In many diseases, most of the available therapies in clinics and hospitals are only effective for a fraction of the patient population. Knowing in advance which patient subpopulations will benefit from a given therapy and developing new tailored forms of care are both use cases for precision medicine, which can be described as the customisation of healthcare for patients based on their biological, behavioral and environmental differences.
Progress in developing and deploying the technologies and techniques that enable precision medicine has been slower than expected. One of the reasons for this has been the challenge of integrating data from disparate sources at scale. In order to deliver true precision medicine, healthcare professionals need to build up a comprehensive and actionable profile of patients, which is difficult to do without access to the right data (Engineering in Medicine and Biology Society).
Digital Technology and its Application to Precision Medicine
Developing and deploying the right technology at scale is therefore critical for achieving the full promise of precision medicine. To help with this, pioneers in digital healthcare are designing different devices to promote wellness, predict potential adverse events, and most importantly, find ways to keep people out of the hospital.
There have been many innovations in healthcare in recent years, such as wearables and mobile devices that can collect information on lifestyle, diet, and exercise habits with some particularly innovative companies looking to integrate this data with genetic and even epigenetic data.
Wearables such as Fitbits and Apple Watches for example, are being used in clinical trials to gather data on the efficacy of a treatment, or even become part of the intervention in a study. Apps integrated into these devices can allow users to keep a record of adverse events or changes in their condition. Doctors can use these data to monitor their patients’ response to a prescribed treatment and intervene appropriately if their patient is experiencing any symptoms or signs that they shoudn’t (Medrio).
Several products designed for precision care have been approved by the FDA. By equipping a patient and their household with data-gathering devices, monitoring patients and tailoring treatments is made a lot more efficient and convenient. These new devices use software to enable the delivery of precision medicine by gathering patient data, assimilating the data, analyzing it, facilitating rapid and accurate diagnosis, and monitoring the results and fine tuning the performance (Ken Dropiewski).
With large volumes of of healthcare data being collected for precision medicine including patient records, genetic data, microbiome data, and lifestyle, dietary and exercise data, patient confidentiality becomes an issue. For precision medicine to become more personalized, patients’ need to share their health data and, in the case of genetic data, provide biological samples for testing. Database that hold all this confidential information will be used to uncover the treatments that are optimal for patients who have similar genetic, environmental and behavioural profiles.
The concern, therefore, is what can be done to prevent such data from reaching, for example, insurance companies or employers, and if it does reach them legally, how to manage the use of that data. Despite government bodies confirming that all this data will be stored securely and strict rules will be established for the use of this data, there is still the risk of cyber hacking.
Cyber attacks are happening in different industries and across different cloud systems. The healthcare arena is no exception to this. Privacy and security needs to be taken seriously by healthcare providers and researchers involved in precision medicine. As such, guidelines need to be updated to the changing circumstances to account for new health data privacy threats (Health IT Security).
Currently, nascent forms of such integrated databases are shared with researchers worldwide, with patients signing a ‘data user agreement’ that offers no recourse if the information ends up being misused or compromised. Patients need to be informed about these risks before they commit to submitting information.
Many governing bodies are aware on the data privacy and security concerns around precision medicine, and highlight the importance of strengthening data security. They also require entities to perform their own security risk assessments to mitigate privacy breaches (Health IT Security).
When data collected for precision medicine becomes more secure and standardized, the world may well start to see better, more economical and more efficient healthcare systems. There will also be bigger opportunities for achieving health equity between the different countries, since more research can be conducted to lessen health disparities between developing and developed countries.
More research and more funding needs to be invested into precision medicine to develop tools and analytic methods to integrate patient data while securing information that influences health outcomes. The more research and investment done in this field, the sooner we can all start benefiting from precision medicine (National Institutes of Health).
Where we are now
Customized solutions are paving the way for more efficient and precise treatments. Treating many chronic diseases and delivering value-based care will help the overall health of individuals, thus we need the public and private sector to give more focus on this area of medicine to create better outcomes for all patients.