“via” Glidepath
   The path ahead offers many opportunities to tackle both the overarching issue of vulnerability and specific interventions targeted at minimizing vulnerability and maximizing thriving. 
   There is an opportunity to tackle the overall issue of vulnerability in America and work on a person-centered strategy that moves beyond the limitations of “stovepipe” programs focused either on specific subpopulations or specific programmatic interventions. 
   We can bring about an overarching model and an overarching strategy a) into which specific interventions can play a constructive role, b) for assessing the benefit (real or projected) such interventions have on reducing overall vulnerability and maximizing overall thriving in America, and, most importantly, c) for perpetually preventing/ minimizing vulnerability and maximizing thriving in America and beyond.
 

 

Vulnerable in America (via)
   In America and in the world today, there are millions upon millions of vulnerable persons. 
   They are vulnerable due to many causes (un- or underinsured; poor education, un- or under-employment, poor housing, etc).  Their vulnerabilities range widely (e.g., low ability, low motivation, low performance, diminished quality of life, high developmental risks for children, high risk for adverse events, short life expectancy for newborns & children, short adult life expectancy).  Many persons have multiple vulnerabilities. 
     While we have many people who are vulnerable today, many more people are at risk of vulnerability in the years ahead.  Further, many people are affected negatively by family and friends who have these vulnerabilities.
   As a result, people do not achieve the state of health and well being commensurate with a modern society that puts 1/5th of its national economy toward “health."
   To rectify this, America needs a sustainable strategy to stop actions that push people down to more vulnerable states and to support actions that lift people out of vulnerability.  America needs A self-perpetuating system in which vulnerability is minimized for all and all thrive.
 

“via” Endgame Strategy
   Two overarching strategies can help minimize vulnerability, maximize health, and maximize thriving on a sustained basis. 
   Vulnerable In America (via) where 1) we analyze a) who are the most vulnerable persons and why, b) what forces are increasing/reducing vulnerability, and c) what strategy would minimize vulnerability and maximize thriving on a sustained basis and 2) we then proceed to execute best strategy as an ongoing effort with ongoing evaluation and adjustments.
   HealthePeople where we maximize health via a) person-centered health, b) care in the community, c) quality and health improvement, d) solving the un- and underinsured problem, and e) virtual health system(s).
    In support are key strategies:

• Person-Centered Health where the person a) is at the center of self care, formal health care and informal health support and b) has that health care/support coordinated via an effective person and clinician partnership.

• Care in the Community where eHealth (including via mass personalization) is utilized as a means to better support people’s health outside (“in the community”) and with health care facilities in real time at any time and anywhere.

• Quality/Health Improvement where we build upon IOM work on quality, better use evidence-based care, and develop and use behavioral models for person and clinician behavior to improve health care quality and health outcomes and status.

• Un- and Underinsured where we build upon IOM work on uninsured and develop and execute strategies that moves us substantially toward solving the un- and under-insured problem in way supportable by key leaders and American public.

• Virtual Health Systems where we develop and use “virtual health system(s)” of electronic health records (EHR), personal health systems/records (PHS/R), information exchange (IE) and standards.