- Written by Healthy
- Category: Precision Medicine
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Let’s say a patient at a hospital needs a blood transfusion. The patient isn’t just given any random blood instead the patient’s blood type is tested to get a match and then that blood being transfused is also tested to make sure it's compatible with the blood of the patient receiving it. This is the simplest of terms is precision medicine. Even though Precision Medicine is a relatively new terminology used in the healthcare industry, the practice has been around for a long long time.
To give a more encompassing and scientific definition and explanation of Precision Medicine, it’s helpful to explore some of the definitions out there:
"Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person." - Precision Medicine Initiative
“Precision medicine is a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge and therapies to select which treatments will work best for which patients.” - President Obama’s Precision Medicine Initiative fact sheet
Put simply, precision medicine understands each patient’s individual illness and delivers the right treatment at the right time. Precision medicine will allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work and in which groups of people. It is in contrast to a one-size-fits-all approach, in which disease treatment and prevention strategies are developed for the average person, with less consideration for the differences between individuals. Medical treatments are often designed for the so-called “average patient.”
But with precision medicine, research is integrated with clinical practice. This cumulative knowledge empowers clinicians to create individualized care for each patient. Clinical improvements to reduce system variation in care delivery can lead to high-quality health systems with lower cost for patients. In contrast, precision medicine seeks to understand pertinent patient variation from an individual’s unique environments and biochemistries. Reducing variation in healthcare is a good thing, but a provision for patient variation in treatments is also necessary.
Precision Decision Registries
So we’ve established that not all patients are the same. But this presents a challenge as there are various opposing views of what this variation entails in healthcare and how it should be measured. A viable solution to this is having Precision Registries.
Precision Medicine Starts with Precise Registries and the key to leveraging this patient variation is precise registries. For example, instead of ICD-code-based inclusion only, a more comprehensive registry would include keywords from problem lists, patients with medications specific to that condition, and other types of supplemental criteria. The difference in patient counts can often be pretty drastic, where relying on the ICD-9 diagnosis code for asthma alone compared to incorporating related terms and medications, yields a far more complete picture of patients and disease.
Remarkable advances in DNA sequencing technology are leading to the discovery of more diseases and enabling the development of treatments tailored to specific characteristics of individuals receiving the care. This molecular transformation of medicine is currently most visible in areas such as cancer, where patients with breast, lung, and colorectal cancers now undergo genetic testing as part of routine patient care. This permits the treating physicians to select a therapy ahead of time that will improve a patient’s chances of survival and reduce exposure to adverse effects. In essence, understanding the genetic variation removes the guesswork of choosing an effective therapy.
We live in a remarkable era of information when all that is known about a person—from family history and genetics to location history and environment—can be balanced against all that is known in the medical domain. This big-picture view of medical decision-making is allowing care providers to focus on prevention and intervention techniques on appropriate individuals and situations and precision medicine helps doctors and healthcare organizations fulfill that.