If your computer isn’t working right, what do you do? You might turn it off and on again, or run a virus check. If all fails, maybe you’ll try a system restore. Whatever your path, the method is trial-and-error; you’re trying one thing after another until something works.
The medical community often takes the same trial-and-error approach. For any given problem, a doctor will try the most likely treatment first. Maybe this drug will help. If it doesn’t, maybe try another drug; maybe adjust your diet and habits. As a last resort, there’s always surgery.
All this guesswork is necessary because every patient is different. Doctors have to base their decisions on the patients’ symptoms and past research. They might know, for instance, that a large percentage of people on a given drug may be prone to a dangerous disease and decide accordingly. But the effectiveness of such guesses is increasingly being called into question. Studies have shown less than 60% of drug prescriptions are effective.
Increasingly, doctors will be able to put guesswork behind them, thanks to precision medicine, which President Obama mentioned in his 2016 State of the Union speech. Obama articulated the possibility of “personalizing medical treatments for patients.” As time goes on, such personalization could become the norm.
Mining data for custom-made medicine
Many organizations have been leveraging data analytics to assess their performance, increase efficiency, and meet their goals. The healthcare sector has been reaping the benefits of self-service analytics thanks to easier access to medical records and the facilities’ use of the Internet of Things to keep track of patients, staff, treatments, and equipment.
This allows for significant increases in efficiency. For example, STANLEY Healthcare supplies equipment to more than 5,000 hospitals and 12,000 senior-living facilities. Since adopting self-service analytics, the company has dramatically increased efficiency, making sure the right staff member or equipment is exactly where they need to be.
And some organizations are even looking forward with their data—at tomorrow, next year, and even 20 years from now. Predictive analytics is having a powerful impact on the field of medicine.
Predictive analysis brings this kind of precision to your particular genome, which, when mapped, reveals the strengths, weakness, and quirks of your unique DNA code. Just as dating sites strive to match you with the best possible dates and Netflix tries to guess which movies you’d enjoy, doctors are already beginning to enjoy a predictive facility that would have seemed like science fiction until recently.
Putting the person first in a new way
We’re all at risk of a variety of health problems that can be scary to contemplate. But we usually don’t know what our risk is, exactly. What are my odds of getting diabetes, brittle bones, or dementia? What if you knew the real odds? That would make a huge difference in your lifestyle choices and medical care, as you could prepare realistically for the health problems you’re likely to face.
Precision or personalized medicine is all about the person, and what literally makes a person is their genome. The capability to map a person’s genome is like finding the fingerprint of their whole body, answering questions that doctors couldn’t have anticipated. A combination of genomic profiling platforms, along with self-service data analytics and electronic records, holds the promise of making a patient’s DNA just as susceptible to analysis as a spreadsheet. And that analysis allows for an accurate assessment of risks.
Managing risk to boost health
While risk management is most often thought of as a business strategy, it applies well to health. However, it requires cooperation and data-sharing to be effective. Doctors, hospitals, and other healthcare organizations—called Accountable Care Organizations by the Centers for Medicare and Medicaid Services—are collaborating in new ways to improve quality of care for their patients. Part of this new approach is population health management (PHM). PHM can work together with personalized medicine to radically improve health. The idea is to segment patients by risk.
High-risk patients would involve more than one condition, including potentially fatal conditions such as heart disease and cancer. Medium-risk patients would have a tendency to develop chronic but manageable conditions such as arthritis and diabetes. Low-risk patients would focus on preventable conditions, such as obesity. With genomic data and predictive analysis, healthcare can finally be truly personalized.
Precision medicine: The new reality
Though some think precision medicine sounds too good to be true, it’s already helping drive doctors’ decisions. Cancer treatment has particularly benefited from the insights of personalized medicine. Doctors have found breast cancer treatments can be fine-tuned to a patient’s genome.
In some cases, chemotherapy is effective, but for women with certain types of aggressive cancer that show up in their genome, Herceptin has been more effective as a first-line treatment. Herceptin has been effective in preventing one of the greatest worries involving any cancer, the spreading to other parts of the body. This is far from a cure-all for all women with this terrible disease, but it can be a life-saver for women with certain genomic markers.
Similarly, at Memorial Sloan Kettering Cancer Center, doctors are using information on types of tumors to target treatment. A diagnostic test called MSK-IMPACT looks at mutations within a patient’s genome and whether such mutations would facilitate or hinder various treatments. These innovative research approaches are allowing for treatment options based on hard genetic facts.
The Inova Translational Medicine Institute is using genomic data in a different way—by looking at the genomes of babies to detect biomarkers for various conditions such as heart disease, cancer, and Alzheimer’s disease. Biomarkers are molecules found throughout the body in fluids and tissues, and they show traces of conditions or predispositions to conditions.
Through the creation of a genomic map of each baby, doctors can identify these tiny, revealing pieces of biological evidence. This eliminates the guessing games of the past and allows healthcare to be exactly tailored to the person. Soon, this type of preventative, predictive medicine could become the norm.
Creating a healthy, evidence-based future
With personalized medicine, doctors can trade in their guesswork for precise knowledge. When all doctors match the treatment to each patient based on genomic data, doctors will know their patients like never before. And armed with this knowledge, doctors will be able to make informed decisions and treat their patients more effectively than ever before.
