Audibility decays according to the inverse square law. Twice the distance, the sound gets four times as quiet. Four times the distance, sixteen times as quiet. More about this at the end.

I encourage you to meet these five people who live within 15 miles of your health system. Their health insurance is with Cigna, Anthem, or Aetna, and they fill their prescriptions at CVS, Walgreens, or Rite Aid.

Sally. She is a forty-seven year old single mom. Her twins went away to college five months ago, an event that has left Sally with a major case of the blues. During that period, she’s lost twenty-six pounds, and has developed a constant tingling sensation in her toes. She noticed what she thought was a dark mole on her back, and she thinks it has grown larger and it occasionally bleeds.

Bill. He is seventy-two and married. He and his wife Mary just moved to a retirement community several hundred miles away from their former home. They enjoy daily walks and arm-wrestling. He’s noticed that his vision seems to be getting worse. Bill tracks his exercise and diet with two different apps on his smart-phone. Mary’s mom and older sister both died from breast cancer, and Mary has not had a mammogram in the last two years. After losing to Mary arm wrestling yesterday, Bill felt short of breath and broke into a cold sweat.

Jose. He is married and has three children. His wife broke her hip three months ago and has not recovered enough to return to work or to care for her children. As a result, in addition to his fulltime job as a factory floor supervisor, he had to take a second job working nights until eleven, and all day Saturday. He still is not earning enough to pay all of their financial obligations. He is completely stressed, tired, overweight, and drinking heavily.

Monica. She smokes two packs a day, does not exercise, and is fond of fast food. All of her family members have high cholesterol, and her father died from heart disease before his fortieth birthday. She had her gall bladder removed three years ago, and suffers from IBS. Using her hands causes her pain to the point where she has difficulty opening a jar.

Paul. Paul runs six miles a day, six days a week. Other than his thinning hair, he considers himself to be the spitting image of a Greek god—just kidding. He watches what he eats and tracks his diet and exercise daily. He had a heart attack thirteen years ago.

So, what else do we—providers, payers, and pharmacies—know about these people? They each have a primary care physician. Three of them have current prescriptions of two or more medications, although only two of them take their meds.

We also know that half of them will have a chronic disease, and twenty-five percent of them will have two or more diseases. A third will be considered obese, and seven in ten of them will die from a chronic illness. Half of them do not exercise, and three of every four do no strength training.

What don’t we know about them?

We know nothing about how they are today. We know nothing about how they were yesterday, or the day before. Providers, payers, and pharmacies do not know anything about them; we just know generalities and probabilities about the population as a whole.

And who are these people? They are what I call consumers. Your consumers. Only they are not consuming anything. They are potential patients. Prospects. They all live in cities that have multiple providers. They have a choice of where to buy care.

And they all have current healthcare needs. Only as far as the provider community is concerned, they do not exist. They are not on anyone’s radar. Monica’s gall bladder removal is in your EMR, but that is the most current data about her health that is available, and as we both know, her gall bladder is no longer a concern.

Several of them track data about their health. But nobody knows anything about that data because neither the provider nor the payer nor the pharmacy is able to collect that data and use it to manage their health.

That is too bad. Imagine for example, that of the multiple health systems in their area, one of the health systems, perhaps yours created a way for those consumers to bank their data in your system. Take Philadelphia for example. There are several notable health systems; Penn, Einstein, Thomas Jefferson, Christiana Care, Main Line Health.

What would happen if Thomas Jefferson had a way to capture, monitor, and assess the current health data of these people? I think what would happen is that those people would begin to consider TJU as their provider, and once TJU began to proactively reach out to these consumers based on what they learned from their data, the health of those individuals would improve.

Audibility decays exponentially with distance.  For most healthcare institutions consumers are too far away to be heard.

What do you think?