How precision medicine will change the future of healthcare

Precision medicine allows doctors to select treatments based on a genetic understanding of the patient’s disease Image: EVG Photos

Nilesh Jain
Founder, Clinivantage Healthcare
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Technological Transformation

Healthcare is rapidly moving towards precision medicine, which offers a deeper understanding of human physiology using genetic insights and advances in technology. This is pivotal in alleviating unnecessary suffering related to medical care, due to unintended side effects which can result from the current one-size-fits-all approach. It will also reduce the cost of treatment by eliminating ineffective treatment plans at outset based on data insights.

Precision medicine allows doctors to select treatments based on a genetic understanding of the patient’s disease, and to create personalized treatment plans. Patients have genetic changes that cause cancer to grow and spread, and these are very different for every patient across various stages. Currently, treatment may be a combination of surgery, chemotherapy, radiation and immunotherapy, depending on the type of cancer, its size and stage. With genetic changes and characterization, precision medicine can help decide on specific personalized treatment plans, with certain drugs proving more effective for specific genetic profiles.

Creating platforms for health data

Technologies that enable a platform ecosystem; that develop and execute the delivery of genetic-based care; and that manage customizations to ensure seamless integration into any system of care, will pave the wave for future ecosystems. Clinicians have begun to advance this science into evidence-based protocols for medical practice based on identifiable clinical indicators.

Genetic discoveries and technological firepower have outpaced systems for effective provision, overwhelming providers of care as well as payers and regulators. The genetic laboratory industry has the data, processing power, science, evidence-based clinical utility, instruments and operators to improve outcomes dramatically for some of the world’s most debilitating and costly diseases. But it has had no infrastructure for effective delivery, until now.

The latest technologies can create platforms that could efficiently connect existing resources in the genetic ecosystem, and then fill the gap for the rest. The solution engages multi-disciplinary expertise and collaboration, with an intense focus on both operations and technology. The operational component would secure more traditional business-related value drivers such as specialization and centralization. The technology component would house, protect and connect massive data sets; manage communication; automate; educate; and calculate.

Organizing operations by epidemiological classifications not only ensures protocol adherence, but also expedites commercialization of a higher number of clinically evident, controlled precision medicine protocols. Clinical pathways for each disease process are accessible to all, but managed through a controlled set of operators until such point that they can be scaled efficiently and accurately across a broader network. With advanced technology, each participant in the process has the time to contribute. Given the limited set of sub-specialist molecular pathologists, managing the time of these essential medical resources is critical.

The solution: precision medicine

For example, in some markets clinicians may provide care plans through a telehealth platform, then let sophisticated technology effortlessly manage orders and follow up care and appointments with primary care, specialists and genetic counsellors. Countries with less infrastructure may demand targeted point-of-care genetic testing solutions, such as to determine whether cancer patients can safely metabolize tamoxifen, an inexpensive treatment but highly toxic to 31% of the population.

Technology can measure many pre-preprogrammed metrics, and can be tailored to calculation needs within any specific environment. As new platform participants join, each one has the opportunity to make their unique resources and tacit knowledge from within their healthcare system available to other participants, enabling a growing ecosystem of connected genetic-based care.

Technology applications and connected partnerships with solutions-driven businesses complete our care ecosystem, providing tools such as insurance and eligibility verification; coverage determination; pre-authorization and pre-certification management; transparent testing costs; courtesy calls for expenses over a certain threshold; informed patient choice; payment plans; financing; automated notifications; and easy but protected HIPAA-compliant data sharing.

How to connect health data

Healthcare systems today organize laboratory test results by provider, not by patient. This method of organization was effective before the era of big data and genetic discovery, but it is no longer sufficient.

Smart connected technology start-up companies provide the operational and software tools for healthcare systems to begin the transition to personalized medicine. Through this platform, participants can utilize existing laboratories in their healthcare ecosystem, begin organizing data by patient instead of by doctor, and begin translating results into a common language without cost and time delay barriers to entry.

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Low-resource healthcare settings have the advantage of the earliest adoption of precision and personalized medicine, in many cases targeting specific population health needs and nimbly implementing protocols without the encumbrances of gridlocked regulation.

Digital platforms provide a fast, stable and cost-effective way to manage system-wide care, even outside genetic medicine. Technology develops an implementation plan that provides immediate utilization controls, followed by measured, right-paced implementation of new disease-process workflows to manage specific risks, issues and costs inherent to that system.

Platforms allow patient data, risk and compliance scores to stay with the patient medical record, even during transitions of care, ensuring that medical records stay intact and that care and cost is managed. The system not only affords, but encourages, participation from multiple stakeholders in the care continuum.

The future of precision medicine

Precision medicine is an emerging approach that looks at the root cause of an illness, rather than addressing symptoms alone. Digital platforms can take into account individual variability in genes, environment and lifestyle for each person. The need for such platforms and their potential in the Indian healthcare scenario is high, driven by the unique genetic characteristics of 1.4 billion people.

The complexity of disease has been deciphered. We all need to receive treatments designed for our physiology and body type. Just the simple factor of reducing treatment time and side effects will have a significant impact on the socioeconomic situation of any individual, in both developing and developed nations.

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