Future of Population Health Management: What Are We Talking About? - Public Health Dorset


Future of Population Health Management: What Are We Talking About?

Wednesday, Week 5.  I had a good meeting today. No — I had two good meetings today.

Not grumpy. Shocking I know. It was brief, to the point, challenged ideas, countered with new ideas. Promise of follow up. Done. Not what you expect in Westminster, not what you expect when talking “Population Health Management”. Go figure.

Here’s the thing. Population Health Management is a word salad. Surely that’s a red flag for all participants in the discussion? You could say almost anything, regardless of how absurd, and people will go along with it. Why? Because there is no shared-understanding of what it is. We all think we know what it is, but then we talk to someone else and it becomes obvious they don’t share your view. Not really anyway.

So rather than add to the mountains of equine egesta already piling up about the place, I thought I’d take a different tact. Maybe take a step back and talk about “Population Health” in this blog. Surely this will be easy to agree on? So my blog title lied, this is about population health, I’ll talk about ‘management’ in this context in a later blog.

So, what do we mean when we talk about population health?

Let’s start with the basics, and have a better conversation.

Population Health System: Politics, pathways, and Wellbeing

Population Health System: What drives and shapes how we look after each other, how we organise health and care services and what are the outcomes – intended and unintended. Humans aren’t perfect (I am learning British understatement) and neither is our population health system.

Politics: The organised efforts of a society to govern itself. “Democracy is the worst form of government, except for all the others” (attributed to Winston Churchill). It’s messy. No one makes it look easy — that’s for sure! Nonetheless, it is the intrinsic starting point for all organised efforts of our society to care for one and other.

Pathways: At the highest level (most simplified, but useful view), I see three pathways — (1) all government agencies that seek to socio-economically develop our communities and people, (2) public health [of course, but we are very small fish in the grand scheme of the system], and (3) health and social care services that generally step in to help when things go wrong [yes there are services that seek to help before things go wrong, but mostly this pathway ‘reacts’].

Wellbeing: In Public Health we often talk about ‘health and wellbeing’, but to me these are completely different things and banging them together just confuses what we are talking about. Population Health to me is about disease, illness and injury. The NHS is not a health service, I see it as a disease management service. Others may see it differently. Population Wellbeing is about happiness and satisfaction with one’s life. All of these things form Maslow’s Hierarchy of Needs, but they are discrete.

The system map, below, lays out what I see as the very highest level of relationships and elements that define our population health system.

Let me know what resonates or not with you.

I’ve used a free to use tool called Kumu to map out what I think our population health system looks like, as with other web based tools — they seem to work better for me using Google Chrome — Microsoft Explorer has problems and often you can’t see buttons on the page that do useful stuff like zoom in and out.

This futures blog

This blog is about how we create ‘healthy places’ and what our possible ‘futures’ could be given current trends and momentum within society, the economic and political systems, and the environment. I use the plural ‘futures’ intentionally, because our future is not pre-determined (I hope), we can and should work towards the future we want. This blog aims to generate discussion (maybe even some debate) around ‘Healthy places futures’ in the hope that if we all put our minds to it, a collective vision may emerge, which would inform any strategy we might put in place to get us to our preferred future. We’ll be leaning on heavily on futuring tools found on our Shaping Tomorrow hosted website: phd.shapingtomorrow.com.

The future is already here — it’s just not very evenly distributed (William Gibson 1993).

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