| Leveraging the Perioperative Period to Address Population Health Michael Englesbe, MD. University of Michigan |
Abstract
The goal of this presentation is to introduce the concept of leveraging the perioperative period to improve the overall health of patients beyond surigcal and anesthetic clinical interventions. On a broad scale, the surgical episode presents an impactful opportunity to advance population health. More so than the clinical care patients receive, social risk factors and health behaviors are the primary determinants of long-term health outcomes. Incorporating interventions such as smoking cessation, promoting physical activity, screening for social risks and connecting patients to resources, substance use disorder screening with optimization of preoperative pain management can have a substantial impact on patients' long-term health. Many of these interventions can be delivered through a comprehensive prehabilitation program.
The key approach to implementing prehabilitation programs include utilizing incremental strategies that avoid placing additional burdens on already overworked caregivers. Integrating these interventions into existing electronic health record (EHR) interactive patient technologies is critical. In Michigan, these interventions are being adopted at scale across major health systems, motivated by support and financial incentives from the state’s largest private payer. Statewide goals addressing smoking cessation, food insecurity, optimal opioid stewardship, and enhanced activity through cardiac rehabilitation are already demonstrating significant impact.
In summary, the preoperative period is a unique opportunity to broadly improve the health trajectory of our patients.
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