Precision medical solutions offer health care providers the opportunity to provide higher-value care to patients at a lower overall cost.
Whilst precision medical examples are often limited to how developments in genome research and genomic technology can help in a better understanding of how genes can affect the health of a cohort of the population, and there, there are others who argue that precision health solutions go further than that. Precision medicine allows for accurate diagnosis of conditions, which can then be integrated with a patient’s data, and that of thousands of others derived from clinical research studies, to devise the right treatment for a patient at the right time, and an appropriate cost.
Precision health is an increasingly popular approach to disease treatment and prevention that takes account of an individual’s genes, environment, and lifestyle. It allows doctors and medical practitioners to more accurately predict appropriate medical strategies and treatments for an individual rather than the more generic “one-size-fits-all” model, which pays less attention to the differences between individuals.
Precision medicine uses advances in information technology processing and “big data” to allow providers, payors, and biopharma to sift quickly through millions of anonymized patient data to identify those with similar conditions and symptoms to the individual they are treating. It also builds on advances in Genomic Technology and Genome research to help produce defined Precision Health solutions.
A key driver for precision medicine advances has been the cost reduction of genomics testing over the past few years, whether this is conducted in a genetic testing lab run by a healthcare provider, or through patient-initiated genomic testing.
Now using next-gen genome sequencing (NGS) based on the DNA of a patient, physicians can work with individuals to identify disease risks and in some cases where changes in lifestyle may be required to reduce their risks of long-term medical conditions. It becomes an essential part of their health management for individuals.
Healthcare organizations are increasingly adopting precision medicine initiatives in order to put a dent on the rapidly increasing cost of healthcare.
Although the term Precision Health has been coined relatively recently, the underlying concept behind Precision Health Management solutions has been practiced within healthcare systems for many years. Precision medicine examples include the use of blood transfusions. Those who need a blood transfusion are not given a sample from a randomly selected donor, as that would serious medical complications. Instead, the donor’s and recipient’s blood types are matched before transfusion is conducted.
Precision health initiatives are long-term research studies with the objective of understanding how a person’s genetics, lifestyle, and environment has a part to play in their long-term health and to identify the best approach to combat or treat diseases.
For example, one such Precision Health Initiative is being led by researchers at the National Cancer Initiative (NCI). They are looking at how an enhanced knowledge of the biology and genomics of cancer can help in the development of more effective treatments. With the use of volunteers on a mass scale who are asked to take a genetic test, provide biological samples, and provide other information about their health, researchers will be able to take the data provided to study a large range of diseases. The goal is not simply to understand how the diseases occur in the first place but to find improved diagnosis and treatment strategies.
Oncology is by no means the only medical field in which Precision Health Initiatives are taking place. They are also being used to research some rare childhood illnesses, cystic fibrosis, and HIV. Some precision health providers have also suggested the extension of precision clinical plans to treat conditions like cardiovascular disease, rheumatoid arthritis, multiple sclerosis, and Alzheimer’s disease.
Precision Health allows physicians and those involved in all branches of medical research – including genome research – to determine the best care for each individual patient. Using genome sequencing, which is carried out in genetic testing labs, they are able to identify the mutations of diseases in patients whose conditions are undiagnosed. Precision medicine also enables them to mitigate the risks of side effects from medications, and to identify specific genetic risk factors which can then be used to make the basis of recommendations to change patients’ lifestyle and behaviors (precision health solutions).
Precision medicine is used by some people interchangeably with the term personalized medicine. However, there is a distinction. Whilst both are concerned with the treatment of patients at the individual level, rather than the broader aims of most health initiatives and programs that are aimed at public health in general, personalized medicine implies that treatments are designed uniquely for any individual. By contrast, precision medicine, meaning an approach based on the use of Genomic Technology and Clinical Research Studies, is designed to identify treatments for individuals based on their genome, microbiome, epigenetics, or other biomarkers, genome environmental and lifestyle factors that they share with others with the same genetic profiles.
And, at a macro level, there are also broader societal benefits as well. The more understanding there is of genomics and medicine, and what precision medicine means in practice, in terms of better treatments for individuals, the more that people will be willing to participate in precision health programs, and to allow their data to be shared – provided, of course, that there are suitable safeguards over their privacy and the confidentiality of their data.
In terms of genome research, the wider the sample size from which to draw, the more accurate the precision health solution. This will also see new scientific and commercial partnerships arise. Within the Precision Health industry itself between Precision Health Analytics Vendors, Precision Health Management Health Consulting companies, and Genetic Testing Labs, for example. And, at a broader level, between Precision Health providers, pharmaceutical companies, clinical bodies, government agencies, and patient body representatives.
Genomics is the field of study that concerns itself with the study of a person’s entire genes (the genome), how they interact with each other, and with a person’s environment. Genomics and precision health have many overlaps, but they are not precisely similar. Genome research and genomic technology encompass fields beyond merely health care, including zoology, agriculture, and evolutionary biology. Equally, some facets of precision health do not rely on the use of genome DNA, such as the utilization of data on human behavior collected from wearables such as smartwatches or fit-bits.
One problem that may hinder the pace at which precision health solutions become more widespread is the need for doctors and medical professionals to gain an understanding of advances in genomic technology and genome research.
This is by no means easy for many of them. While they may have a basic understanding of genomics and medicine from when they were studying in medical school, for many, that was a long time ago, and the subject and discipline have evolved considerably since then. Precision health companies can help close the education gap, but the learning curve might still be steep in some cases.
The development and evolution of precision health is part of a wider shift from quantitative to qualitative health care delivery models, where outcomes and the value of care are rated and rewarded ahead of quantity. Precision for medicine will gain increasing currency.
Increasingly the trend is to identify at-risk groups within the population and to find a way of encouraging them to live longer by living healthier lives. Wellness will replace illness as the primary focus of healthcare management.
People no longer have the same phobias about taking a genetic test, and, provided that data privacy and confidentiality concerns can be adequately addressed by precision health companies, and that precision health resources are appropriately directed to identifying new and better treatments, then there will be much greater support, both within the population at large and amongst health care professionals, for precision health solutions.
There are numerous current precision medical examples of how precision health is being used to develop more targeted and cost-effective methods for early diagnosis of disease, and the development of suitable treatments.
Stanford School of Medicine, for example, used a national library of DNA sequencing of tumors to detect the one molecule amongst thousands of healthy molecules, which could be cancerous. Another such study was able to identify a pattern of gene activity that can lead to sepsis, which is linked to 750,000 deaths a year in the US alone.
Meanwhile, researchers at Stanford Medicine are collaborating with Apple to develop an app called “My Heart Counts.” The application will collect data about an individual’s physical activity and factors involving their risk of cardiac problems in order to advance the understanding of the human Cardiovascular system.
Precision medicine is using advances in genomic research and genome technology, harnessed with developments in big data and machine learning to more accurately understand the causes of diseases, how an individual’s genes, environment, and lifestyle impact upon them, and how better to tailor treatment to the individual.
It comes with as part of a broader realization that genomics and medicine are inextricably linked, and that, with the demand for ways of curbing rising health care costs, care providers are increasingly looking for value over quantity. Precision for medicine offers, therefore, the opportunity to move away from the old, one-size-fits-all model of healthcare, to one that is more focused on the individual, where prevention is better than cure, and wellness replaces illness as the health mantra.
In summary, a precision health approach to medical treatment benefits both the patient and the health care provider by shifting the emphasis from reacting to prevention, ensuring more targeted therapy and the application of the correct drugs, increasing the adherence of patients to treatment, and reducing high-risk procedures. The net result of all these factors is a reduction in the overall cost of health care.
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