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St. Luke's Blogs

Population Health: Anthony and Barbara

By Dr. David C. Pate, News and Community
May 26, 2015

Editor’s note: This is the sixth part of an eight-part series that previously appeared in an abridged form in Becker’s Hospital Review. Examples below illustrate the segmentation and care of subpopulations; others will follow in the series.


Anthony is a 24-year-old man who is healthy and has no known medical risk factors. He signed up with an insurance plan for which your health system takes risk. He has selected a physician and, right after his check-up, downloaded an app through which he can log in to email his physician, check lab results, and schedule visits online.

He filled out a health risk assessment form that showed him his “vitality” score and allows him to monitor his health status. He got information about diet, exercise, and health behaviors.

After his check-up, his doctor wanted him to have a fasting blood sugar and cholesterol blood test. Logging into his online account, he noted the appointment made for the lab tests.

Anthony returned to work after the tests and received an email that indicated his lab results were ready. He logged into his online medical record, clicked “test results,” and received the results and a note from his physician indicating that his tests were normal.

A couple of months later, Anthony developed sneezing, itching eyes, and a runny nose. Not experiencing relief with over-the-counter medications, he sent an email to his physician explaining his symptoms. Within two hours, Anthony received an email from his physician’s assistant, letting him know that a prescription was sent electronically to his pharmacy and explaining that he should contact them for an online video visit if he was not better in a few days.

In the fall, Anthony received an email reminder to get a flu shot.


Barbara is a 24-year-old woman who is overweight and smokes, is not physically fit, and has a family history of diabetes, hypertension, and heart disease. She works for a company that has chosen your health system to manage their employee wellness program.

Barbara took a health risk assessment online. Her vitality score indicated that her health was suboptimal and that she was at high risk for heart disease, stroke, and cancer because of her smoking history, her weight, and her level of physical activity. Wellness team members then visited her workplace and conducted health screenings. Her BMI, blood pressure, blood sugar, and cholesterol were checked.

Barbara told her health coach that she had wanted to stop smoking and lose weight, but didn’t know how and feared stopping smoking would aggravate her weight problem. With the help and support of her coach, she started a smoking cessation program and a journey toward improved wellness. A nutritionist took her and others beginning the same journey to the grocery store and taught her how to read labels and make healthy choices.

With continued direction from the health coach, Barbara began using a pedometer and started a daily walking program with friends. She checked in with her health coach every week and received new ideas and encouragement. She attended cooking classes and started exercising.

Now Barbara is a non-smoker. She’s losing weight, and feels stronger and fitter than ever!

In the next part of this series, we will look at another subpopulation.

About The Author

David C. Pate, M.D., J.D., previously served as president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009 and retired in 2020. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.