Today, clinicians don’t have access to all the patient data needed to create a care plan that directly addresses their unique personal circumstances and genetic makeup.
However, this could soon change with the introduction of precision medicine – an approach to care which provides clinicians real-time access to all information relevant to a patient’s care.
But precision medicine is not a new innovation in healthcare. It is an evolving field in which treatments are further tailored to an individual’s genomic and other biological characteristics, as well as environment and lifestyle. It will ultimately help refine our understanding of disease prediction and risk, and the onset and progression in patients, informing better evidence-based diagnoses.
For healthcare providers, precision medicine will pioneer a new model of patient-powered research that will provide clinicians with new tools, knowledge, and therapies to select which treatments work best for each patient. Providers will be better equipped to identify diseases, target them, personalize a treatment plan and, ultimately, provide better care. And with knowledge comes empowerment. When clinicians are able to determine a course of treatment in a shorter period of time, they can develop personalized care plans that have the strongest impact possible.
For the individual, when they know more about their own health, they are motivated to contribute and engage with their care plan. Further, by adding genomic information to care plans, patients are better equipped with the information needed to make tough medical decisions.
As I’m sure you’ve all read, a popular example of someone being more engaged in their care is Angelina Jolie who comes from a family ravaged by cancer. A genetic test revealed she also had the BRCA1 gene which put her at an increased risk of developing ovarian cancer and breast cancer. This knowledge allowed her to take preventative action - having undergone a double mastectomy and the removal of her ovaries and fallopian tubes.
Learning more about mapping our genome sequence will provide us with the vital information that is required in order to practice precision medicine.
Scientists have long known that microscopic bugs living inside each of us known as the human microbiome can be either extremely beneficial or harmful to our health. However, with the ability to now analyze the components of the microbiome rapidly, doctors will have a much more accurate picture of the nature and type of bacteria in your gut which can guide more accurate diagnosis and treatment strategies.
So what role will wearable tech and apps play in precision medicine? Ultimately, they contribute another piece of information on the patient not currently collected elsewhere. Increasingly, mobile devices are turning into a significant tool in disease prevention. For example, smartphone apps and devices like Apple Watch and Fitbit collect data on our exercise and sleep patterns and display this information in an easily digestible format. This knowledge can be extremely helpful for an individual to track and analyze their progress and take responsibility for their health. Technology already exists that can integrate all device, genomic, microbiome and clinical data into a complete picture for both clinicians and patients.
Governments around the world, including Canada are investing heavily in precision medicine. South of the border, US President Barack Obama launched a $215 million precision medicine initiative that will provide clinicians with the knowledge needed for better care plans. For precision medicine to become
a clinical reality in Canada, we need to:
• Encourage Canadians to have their genomics tested in an affordable and accessible manner;
• Develop mechanisms to adopt, scale up, and contribute new clinical genomic insights from global best practices;
• Focus on specific diseases like Cystic Fibrosis and identify research efforts to better understand and manage its prevalence in Canada;
• Work with research universities to support their efforts in precision medicine;
• Identify how we will manage and process the substantial amount of data needed for precision medicine.
Having said that, it is still early days for precision medicine and although there is a lot of research going on in Canada and beyond, it will be some time before we see benefits. Currently, we are in a transitional phase, from collecting and making data available, to being able to use that data in a meaningful way. We have made some progress by being able to access data through EHRs in connected provinces like Alberta, New Brunswick, and Quebec. But Canada runs a risk of wasting opportunities and money and falling further behind our peers if we do not adopt a cogent strategy and infrastructure to translate successful discoveries into improved clinical care.
Properly executed, precision medicine will make it possible for Canadian healthcare organizations using new and existing models of care to drive informed action across various clinical settings, communities and an entire nation. This will be achieved by extending health information exchanges (HIEs) in operation today in Canadian jurisdictions, so that more information is aggregated and made accessible to care providers, ensuring they –and patients – are equipped with the right information now and in the future.
With the explosion of new data sources and the pervasiveness of electronic health and medical records, precision medicine will help health organizations harness and leverage high volumes and velocities of data, simplifying the world of big health data for organizations regardless of their size.
This article originally appeared in an article on the Healthcare Information Management & Communications Canada website.
About the author: Gary Folker is Executive VP, Orion Health, North America & Chair, ITAC Health Board of Directors.