Optimizing Patient Care Through Personalized Medicine

Today, I want to talk about you, and how you can harness your greatness to optimize your patient care, said Ashley Koff, RD, at the 2023 Integrative Healthcare Symposium in New York City.

In a panel presentation, Koff, founder of The Better Nutrition Program, and her colleagues, Tom Blue, and Myles Spar, MD, discussed the current landscape of personalized nutrition as well as the role of integrative practitioners in the practice as whole.  

In 2021, the personalize nutrition market estimated to be a $14.6 billion industry and it’s expected to grow to $45 billion by 2040. Consequently, direct-to-consumer businesses are desperate to get into the market, leaving the industry highly fragmented with products varying in quality. In fact, the majority of personalized nutrition money is spent without healthcare practitioner involvement, Koff explained.

Those selling personalized nutrition, said Koff, like supplement companies, genetic testing companies, and wearable companies, can only provide the products to consumers. Practitioners, however, are the only ones who can direct patients on how to properly use these products and deliver wins.

“Our superpower is personalization,” said Koff. “That P in personalization stands for practitioner.

The integrative practitioner’s role in personalized medicine

There’s an important distinction between personalized medicine and precision medicine. Spar, vice president and national director of medical services at AndHealth.

Unlike precision medicine, which focuses on treatment, personalized healthcare is all about prevention. “It’s predictive, its participatory, it’s personalized, and its preventative,” Spar said.

The key to successful outcomes with personalized nutrition, he explained, is collaboration between direct-to-consumer companies and integrative practitioners.

“Truly personalized care is actually talking to patients, understanding the context, looking at their medical history, their lifestyle, their goals, their capabilities, their mindset, their readiness to change, and then proving recommendations,” said Spar.

Yet, many direct-to-consumer brands are not personalized at all, according to Spar. They split people into broad categories and market single tests as a diagnosis of some sort without further testing or expert analysis.

“As opposed to buying a test that is sold as the ‘one single best test for you’, we need to identify what the best test for the patient is based on their actual background and needs,” he said.

Many personalized medicine products can however be a very helpful tool for integrative practitioners. According to Spar, to deliver quality personalized care, practitioners should make sure personalized medicine businesses have:

• Knowledge of testing options, such as genetics, ‘omics, and imaging
• Knowledge of remote data collection options
• Incorporation of measures of success
• Expertise in integrative/functions/ lifestyle medicine interventions
• Ability to implement support, feedback, and accountability
• Business models that works for patient needs as well as the goals, skills, and businesses of integrative practitioners.

“You don’t have to do it on your own,” said Spar. “There’s help you can get but you need to know how to leverage your expertise and stay in your zone of genius and getting support from the outside.”

The argument for bundled programs

I am going to talk about how to package your services and deliver them efficiently, as well as the very important relationship between those two things, said Blue, senior vice president of healthcare at AndHealth.

Integrative practices must be focused on providing disease reversal instead of disease management, said Blue. Not only is disease reversal the best outcome for patients, it’s also far more sustainable and profitable for practitioners. These programs for disease reversal are multifactorial, explained Blue.

“I like to think of patient care as a journey,” said Blue. “A journey that’s peppered with visits with practitioners, and peppered with devices for tracking, lab tests, supplements, and food.”

There are two critical questions for every practice, said Blue.

1. How should I package this journey for patients to purchase?
2. How do I implement the journey?

When choosing how to package services, Blue said there are two main options: fee for services and bundled program. This choice determines a practice’s financial sustainability and profitability, growth, and quality of health outcomes.

Blue recommended using a bundled program. Using a bundle program allows practitioners to sell a targeted solution without ambiguity, as well as:

• Create standardization to track outcomes and optimize services
• Establish and intelligent price
• Creates a single decision for treatment plans so patients can focus on the work at hand
• Improves outcomes

Implementing bundle programs can be a challenge, Blue admitted. Practices are not designed to provide patients with every aspect of a bundled program. Thus, Blue said, successful bundled programs require personal coaches trained in the program protocol and technology to facilitate learning, tracking, and communication.

Blue recommended providers integrate specific apps into their practices that house program curriculum, tracking capabilities, and trained coaches embedded into the program.

Apps like these allow practices to purchase the program wholesale, integrative products, and practice services, as well as sell the bundle profitably at scale, said Blue.

Personalized nutrition solutions

We need to look at the patients’ needs as well as what we can do for the patient. Then, we need to use resources like technology to fill in those gaps, said Koff.

“It’s not about us coming in and being the heroes,” said Koff. “In order for patients to be empowered and be heroes themselves, they need to use these tools and actually engage with them.”

Before investing in a resource for your practice, explained Koff, there are several questions to ask yourself, among them:

• Does it help my patient implement my recommendations?
• Does it deliver personalized education?
• Does it help my patient identify and make their better choices more often?
• Does it keep me getting real-time data about my patient so I can adjust recommendations?
• Does it help them understand the value of working with me long-term?

A practitioner cannot optimize each patient’s health outcomes without adequate resources, Koff explained. In personalized medicine, a patient needs education, experimentation, evaluation, and consistent support.

The Practitioner’s job, Koff said, is to diagnose and recommend treatments for patients, answer their questions, review patient progress with data, and revise their previous recommendations as necessary. Additional services, Koff suggested, can be provided through personalized medicine programs.

“What I want you to think about is, it’s not about just pieces and parts. What we need to do is take everything you do with a patient when they’re having a successful experience.”

For instance, for blood sugar optimization, personalized nutrition programs can provide assessments, like an added sugar evaluation and blood work. Then, after providing patients with expert education resources, they can engage them with experiments to understand what works for them as well as what doesn’t. Finally, and crucially, these programs provide continuous support through health coaches, messaging, and group live sessions.

It's not about providing an app to your patients. These programs are about giving patients individual solutions, regardless of what that may look like.

“We need to continue to make patients heroes in their journey,” said Koff. “We are just here to support them.