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Precision Medicine

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Most medical treatments are designed for the ‘average patient’ following a one-size-fits-all approach, which may be successful for some patients but not others. PM is an innovative approach to tailoring disease prevention and treatment that considers differences in people's genes, environments, and lifestyles. The goal of Precision Medicine (PM) is to target the right treatment to the right patient at the right time.
​​​Although the term "PM" is relatively new, the concept has become mainstream over the past few years. For example, for certain conditions like acute lymphoblastic leukemia, the most common childhood cancer, we have seen the emergence of targeted therapies like CAR T-cell therapy (CAR stands for "chimeric antigen receptor"). The treatment, designed to turn one's immune system into a powerful weapon against cancer, is one of the earliest examples of targeted precision therapies.  

While the role of PM in day-to-day healthcare is still in its nascent stage, examples of precision medicine can be found in several areas of medicine. And researchers hope to leverage Genomics and Clinical and Patient-Generated Health Data to expand this approach to multiple new areas of healthcare in the coming years.

The rapid advancements in PM are already catalyzing discoveries with multiple FDA-approved treatments in place, tailored to individual-specific characteristics like their genetic makeup or the genetic profile of their tumor. Patients suffering from diverse cancers routinely undergo molecular testing as part of their patient care. This enables physicians to select treatments that improve their chances of survival and reduce exposure to adverse effects.

Precision Medicine can help doctors understand the underlying mechanisms by which various diseases occur, helping them improve their approach to prevention, diagnosis, and treatment of a wide range of conditions. With the ability to better predict the appropriate course of treatment, doctors will be able to develop better patient-doctor relationships. The crucial element of this concept is leveraging all clinical, genomics, and PGHD environmental information of the patient to understand and treat diseases holistically. This paradigm shift in treatment will enable truly personalized treatment by developing and delivering the proper patient intervention for each patient.

Big data analytics as to the key driver of PM

The foundation of PM rests on the emergence of disruptive technologies that make certain diagnostic tests more affordable, accurate, and more in sync with the overall patient care requirements.

If we take the example of advancements in the genetic sequencing domain, PM can leverage genomic data to provide the right treatment to the right patient at the right time. The Next-Generation Sequencing (NGS) technology in PM can allow for rapid and accurate sequencing of many genes at once. NGS is significantly cheaper, quicker, needs considerably less DNA, is highly reliable, and more accurate than any other sequencing. The technology is becoming commonplace in oncology, but the clinical benefit of incorporating it into PM strategies is still under debate.

Costs have dropped from millions of dollars for complete genome sequencing, leveraging NGS, and it may lower even further, making it accessible to the larger population. We believe it won't be long before the cost of analyzing a person's genetic data reaches the price levels of laboratory-based blood tests. We are fast approaching a future where a doctor may prescribe genetic sequencing as part of a patient's annual physical check-up.

Big data and advanced analytics are finding their way into medicine to gain new insights into the biology of diseases, identify and correlate large amounts of patient information, make sense of all this data and testing, and apply it to patient care models. Big data tools can be used to bring together genomics, clinical, PGHD, and other patient data sets to get holistic and detailed patient insights. This will help doctors manage patient health with improved accuracy.

Wearable health devices play a vital role in this regard. These smart connected devices monitor the health and vital signs of the patient, conveying this information directly to the doctor, who can then keep tabs on the biometric readings. This data can be integrated with the patient's genome data to get a clear picture of the illness and the current state of the patient, allowing the doctor to make effective curative interventions specific to the patient.

Improved integration of electronic health records (EHRs), clinical data, and PGHD data will allow doctors and researchers to access medical data easily and efficiently and deliver precision medicine. 

The Road Ahead for Precision Medicine 

PM does not target the diagnosis but takes each patient's complex genome and history into account. PM intends to find the perfect treatment for patients based on data, like their family history, genetic characteristics, and even their lifestyle. Like Netflix or Amazon's recommendation tools that recommend content to us based on our previous history, healthcare providers can use individuals' data to predict diseases and recommend procedures, drugs, and dosage.

It is expected that the development of the Office of the National Coordinator for Health Information Technology's final interoperability rule will further advance precision medicine in the future. The rules will help promote patient data access using third-party apps and APIs. The new guidelines may make patient genetic data interoperable between healthcare organizations and the patient's entire healthcare network. This move will give the healthcare industry the much-required impetus to consider precision medicine as an integral and rewarding approach to caregiving, now and in the future. Further benefits will result from long-term research in precision medicine. These benefits may then be realized in the coming years, thanks to the numerous technical programs accelerating the adoption of precision medicine.

The Healthcare industry should look towards new partnerships and consortiums to promote PM, improve data recording capabilities, standardize and integrate data access, privacy, training, and promote PM and compliance to drive PM adoption for advanced patient treatment and experience. 

  • New partnerships of scientists in a wide range of specialties, as well as people from the patient advocacy community, universities, pharmaceutical companies, and others

  • Improve data recording capabilities. For PM purposes, more additional patient information is needed, like a person's diet, lifestyle, family health history, race, allergies, and maybe even data collected from wearable technologies (PGHD). 

  • Standardize patient data: Most EHR systems support the Common Clinical Data Set (CCDS) – a list of patient reporting standards required for getting a certification in health technology. It features industry-known standards such as HL7, SNOMED, LOINC, National Drug Code, RxNorm, USCDI, and more. The final interoperability rules broadened them with two additional classes: clinical notes and extra information about the data creation. It's time to start using these standards as they are to become industry-wide and will be a basis for PM data.

  • Integrate data access and sharing via APIs

  • New approaches for protecting research participants, particularly patients' privacy and the confidentiality of their data

  • Improvement of FDA oversight of tests, drugs, and other technologies to support innovation while ensuring that these products are safe and effective. Opportunity for a million people to contribute to the advancement of scientific research. 

Harman presented 'Connected Health: Scaling Programs with Advanced Analytics' at the HIMSS Global Health Conference in March 2022, bringing together professionals across the healthcare ecosystem to innovate and collaborate on new ideas to improve health and wellness outcomes for all. 

Stay tuned for the next blog in this series for the latest updates from the leading-edge healthcare technology discussed at the HIMSS Global Health Conference.