There is significant attention and funds invested around the world in pursuit of personalized and precision medicine. What is precision medicine, what role will it play in routine clinical practice and how close are we as Canadians to realizing significant benefits and value?
What is precision medicine?
Precision medicine is an emerging field in which current treatment clinical guidelines are tailored to an individual’s genomic and other biological characteristics, as well as environment and lifestyle. It will help refine our understanding of disease prediction and risk, and the onset and progression in patients, informing better evidence-based diagnoses. The broader agenda for research is focused on the disease and then applying translational research to prepare for inclusion for clinical practice guidelines.
Today, clinicians don’t have access to all the data needed about a patient to create a care plan that directly addresses their unique personal circumstances and genetic makeup. Gathering this information and making it accessible to a clinician in real-time is a positive step on the journey to precision medicine, but more accurately, labeled as ‘personalized’ medicine.
How will precision medicine support healthcare providers?
When doctors are able to more quickly determine a course of treatment for a disease, they can help develop more personalized care plans. For example, when clinicians prescribe Coumadin, a powerful blood thinner, some patients react to a low or high dose. Currently it is impossible to know their response to dosage. With access to the patient’s genomic data, it will be possible to know their reaction ahead of time, sparing the patient from a prolonged stay in hospital and the stress of trials.
What needs to happen before precision medicine is a reality in Canada?
In order for precise and personalized medicine to become a reality in Canada, we need to:
- Enable 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 MS and identify research efforts to better understand and manage this chronic disease
- Work with researchers and universities to support their efforts in precision medicine; and,
- Identify how we will manage and process all of the substantial amount of data needed for applied personalized medicine.
How does Canada's progress in precision medicine compare to other countries?
Governments around the world, including Canada are investing heavily in 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 transition 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 Orion Health’s EHR in provinces like Alberta, New Brunswick, and Quebec. Now is the time to influence these investments to improve patient outcomes by leveraging personalized medicine in regular clinical practice setting.