Hard Cases: The Case of the Invisible Patient

This article is part of LinkedIn’s Hard Cases series, where doctors share the toughest challenges they’ve faced in their careers. You can read more about it here and follow along using hashtag #HardCases. The article was originally published here.

Dr. Nick van Terheyden, CMO, BaseHealth

“With the right medical intervention at the earliest opportunity, the Invisible Patient’s healthcare trajectory can be improved.” — Dr. Nick van Terheyden, CMO, BaseHealth

Many patients have underlying issues with their health. Oftentimes, these issues can be identified by certain markers, like a patient’s speech pattern, gait or by looking at vital signs including blood pressure, heart rate, and weight. To an untrained eye, it might be unnoticeable, but physicians are trained to look for these patterns as indicators of a patient’s health.

However, far too frequently, patients in need put off trips to the doctor’s office, eliminating the opportunity for a critical visual and vital sign assessment.

While it’s true that most people who skip a regular visit to the doctor don’t have a major looming medical crisis, there are a small group of people who appear to look healthy on paper but are just one step away from a major medical issue. At BaseHealth, we call these patients “Invisible Patients.” They’re the patients who look healthy on paper until they hit a medical tipping point.

So why don’t patients go to the doctor’s office more often? In some cases, they don’t see what’s happening. We tend to compress the timeframe of how our health is changing. Because these changes are often subtle, we normalize them as minor inconveniences, rather than indicators of our health.

For example, let’s say we have an individual who goes for a one-mile walk daily, but over the course of six months, finds this walk is becoming increasingly difficult. The individual may notice that they’re tired, or start to feel pain during their walk, so they start taking shorter walks. Eventually, this new, shorter walk becomes the norm. Fast forward six months and the individual stops taking walks altogether. Soon, they can’t even walk up the stairs. This becomes their new normal and they don’t want to bother their busy doctor or admit to themselves that there might be a problem.

And while healthcare systems have a lot of data and tools that can help provide insights about a patient’s risk of getting sick, it’s often based on medical history, retrospective claims, and ICD-10 data.

The Invisible Patient doesn’t have a complicated claims history as they have not interacted with the health system raising any red flags or concerns over the status of their health or pending health issues. They’re currently considered healthy as far as their health system is concerned, but in reality, they have a very real and looming risk of a major health problem.

For comparison outside of healthcare, let’s take the aviation industry as an example. Hundreds of jets are flying across continents daily, sending messages about the engine systems, fuel use, crew activity, and even weather systems they encounter. With the data provided, flight operations are optimized, future maintenance is anticipated, air congestion can be reduced and flight routes altered well in advance of take-off to avoid storms.

The same concept can be applied in healthcare.

With the right medical intervention at the earliest opportunity, the Invisible Patient’s healthcare trajectory can be improved and physicians can begin to center on well care instead of sick care — in turn, delivering more value at a lower cost.

Our mission at BaseHealth is to identify the Invisible Patients and move from a random roll of the dice encounter that might pick up a looming health problem, to focus finding the needles in a haystack (aka Invisible Patients) who need our help now. We offer physicians the opportunity to identify the hard to uncover cases hidden within their patient population and give them the information they need to intervene immediately with proactive patient care plans to help before a patient encounters a medical tipping point.