President Barack Obama’s recently announced Precision Medicine Initiative has opened an exciting window onto the role of data in the 21st century health system. By using data to create technologically customized treatments based on a patient’s individual biology, precision medicine promises therapies as unique as the people who need them.
But this is just one way in which marvels like big data, analytics and devices are reshaping the health care landscape. Although technology’s impact on medicine will be great, its potential to improve the overall health of people and communities is even greater.
Medicine is, in a sense, just one answer to a complex question — one among many sets of tools that help people get well.
But better health is the outcome we want to achieve. It’s in the broader area of health that these sorts of data-driven strategies show the greatest promise.
Hopefully, this effort will reach well beyond information about people’s specific genomes. Better health will come with insight into people’s lives, not just their biochemistry.
Consider children with Type 2 diabetes: Precision medicine would tell us which drugs to use based on these children’s specific biology. But by focusing on health, we illuminate the landscape of their lives and see where a drug would fit into a range of potential interventions.
Physicians — and many other key players such as pharmacists, city designers and food policy councils — could access information revealing what’s going on in children’s bodies and their world, from the safety of their neighborhoods to the conditions of their sidewalks to the proximity of grocery stores.
By coupling that data with evidence on the relative efficacy of drugs, exercise and diet, physicians get powerful, person-specific guidance that wraps in nutrition, exercise and other vital considerations. It may be that a “precision medicine” drug is not as effective as precisely prescribed exercise.
The Precision Medicine Initiative also demonstrates the importance of focusing care on patients, their history and individual preferences. But by taking a wider perspective, physicians can not only address people’s concerns about their lives as well as their illness, they also can draw their patients into the decision-making process.
At least 33 percent — and sometimes as much as 69 percent — of medication-related admissions to hospitals are due to nonadherence to prescriptions.
By applying the lessons of Precision Medicine to overall health, physicians can ensure that patients’ adherence to their prescriptions is as central to the healing process as the prescriptions themselves. Through innovations such as mobile phone games tied into a patient’s prescription, or pills with embedded tracking chips, fine-tuned science can achieve its fullest potential in the lives of patients.
This also encourages enterprise and innovation across the full spectrum of health-improving technologies, ensuring “precision” is delivered in practice, and the entire system benefits from it.
And it forces us to think about who will pay for these innovations, creating a system that supports sustainability and value — better outcomes at lower costs — rather than progressively expensive medical tests and therapies for insurance companies to sort through.
Improving health outcomes means addressing all barriers at every stage, including cost, while integrating scientific, entrepreneurial and policy innovation across the board. We must be smarter about what to prescribe, find ways to reward better health for more people, and seize every technological tool that advances these goals.
The results, both for our health and our economy, could be dramatic and liberating.
The president’s initiative is an exciting step, one that holds great promise in revolutionizing the ways in which we provide care. We can — and we should — maximize its potential by redesigning the ways we deliver and support health.
Mini Kahlon is vice dean for partnerships and strategy at the new Dell Medical School at The University of Texas at Austin.
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