Let’s not blame the patient: Understanding the benefits and shortcomings of population health in orthopaedic surgery

Population health is a concept that emerged from the desire of providers to care for patients in a manner that produces the best possible outcomes while minimizing cost. It may be defined as the study of medical data of large groups of people in order to recognize and investigate patterns. This information is then used to create disease management guidelines that streamline care and regulate practice patterns. Whereas population health looks to recognize commonalities in data, the concept of patient-centered care focuses on embracing individualization and increasing the involvement of each patient within their treatment planning. Combining both perspectives creates a challenge for providers and patients to strike the proper balance between adhering to standardized guidelines based on the treatment methods and outcomes recognized in populations and applying it clinically to individual patients. A significant contribution of population health studies is the identification of risk factors associated with increased rates of complications following total joint arthroplasty as well as preventative measures for conditions such as osteoarthritis. However, to employ these findings in a patient-centered manner orthopaedic surgeons must take this a step further and also evaluate a patient’s ability to adhere to the recommendations by exploring factors such as home environment and socioeconomic factors, thus proactively addressing issues that could hinder patient compliance. With focused collection methods of acquiring data, these two practices of care will hopefully begin to see less divergence when it comes to applying data derived from population health initiatives to individual patients in a patient-centered manner.