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Technology and Precision Medicine

“In the long term, a robust health IT network will support personalized treatment that adheres to proven best practices, and adapts to your personal health circumstances,” Senator Sheldon Whitehouse.

A brightly clothed woman raises her arms in joy and expresses her personality

What is Precision Medicine & What is its Relationship with IT?

Precision Medicine (PM) has been one of the leading buzzwords throughout the healthcare community. That’s been the case ever since the President announced plans to support research into the field back in 2015. But what is it really? Many are already familiar with the phrase ‘patient-centered care’: Healthcare designed to respect and respond to individual patient wants, needs, and values throughout treatment. Precision Medicine simply takes patient-centered care to the next logical step. It includes care that’s customized to groups of people at their molecular level. It invites us to ask, ‘What can our DNA tell us?’ In other words, “Precision medicine is a medical model that proposes the customization of healthcare, with medical decisions, practices, and products being tailored to the individual patient” (Wikipedia).

“We should have lifelong monitoring of our vital signs that predicts things like skin or pancreatic cancer so we can eradicate it. There’s a huge amount of innovation possible,” Professor, Computer Scientist, and Google X Founder, Sebastian Thrun.

What is the difference between precision medicine and personalized medicine?

Young precision medicine researchers at work

Another common term used to refer to this concept is ‘personalized medicine’. However, there is a distinction between the two terms. As the National Research Council aptly explains, precision medicine is distinct from personalized medicine because it “does not literally mean the creation of drugs or medical devices that are unique to a patient. But rather the ability to classify individuals into sub-populations that differ in their susceptibility to a particular disease, in the biology, and prognosis of those diseases they may develop, or in their response to a specific treatment,” (Xconomy). It’s precise, not personal.

“In precision medicine, the focus is on identifying which approaches will be effective for which patients. This is based on genetic, environmental, and lifestyle factors. However, some people still use the two terms interchangeably,” (National Institutes of Health).

What is the relationship between precision medicine and IT?

In 2015, an announcement was made that highlighted a new national research initiative designed to integrate precision medicine into modern healthcare. That is, The Precision Medicine Initiative. Within this plan are two types of goal. “The short-term goals involve expanding precision medicine in the area of cancer research. While, the long-term goals focus on bringing precision medicine to all areas of health and healthcare on a large scale,” (National Institutes of Health). All of this follows and complements the 2009 HITECH Act, which was created to improve our healthcare technology for both patients and providers. So when implemented at large on the clinical level, the delivery of precision medicine will depend in part on the systems and technologies that are now in place as a result of the previous act.

A doctor investigates DNA, which is at the heart of Precision Medicine

The relationships that have been established between leaders and organizations in both the technology and healthcare sector will continue to be significant, as we push towards this next level of custom care for patients throughout the country. The good news is that the right conversations are already occurring. As one article noted, “Interestingly, the subject (i.e. precision medicine) produces commentary and presentations from physicians who sound much like technologists, and from technology industry scions who sound much like medical theorists. The potential of this cross-disciplinary field excites representatives from both spheres. Streamlining technological adoption and integration must be a primary focus of collective, cross-industry efforts if we are to enable wide-scale application of personalized medicine,” (Healthcare-Informatics). Healthcare and technology teams must turn to and collaborate with one another in order to reach this exciting new goal.

To support these goals the National Institutes of Health (NIH) will be recruiting about 1 million volunteers from across the country. These volunteers will provide the large volume of genetic data and samples needed to research and improve our understanding and treatment of human diseases. The National Center for Biotechnology Information a.k.a. NCBI has stated that, “A large, diverse, and inclusive precision medicine cohort (i.e. a group of people with similar characteristics) could eventually allow the United States to reap long-term benefits from a better understanding of human disease. Additionally, in the short term, there exists an immediate opportunity to deploy genomic information that could benefit patients, families, and communities,” (NCBI). So there will be a role for anyone interested in the public to play, as well.

What are the benefits of precision medicine?

According to data provided by the world’s largest biomedical library, the National Library of Medicine, the potential long term benefits of research into precision medicine include:

  • Better integration of electronic health records in patient care, allowing doctors and researchers to access medical data more easily
  • Wider ability of doctors to use patients genetic and other molecular data in routine medical care
  • Improved approaches to preventing, diagnosing, and treating a wide range of diseases
  • Better understanding of the underlying mechanisms by which various diseases occur
  • Improved ability to predict which treatments will work best for specific patients

Ultimately, it all comes back to patient-centered care and the effort to continually make meaningful improvements to that care from all possible angles. That includes everything from the tools and technologies to the treatments and strategic practices used to support decision-making, customized for patients in need.

Take a moment to just imagine what the future of healthcare with such precision could offer the world. Ryan Phelan, founder and CEO of DNA Direct, was once quoted saying, “You’d no more think of getting a drug without knowing your genome than you’d think of getting a blood transfusion without knowing your blood type,” (McKinsey & Company). We’re pushing for a greater future because we know we can always do better tomorrow, than we have today. Progress is still possible.

How Will We Pay for the Cost of Precision Medicine?

Cost

The Precision Medicine Initiative was announced in 2015, so you might first consider how we’ve paid for things so far. “The President’s budget for fiscal year 2016 included $216 million in funding. This supports the initiative through the National Institutes of Health, National Cancer Institute, and the Food and Drug Administration,” (NIH). That may seem like a lot at first glance but it will require more over time. Remember, this is a project that will involve reviewing the genetic data from up to 1 million volunteers. That data will be a treasure trove of medical insights. And it will have to be protected as such with a strong, not inexpensive data security system. It will also require information systems that enable researchers to store, organize, and review that mass of data, quickly and effectively.

Though the initial funding was granted, Congress will be charged with approving the capital needed to continue making progress in the coming years. Going forwards, “To implement wide adoption of precision medicine and eventually dramatically drive down healthcare cost, the healthcare industry must make an investment in new data systems, new business models, and new procedures,” (ZDNet). In short, IT is the foundation needed to power this new model. However, the demand for funding urges us to review the results thus far. It begs the question, why should we continue to invest in precision medicine?

  • What’s in Progress?: You can visit the National Institutes of Health’s All of Us Research Program online at https://www.nih.gov/research-training/precision-medicine-initiative/funding for a list of past and currently funded research.

What’s the ROI of Precision Medicine?

An individual stands out in a crowd

It’s not difficult to imagine a future in which precision medicine is more than a solution for modern diseases. With the right technological support, it could become a powerful tool for preventative care. In fact, that’s one of the best areas we may look to for a reliable long-term return on investments into precision medicine. As business analyst and investor Esther Dyson explained, “Think of an employer who spends $500 million a year on health care, and it’s growing at 3 percent a year. If you agree to take that over, to keep those people healthy, and you can cut costs by $50 million, well, you are making $50 million a year,” (MIT Technology Review).

It’s pretty simple. When people are healthy, they perform better on the job and it cost less to provide them with healthcare. Better healthcare is better for businesses and national economies. So it’s not just an inspiring step towards societal progress, it’s also a shrewd business move.

When Will We, the Public, Get Precision Medicine?

Remember, expanding precision medicine in the area of cancer research was the first short-term goal. Fortunately, the preliminary gains have been made and precision medicine is already helping to save lives, today. Cancer is where the focus has been and where potential has been made incredibly apparent. “Dr. Charles Sawyers, who directs the human oncology and pathogenesis program at Memorial Sloan Kettering Cancer Center explained. ‘Lots of dramatic successes have come out in the last year or so. Further progress on cancer — ‘the low-hanging fruit’ — could be greatly accelerated with the support,” (NYTimes). Patients with tumors have already begun to benefit from precision medicine through treatments targeting the specific genes impacting their disease.

The timeline for when we will all have access to precision medicine at our local healthcare centers isn’t crystal clear. But industry leaders have begun to make some encouraging projections:

Jonathan Sheldon, Global VP of Oracle Health Sciences shared his insights. “‘Precision medicine has always been moving fast. But over the last two years or so, it has really accelerated into the clinical space. A lot of academic medical centers are already equipped with the sequencing facilities that are up and running. If the reimbursement landscape changes, I think [genetic] sequencing could be routine within the next two years, easily – at least at those top academic medical centers. And that would increase the incentive for other organizations to follow suit,'” (Health IT Analytics).

This is a hugely important goal for those in our medical and information technology communities. So, you may be wondering what your university is doing to usher in the era of precision medicine? On that note, we have excellent news. The state’s first genetic counseling degree program is now available at The University of South Florida. So, in the heart of Tampa Bay the next generation of precision medicine practitioners are training for a brighter future. That said, the burden of bringing about that future depends on awareness and support from all of us. So, remember to stay up to date on this topic. For high quality insights on what’s upcoming in the world of technology simply stay tuned to the Technology Blog.

Happy Computing!

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Technology and Precision Medicine

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