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EditorialEditorial

Clinical Population Medicine: Integrating Clinical Medicine and Population Health in Practice

Aaron M. Orkin, Aamir Bharmal, Jenni Cram, Fiona G. Kouyoumdjian, Andrew D. Pinto and Ross Upshur
The Annals of Family Medicine September 2017, 15 (5) 405-409; DOI: https://doi.org/10.1370/afm.2143
Aaron M. Orkin
1Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, Ontario
2Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
3Department of Family Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario
MD, MSc, MPH, CCFP(EM), FRCPC
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  • For correspondence: aorkin@gmail.com
Aamir Bharmal
2Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
4Fraser Health Authority, Surrey, British Columbia
MD, MPH, FRCPC
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Jenni Cram
2Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
MD, MPH, CCFP
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Fiona G. Kouyoumdjian
5Department of Family Medicine, McMaster University, Hamilton, Ontario
6Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario
MD, MPH, PhD, CCFP, FRCPC
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Andrew D. Pinto
2Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
3Department of Family Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario
6Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario
7Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario
MD, MSc, CCFP, FRCPC
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Ross Upshur
2Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
8Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario
MD, MA, MSc, CCFP, FRCPC
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    Table 1

    Clinical Population Medicine (CPM): What it Is and What it Is Not

    Clinical Population Medicine is the conscientious, explicit, and judicious application of population health approaches to care for individual patients and design health care systems.
    Clinical Population Medicine is:
    • a deliberate practice applied by practitioners and institutions

    • engaged health care institutions that reduce health inequity through improved access, health promotion, and disease prevention

    • using patient and population level data to deliver immediate and accessible indicators for clinical decisions and system design that are responsive to changing community health needs

    • grounded in the science of epidemiology and medicine, and the practices of public health and clinical care

    Clinical Population Medicine is not:
    • a threat to patient-centered clinical care through rationing or under-mining patient or clinician autonomy

    • a substitute for comprehensive, multi-sector public health practice

    • limited to partnerships between public health institutions and health care institutions

    • a new medical specialty or discipline limited to specially trained practitioners

    • the same as health services research or quality improvement

    • View popup
    Table 2

    Characterizing Clinical Population Medicine (CPM) Articles to the CDC Public Health Core Functions and PHAC Essential Functions of Public Health

    CDC Core Function and DefinitionCPM Exemplars in This Virtual IssuePHAC Essential Function
    Assessment
    • Monitor health status to identify and solve community health problems

    • Diagnose and investigate health problems and health hazards in the community

    Williamson et al, 2014. Validating the 8 CPCSSN case definitions for chronic disease surveillance in a primary care data base of electronic health records9Health Surveillance
    Sloane et al, 2006. Syndromic surveillance for emerging infections in office practice using billing data10Health Surveillance
    Naessens et al, 2005. Predicting persistently high primary care use11Population Health assessment
    Trachtenberg et al, 2014. Inequities in ambulatory care and the relationship between socioeconomic status and respiratory hospitalizations: a population-based study of a Canadian city12Population Health Assessment
    Policy Development
    • Inform, educate, and empower people about health issues

    • Mobilize community partnerships to identify and solve health problems

    • Develop policies and plans that support individual and community health efforts

    Thom et al, 2013. Impact of peer health coaching on glycemic control in low-income patients with diabetes: a randomized controlled trial13Health Promotion
    Mainous et al, 2009. A community intervention to decrease antibiotics used for self-medication among Latino adults14Health Promotion
    Rosenblatt, 2005. Ecological change and the future of the human species: can physicians make a difference?15Disease and Injury Prevention
    Assurance
    • Enforce laws and regulations that protect health and ensure safety

    • Link people to needed personal health services and assure the provision of health care when otherwise unavailable

    • Assure competent public and personal health care workforce

    • Evaluate effectiveness, accessibility, and quality of personal and population-based health services

    • Research for new insights and innovative solutions to health problems

    Kiran et al, 2014. Effect of payment incentives on cancer screening in Ontario primary care16Disease and Injury Prevention
    Roetzheim et al, 2004. A randomized controlled trial to increase cancer screening among attendees of community health centers17Health Protection
    Jerant et al, 2012. Primary care attributes and mortality: a national person-level study18Population Health Assessment
    • CDC = Centers for Disease Control and Prevention; PHAC = Public Health Agency of Canada.

Additional Files

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    • Supplemental data: Appendix - PDF file
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The Annals of Family Medicine: 15 (5)
The Annals of Family Medicine: 15 (5)
Vol. 15, Issue 5
September/October 2017
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Clinical Population Medicine: Integrating Clinical Medicine and Population Health in Practice
Aaron M. Orkin, Aamir Bharmal, Jenni Cram, Fiona G. Kouyoumdjian, Andrew D. Pinto, Ross Upshur
The Annals of Family Medicine Sep 2017, 15 (5) 405-409; DOI: 10.1370/afm.2143

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Clinical Population Medicine: Integrating Clinical Medicine and Population Health in Practice
Aaron M. Orkin, Aamir Bharmal, Jenni Cram, Fiona G. Kouyoumdjian, Andrew D. Pinto, Ross Upshur
The Annals of Family Medicine Sep 2017, 15 (5) 405-409; DOI: 10.1370/afm.2143
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