Precision medicine isn’t the future of healthcare; it’s here now.
In the past few years:
- Science has rapidly advanced, enabling providers to use genomic information to arrive at accurate diagnoses sooner, and to determine the most effective care plans for individual patients faster.
- Pharmaceutical companies have developed new drugs and targeted molecular therapies based on these breakthroughs.
- Quality and safety experts have begun to advocate for using patient genomic profiles to individualize care.
- Consumer awareness of precision medicine has grown to where providers report that patients ask about it frequently.
Despite this progress, one significant gap remains: Providers are not yet integrating genomic results at the point of care in a meaningful way. This would allow them to factor it into clinical decision-making, where it can have real and substantive impact on care and outcomes.
Bridging this gap will require an informatics and data management strategy to bring current genomic data and analysis into the workflow, while future proofing healthcare organizations’ need to adapt to new scientific discoveries and clinical applications.
With this approach, providers can leverage the advantages of precision medicine as they seek to improve quality of care for their patients, while reducing stress and burnout among their ranks.
Precision Medicine Improves Quality and Outcomes
Genomic data delivers precise insights to clinicians, speeding accurate diagnosis and influencing the preventive care, treatment and medications they choose for each patient.
Consider a patient diagnosed with high cholesterol, a condition commonly included in quality programs that incentivize providers to offer better care management. The patient, concerned about potential side effects, may be reluctant to take statins. Her physician could then order a genomic test, which would allow him to better pinpoint the type of cholesterol the patient has (for example, is it familial hypercholesteremia, which might require a different class of medication altogether?) and prescribe a medication with the fewest side effects. The physician could then share the genomic test results with the patient to explain the choice of medication, which could make the patient more comfortable with taking it and, therefore, more likely to comply with her care plan and see improvement.
Costs Drop with Precision Medicine Initiatives
The faster diagnosis and effective treatments afforded by precision medicine also help drive down costs.
A child born with a seizure disorder, for instance, could be immediately admitted to the newborn intensive care unit at a cost of approximately $3,000 per day. A genomics test could help the neonatologist determine the cause of the disorder and what therapies will relieve the seizures.
In other words, she can prescribe what would have been the sixth or seventh line of therapy first. This information could, in turn, significantly shorten the child’s stay as well as prevent repeat office visits, possible readmission and trial-and-error medication orders, not to mention the medical costs associated with failure-to-thrive status.
The Patient Experience Gets a Boost from Genomics
Patients want to feel better, with the fewest office visits, treatments and hospitalizations possible. Moreover, patients want the peace of mind that comes with knowing their conditions are under control. Precision medicine can make way for all of these. A patient with a family history of both breast and colon cancer, for example, can take advantage of genomic testing to understand her risk. That same data can help her physician decide what preventive activities to pursue, if necessary.
Similarly, via genomic testing, a physician could order a patient with, say, a wrist fracture a pharmacogenomic test to identify the painkiller that would be the most effective.
How Precision Medicine Mitigates Physician Burnout
While many factors contribute to physician burnout, a significant contributor is practicing trial-and-error medicine: Narrowing in on a precise diagnosis, treating nonspecific symptoms or “playing” with various medications until one finally works, for example.
Precision medicine offers clinicians the ability to stop this cycle and approach medical challenges in new and effective ways. As a physician, it is wonderful to hear that “nothing has ever worked” for treating a patient’s depression until a pharmacogenomics test revealed an effective medication. It is rewarding to be able to use genomics to arrive at an accurate diagnosis for a patient frustrated by unusual symptoms and, from there, to initiate treatment that improves health and quality of life.
If genomic information is not readily available within the clinical workflow, however, progress toward achieving an optimal care approach is stymied. Providers need genomic information most while they are with a patient, making decisions about what to do next. For this reason, it is critical that healthcare organizations bridge the gap between genomics testing and clinical utility.