To Make Precision Medicine a Reality, Start Small and Expand

The hopes for precision medicine are high. More personalized care, led by data, offers patients better health outcomes and clinicians more time back in their day. As wearables, artificial intelligence and health apps begin to pour reams of patient data into the health system, the path to more ubiquitous PMI may seem to be on fast-forward, but the truth is that there are still hundreds of hurdles to jump, particularly around pharmaceutical costs and social equity.

So how can providers begin to move toward the idealized future that PMI offers? The answer, according to experts at the Precision Medicine Summit in Washington, D.C., is to start by dipping a toe into precision medicine programs before taking the plunge.

“You don’t boil the ocean; you boil pockets in that ocean, you boil pieces, and you let the system connect it,” said Peter Bergathon, vice president and head of quantitative medicine and clinical technologies at neuroscience company Biogen, speaking on the panel “Wearables, AI and Biology: A New Triad for Precision Medicine,” on May 18. “You don’t force everyone into the same monolithic [model].”

Already, wins in the precision medicine space have improved patient experience and physician workflow on a small scale. At the Mayo Clinic, for example, a partnership with IBM Watson for Clinical Trial Matching that tapped artificial intelligence to match breast cancer patients with clinical trials they could be eligible for prompted an 80 percent jump in enrollment in trials.

“We’re doing little things and taking little steps to start bringing that technology to light in real ways,” said Aviva deBeer, global solutions executive for digital health at IBM Watson Health.

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The Way Forward with PMI: Research, 5G and Failure

Providers can expand these smaller efforts by tapping into areas where research has already begun and algorithms already exist to begin focusing on personalized care.

“It’s time for us to actually bring some of this to ground,” says Bergathon, pointing to diseases where clinicians already possess insights, such as Parkinson’s, where the motor aspects of the disease are well understood. “The fact is, in a lot of ways, there are certain areas like [Parkinson’s disease] that are ready to move forward … We’ll agree to share data, we’ll look at data, we’ll look at methods and we’ll use methods to bring these tools into community practice — to the FDA, to physicians — and it’s time to do that.”

Bergathon believes there are already “half a dozen” areas where expansion can begin, such as EKGs and blood-pressure monitors.

“The way is there, and it’s time for us to do it,” said Bergathon.

Further, advances in underlying infrastructure could also push forward the technology aspects of precision medicine initiatives. 5G is one area that offers to bolster PMI.

“5G, which will be available in the next year, [will enable] the transport of large pieces of data from multiple sources to create a true connected care opportunity for patients,” said Derek Corthoran, senior vice president of client strategy and development at EnvoyHealth. He notes that the ability of 5G to enable IoT will help address the more complex aspects of connected care, including affordability and access. “That’s the one enabler we’re patiently waiting on.”

As providers pursue pilot programs that seek to personalize care and bring patients more closely into the fold, however, they should be aware that even with the right technology, data and mindset, PMI programs are difficult and not all will be a success.

“We’re seeing companies start to see some of those consumer tactics into healthcare in a way that will work, but we’re struggling for ways to do it well. The challenge there is that you fail a lot more before you succeed,” said deBeer. “How many Blockbusters were there before there was Netflix? A lot.”