To attain precision medicine, we must first personalize
Monday, February 22, 2016
In his 2015 State of the Union Address, President Barack Obama announced the launch of a new Precision Medicine Initiative and its goal to cure diseases and help us all improve our health. One year later, in his 2016 State of the Union address last month, Obama reinforced his support for this initiative and announced his goal of curing cancer.
So, what is precision medicine and what does it mean for healthcare leaders?
The ideal of precision medicine is focused on disease prevention and treatment that accommodates individual variation — our clinical history, genes and lifestyle. We have advanced genomic research and are taking a more molecular approach to help identify mutations that protect some individuals against disease.
It will take some time to fully work out details related to sequencing the human genome, determining what has clinical utility, identifying who will pay for the research and testing of theories and adjusting regulatory oversight to accommodate researcher needs. However, there is plenty we can do now to contribute to more precise care.
We currently leverage clinical data already available to identify best practices for which interventions work, creating evidence-based clinical guidelines for common conditions and diseases. Advancements in technology are helping to speed the analysis of data and information from clinical databases and other large data sets to facilitate better decision making.
Technology is also contributing to more engaged patients who are using social, mobile and other tools to contribute to research and management of their health by collecting and sharing personalized information about their activities, behaviors and environment.
It is important for healthcare leaders to recognize that as we increasingly personalize care and treatment for individuals, we come closer to the ultimate goal of precise medicine. For example, we mine data in cancer and other disease registries to create decision support guidelines for physicians on which medications work best, for which patients and when they should be started. We also use this data to determine which joint implants have the best results for which patients, and when is the best time to perform the surgery to realize the best outcomes.
Leaders representing health payers, providers and patients can contribute to more personalized practices that will help move us toward more precise medicine by recognizing opportunities for the following:
- Use of data to increase the understanding of disease and change practices and behavior.
- Recognizing variation — when people with the same disease, treated in different locations have different outcomes.
- Analyzing the reasons for variation, testing theories, identifying best practices and sharing these stories.
- Adopting technologies that can be used by patients to help them longitudinally track their own data, manage their conditions and prevent disease.
- Communicating and connecting with patients during their care and across transitions as they prefer, in a language they understand and in a way that builds upon their health literacy so they can take the right action(s).
- Measuring the results of more personalized care practices — reduced readmission rates, fewer ED visits, attainment of developmental and growth milestones, quality of life, etc.
- Leveraging the lessons learned adopting new strategies, techniques and practices that drive improved outcomes for individuals and populations of patients.
Today's healthcare leaders have an opportunity to help move us closer to precision medicine — not by understanding the details of how the human genome will transform medicine, rather by better understanding patients and their activities, behaviors and environment and finding ways to deliver more personalized care.
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