Population Health & Precision Medicine with David Nash

Robin chats with Dr. David Nash, the Founding Dean and the Raymond C. and Doris N. Grandon Professor of Health Policy at the Jefferson College of Population Health in Philadelphia, about the intersection of population health and precision or personalized medicine. Nash, who helped create the first college of population health, says that population health must involve better outcomes, especially since the country spends 20 percent of its GDP on health care. Eventually, he explains, we need to get to a "no outcome, no income" world, which although it sounds "harsh," will ultimately lead to better outcomes. And we need to get rid of waste in health care by "shutting off the faucet instead of mopping the floor." The bottom line, according to Nash, is that population health management, combined with precision medicine, can make a difference in our health care system. Zip code, personal behavior, and genetic makeup are the significant determinants in personal health, which is why population health and precision medicine are complementary, and not competitive concepts. Gene therapy and cellular therapy both are innovative strategies for optimizing the intersection of population health and precision medicine. An example of optimizing population health, Nash notes, occurs when a patient is at risk for a particular disease and his or her physician can order the right diagnostic and screening tests for that person's specific genetic makeup. In general, he says, we need to go from volume to value and improve individual health, achieve optimal outcomes from unsatisfactory results, and get rid of unnecessary waste to improve per capita spending, all goals of population health.