Putting the Precision into Precision Medicine
I was invited to speak at Oxford Global’s inaugural Precision Medicine Congress, April 25 and 26 in London, England. My topic, “Big Data Analytics for Precision Medicine”, stood out from the other presentations, as intended, since I was one of few non-clinicians or genomics scientists invited to speak at the Congress but believe that as I professor and data scientist I was able to hold my own. As an added bonus, I had to pleasure to meet a ‘Sir’ and a ‘Dame’, which are knighthood titles bestowed on extraordinary subjects, in recognition of their great achievement or outstanding service to the United Kingdom. Both worked in the healthcare industry either in the public or private sectors.
One of the many things I like about London is its cosmopolitan nature. People live in and visit the city from all over the world. If you listen closely, you can hear multiple languages spoken on the street, in the hotel lobby and in most restaurants.
At the Precision Medicine Congress, everyone spoke the same language though – how precision medicine was the future of healthcare worldwide. I wholeheartedly agree with them. It has vast potential to provide personalized healthcare to patients based on their genomic background. An example widely used at the Congress is that of a cancer patient being prescribed the best medication and dosage based on their genomic makeup.
In my presentation, I encouraged them to go further. First, cancer is a great starting point, but there are other diseases like cardiovascular diseases that have an even higher annual mortality rate that should also be addressed. Imagine a patient with hypertension going to their physician and instead of prescribing the medication the physician is most familiar with, the patient is prescribed the medication proven to work best with patients with similar genomics.
Second, healthcare can’t make the same mistakes it made with other technological implementations. Electronic health records, population health analytics and other “game-changing” technology innovations have proven to be a challenge for many organizations to implement. This is primarily because many organizations focused on the data and technology and failed to lay the groundwork with a solid foundation of leadership and processes, which is discussed in my book, Competing on Healthcare Analytics: The Foundational Approach to Population Health Analytics. The industry has to not be distracted by the ‘shiny objects’ (data and technology) and pause to build the proper foundation for success with effective leadership and well-developed processes which has been supported by our research in these areas.
Third, the success of precision medicine will depend on information that is not in any EHR or other patient data, such as lifestyle and environment data. For example, the chances of precision medicine’s success will be diminished if the patient can’t get to their follow up appointments or therapy due to a lack of transportation. Other factors include not adhering to a proper diet because they live in a food desert and don’t have regular access to fresh foods. They could also lack a caregiver who makes sure they take their medications and helps them make and keep their follow up appointments. These are things that have been proven to have a significant impact on a person’s wellness.
Precision medicine can be the future, but we must learn from the past to make it successful. I’m reminded of the announcements and notices on the walls of the London underground subway system to “Mind the Gap”. This reminds passengers to watch their steps when boarding or exiting the trains when stepping over the sometimes significant gap between the train door and station platform. I personally noticed gaps anywhere from 2 to 6 inches (5 to 15 centimeters). The platform gap could be above the train door, below the train door or even a space between the platform and the train.
We must also “Mind the Gap” in healthcare. There are gaps in the data, gaps in the processes and gaps in leadership that must be identified and addressed to achieve success in the industry’s transformation.