Welcome to the Blog of the Duke Center for Research on Prospective Health Care

The mission of the Duke Center for Research on Prospective Health Care is to support the development and implementation of prospective health care, a personalized, predictive, preventive and participatory approach to care that is based on the integration of three key elements: (1) personalized health planning, (2) coordination of care, and (3) rational reimbursement. On this blog we discuss current issues in prospective health care and personalized medicine, including ongoing research and outreach in the Center, the work of other leaders in the field, and innovations in science and technology that can promote this model of care. We invite you to this important conversation and look forward to your thoughtful comments and ideas.

The views, opinions and positions expressed by the authors and those providing comments on these blogs are theirs alone, and do not necessarily reflect the views, opinions or positions of Duke's Center for Research on Personalized Health Care.

Thursday, June 28, 2012


The factious debate regarding the constitutionality of the Accountable Care Act (ACA) is over.  The Supreme Court has ruled that the law is constitutional, including the health insurance mandate which was judged to be a tax.
Health care reform will now be elevated to a major political referendum in the upcoming national election.  Virtually all agree that we need a health care system that is accessible, affordable, and effective in providing quality health care.  Whether the best route forward is through the ACA or other legislative-directed approaches is far less certain than the need to change our underlying approach to health care delivery.
We must move from our current reactive, sporadic approach, using expensive technologies to treat late-stage preventable disease-events to a coordinated preventive, personalized model of care.   Personalized health care addresses the specific health needs of individuals at any time in their life and utilizes predictive technologies to evaluate health risks and employs planning to provide the care most likely to be effective.  This approach to care is personalized, predictive, and preventive and involves an engaged and enlightened patient.  A great barrier to innovation in health care has been a reimbursement system that handsomely rewards high cost intervention for late-stage disease and punishes prevention and coordinated care.  Reimbursement models that reward successful outcomes will help unlock innovation.  As a consequence, personalized health care will be embraced by more and more enlightened providers, employers, and insurers.  So, while the heated debate will focus on legislation, the real work of resolving the problem will occur through fixing health care reimbursement and developing and adopting health care approaches that work.  There is a great degree of creativity being deployed to create the most effective models for care.  New technologies are enabling increasing personalization and are putting capabilities in the hands of consumers and lower cost providers.
With a more rational approach to health care, access and affordability will be attainable.  Absent changes in how care is delivered, health care legislation will do little more than drive up costs and add to the burden of an already struggling economy. The solution to affordable quality care is attainable but the solutions will need to occur outside the partisan health arena.

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