutic range of patients in Japan and Taiwan (0.4 – 0.8 mEq/L) and those in the U.S. (0.6 – 0.5 mEq/L).
  • A patient’s background and upbringing have major effect on their behavioral health, and in turn their overall health.

Such differences and dynamic shifts call for a specific and culturally competent care plan which acknowledges all the social determinants and is driven by an in-depth exploration of all the demographics associated with a patient, and being sensitive.
Patient Demographics

To define a care plan specific to a patient, genomics can provide many answers and be helpful in long term, however, the providers have to understand all the demographic characteristics associated with a patient. Broadly, these are a few of many things providers must realize and address when delivering care:

  • Date of Birth, age, birth year
  • Gender and marital status
  • Ethnicity
  • Socioeconomic factors
  • Region

Other than these, there are several other factors relevant to a patient’s health:

  • Children tend to fall sick and get injured more frequently than adults.
  • Educated and aware patients understand the need of urgent care and possible alternatives.
  • Employed and educated people are more likely to have health insurance.

The key is to provide urgent and quality care – so providers should observe and derive insights about their patients by asking the right questions and designing a care plan best suited to their needs. It is important to cover the people who are not educated and need urgent attention.
Caring for all Patients: A Basic Framework

In order to cut down the looming disparities in a diverse population, providers have to develop a framework which accommodates these variations and addresses the need of the patients.

1.Drawing an action plan

The first thing that has to be done is to study the patient population but not treating the patient as population. It’s important to identify demographic characteristics and prioritizing them.

2. Data Collection

Collection of patient as well as community data is essential to developing plans and services specific to the need of the patients, and is vital for the growth and continued improvement in quality of healthcare services. Massive amount of data is required for that, additionally, desired interoperability standards are necessary for the same.

3. Data Analysis

The collected data has to be reviewed, monitored, measured and evaluated by providers for planning and designing these services. Analysis will also be beneficial in understanding how the services are faring. Predictive analytics can provide many answers to underlying health care problems, subsequently, help you understand population better and improve on measures.

4. Evolving organizational dynamic

Organizations, hospitals, and clinics have to evolve with the needs of patients and develop policies that encourage communicating with patients and getting to be aware of how a patient thinks, his beliefs, values, practices, and customs and how they affect overall health.

5. Catering to the needs of specific population

Providers today are developing their practices to overcome the language, cultural and specific health barriers in   population care. Proper training internally is required in the hospital to help patients navigate the system and educating them to take control of their own health.
Challenges And Shortcomings

Although there have been substantial leaps in incorporating demographic characteristics with a patient-based approach in delivering care, there are still a few but stark barriers lurking:

  • Collecting data

One of the biggest challenge the healthcare professionals are facing is unavailability of enough data to generate   actionable insights. More often than not, providers have to deal with black box models.

  • Leveraging data

Determination of social context in which a patient lives is easy but reviewing them and putting it together to develop a care plan is still overlooked. It’s important to interact with the patient to know how they want their health plan to look like.

  • Poor coordination in and out of network

Lack of coordination between providers is another issue that needs to be addressed. If providers, hospitals and systems are not working together, patients are at a much higher risk of being dissatisfied with their care at best, and having negative health consequences at worst.

  • Reluctance

Another factor that should be taken with a pinch of salt is reluctance. Providers are still reluctant and wary of   certain minority groups, and these groups report being treated disrespectfully. Besides this, patients are     reluctant to share their data with healthcare providers.

Considering demographic characteristics is a continuous learning process. Many healthcare organizations have enhanced their policies, research and training efforts to develop this competency and established guidelines. Along with that, the Federal Government has also set some standards backing cultural competency to provide culturally and linguistically appropriate care

  • The Department of Health and Human Services (HHS) has set up guidelines for culturally and linguistically appropriate health care services (CLAS).
  • The Office of Minority Health in HHS issued 14 national standards on CLAS in 2000, aiming to rectify current inequities.
  • CMS issued guidance to all state Medicaid directors, emphasizing on interpreter and translation services.

The Road Ahead

Providing quality care to a diverse population is no small task, but it is of paramount importance today in a constantly changing world. In this dynamic scenario, providers have to focus on practicing preventive measures and providing holistic care services, but they also have to navigate the shifts in patient demographics. The future of healthcare delivery system depends on managing these complex needs with refined practices to address present and upcoming challenges.


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Tags: Accountable Care, Healthcare, Integration
Abhinav Shashank
Why Do We Need Patient-Specific Care Plans?

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