Susan Anderson discusses her Three Cs - cost, capacity and the consumer - of personalized medicine from her panel at the 16th Annual Healthcare Summit.
I recently participated on a panel entitled Personalized Medicine, is the Healthcare System Ready for it? as part of the 16th Annual Healthcare Summit in Kelowna, BC. Moderated by Dr. Kendall Ho, Director of Digital Emergency Medicine at the University of BC, the panel featured five individuals with unique perspectives on the topic.
Part of our conversation was to define personalized medicine which was described as measuring what matters most. Maslow’s hierarchy of need emphasizes the importance of social determinants of health but many people don’t know that only 25% of that is related to health and 75% from the social context.
Panel members were asked to describe compelling examples of personalized medicine that convinced us we needed to change our health system towards this focus. From my perspective, we need to address three critical areas: cost, capacity and the consumer.
Canadian healthcare costs continue to ramp upward, and we can’t spend our way to a sustainable health system. During my recent role as Assistant Deputy Minister in Alberta’s Health Ministry, I was engaged in refining and wrestling with the public health budget. Alberta’s public healthcare spending costs are higher per capita than most of the jurisdictions in Canada, yet the Ministry’s analysis showed that patients’ quality outcomes and life expectancy were not improving over the longer term as costs continued to increase. The introduction of personalized medicine in our healthcare system includes expected benefits of more effective preventative care and supporting the triple aim for healthcare while offering the enticing opportunity for reducing healthcare costs.
Another area covered off during the panel was around what led us to personalized medicine and what were our contributions to its advancement.
Twenty years ago, I was the project lead to reengineer the Department of Paediatric Laboratory Medicine for The Hospital for Sick Children in Toronto. I worked in collaboration with renowned genetic researcher and pathology leadership. Sick Kids had an extensive roster of significant discoveries in the genetics domain including publications on identification of genes for rare diseases like the Cystic Fibrosis gene. Our change management team of seven consultants were tasked to make significant changes over 12 months including:
- Migrating all clinical labs from eleven floors of the hospital facilities to one floor of the hospital, and
- Achieving a 30% reduction in overall operating budget (in resources, this meant discontinuing 75 FTEs) while maintaining the current volume of diagnostic services and preserving quality of service.
The result of this laboratory reengineering initiative was to create new capacity to strategically expand and hire new laboratory staff with prior competencies in Molecular Diagnostics for Genetics Programs, Cytogenetics, and Molecular Microbiology/Virology. Two years following the lab restructuring, Sick Kids migrated the Department of Energy Human Genome database from John Hopkins, and creation of a dynamic networking for international human genome research exchange.
We then addressed what key changes we introduced in our work to change the health system to adopt personalized medicine.
During my time in the Ministry of Health in Alberta Government, I was executive sponsor and champion of the consumer health strategy to educate public consumers. Alberta embraced the consumer health strategy goal to educate, empower and engage the public to take greater personal accountability in making wise decisions in pursuit of wellness and preventative health.
Many of Orion Health’s Canadian clients are all facing budget cost and capacity issues that seem at times insurmountable in the introduction of new clinical guidelines including those aimed at personalized medicine. Each of the Canadian jurisdictions are enthusiastically holding conversations and engaging with members of their public on the shift in focus towards community, family and the patient, and the healthcare system of the future.
For personalized medicine to be successful in our healthcare system, the public must be directly engaged as peers with the health provider community. Both the public and the provider communities are opportunity targets for education to realize benefits under the triple-aims of cost, quality and access.