By Marc Helberg, Pariveda Solutions
Precision medicine might be one of the most promising advances in the medical arena today. The hope is that by taking patients’ genetic makeup, environment, and lifestyle into account, their doctors can tailor highly precise, effective treatments.
Unfortunately, these promises also cost a lot. Precision medicine is still experimental, so it needs to prove its effectiveness consistently before payers agree to cover it. Providers might also hesitate until they know for certain that precision medicine will boost patient outcomes, lower healthcare costs, and provide returns on substantial investments.
Until then, patients who desire personalized care have to pay for it themselves. Precision cancer treatment, for example, is highly celebrated by researchers — but most insurers still won’t cover it. Conventional cancer treatment is already expensive, too. A study published in the American Journal of Medicine estimates that patients pay an average of $92,098 just two years into their diagnoses, with more than 40 percent depleting the entirety of their financial assets at this time.
Therefore, the hesitation isn’t entirely about the costs of pursuing precision medicine. It’s also about demonstrating its value to patient outcomes compared to conventional treatments. To do that, information technology leaders in healthcare will need to introduce effective ways to gather, analyze, and organize data surrounding the results of precision medicine.
The Value Of Precision In Healthcare
A recent Harvard Business Review analysis noted that current uses of precision medicine are already improving life expectancy and quality of life in several areas, including cancer. According to this analysis, eliminating much of the guesswork in medical care also can reduce patient management costs by 35 percent or more.
The University of Colorado’s PrecisionProfile system — which Pariveda previously partnered with — is another testament to precision medicine’s promising applications within oncology. The platform allows doctors to take patients’ genomic profiles into account and compare the information with treatment data from genetically similar individuals. In this way, doctors can prescribe highly effective, personalized treatment plans based on pre-existing data instead of relying on potentially lengthy trial-and-error processes.
Cancer treatment isn’t the only area in which precision medicine could be highly effective, either. At the University of Utah’s Department of Pharmacotherapy, researchers evaluated variations in six genes responsible for metabolizing drugs and examined 55 prescription drugs in total.
The study followed a large group of participants age 65 and older, all of whom were taking at least three prescription medications. A portion of the participants received genetic testing, and doctors received those results. These tests included guidance on the prescriptions that could be changed along with the ones doctors should monitor.
Over the next few months, members of the group that underwent testing visited the emergency room less often and weren’t as likely to be hospitalized. Compared to other groups, those who were tested also saved enough on patient management costs to cover the cost of the tests. Because genetic results are relevant for life, tests such as these can help patients save and stay healthier in the long term.
With the availability of precise and personal patient data, it becomes easier for healthcare providers to fully embrace the four pillars of care that are key to precision medicine’s future: improving diagnostic accuracy, reducing unjustified diagnostic variations, improving personalization of care, and embracing advances in therapies.
The Role Of IT In Enhanced Patient Care
Research is paving the way for healthcare institutions to fully embrace the age of precision medicine. Providers and payers alike have already begun shifting toward value-based care, with many insurers tying it to precision treatments. The Centers for Medicare and Medicaid Services has even entered the arena, with proposed coverage for next-generation sequencing tests.
Developing tests and tailoring treatments can be expensive, so the costs of precision medicine should be able to be justified. However, many more payers argue that they need more definitive proof that the approach will reduce costs and improve patients’ lives consistently. There’s plenty of data to show this. As of now, though, there’s no IT infrastructure dedicated solely to it.
This creates a gap that only IT leaders in healthcare can fill. Providers need timely data based on predictive practices to direct future care more successfully. Therefore, IT leaders must work with them — and other stakeholders — to make that data more widely available. There are three ways they can start:
1. Recognize the need for data. Data — think population health, patient health histories, previous treatment results, similar disease profiles, social determinants, and more — is the backbone of precision medicine.
IT leaders must recognize that providers need that data to be well-structured, organized, and prepared for every individual patient. They’ll need to build databases and find data sources that are not only comprehensive and secure, but also easily accessible to providers at every stage of the patient care continuum.
2. Deliver data faster. Having a comprehensive database is one thing. But for it to truly contribute to precision medicine, providers need access to relevant data as quickly as possible.
The core of precision medicine involves delivering the right treatment for every patient at the perfect time. This should be done without interrupting clinical workflows or a doctor’s ability to make decisions. This will require policy initiatives to ensure that the data can be delivered quickly without compromising its security.
3. Let smaller, more agile leaders shine. Healthcare has relied on data for a while, but IT needs to change to accommodate precision medicine — and change is always difficult.
That’s especially true for the monolithic health-tech providers that currently dominate the space. They — and healthcare organizations themselves — will need to forge partnerships with smaller, ambitious, and entrepreneurial organizations that have the agility to keep up with precision medicine’s shifting demands.
Those who have studied and experimented with precision medicine can attest to its value for both patients and providers. Yet it takes more than that to get the entire industry on board. As more stakeholders jump into the field, healthcare IT leaders can work to develop the solutions providers need to bring patients the quality of care they deserve.
About The Author
Marc Helberg is the managing vice president at the Philadelphia office of Pariveda Solutions, a consulting firm driven to create innovative, growth-oriented, and people-first solutions. Read more about the work Pariveda Solutions does here. He has extensive expertise delivering strategic initiatives and brings more than 25 years of consulting and industry experience to helping Fortune 100 companies transform their operating models and achieve their business goals. Outside of the office, he enjoys scuba diving, photography, cooking, and playing music.