Medicine is the science of relativity where every individual is unique and every scenario and case is different. Every factor from molecules to genes, psychology to physics, environmental to social contributes to the diversity of medical delivery. Medicine is complex, but that doesn’t mean healthcare also has to be complex.
Every medical case can be regarded as a textbook, but delivery can be seamless between the patient and physician or provider. The right technology and strategy become vital especially with the advent of value-based physician reimbursement, Medicare Access, and CHIP Reauthorization Act of 2015 (MACRA). The measures question the effectiveness of the population health model in ensuring the necessary prerequisites which define the quality and ultimately the value of service provided to the patient. We can achieve effective delivery by means of providing healthcare that follows the free market system without pluralistic and populist bias. Thus, we can entail the production of services and products by pharmaceutical and technological companies, manufacturing and sale of medical equipment by private companies, and the training, marketing, and practice of medical practitioner skills and labor.
Personalization of Medicine and Genomics
We can reach our target by using and improvising the tools as healthcare is not a destination but a journey where the doctor walks with the patient. The physician customizes the experience using required resources which gives birth to the personalization of healthcare.
Over years, the definition of personalized medicine has gone through many transformations with the latest focusing more on technologies that deliver precision treatment to patients like genomics, smart polymers, immunotherapy, and biomarker immunoassays, and so on. In my personal opinion, the personification of the practice of medicine matures into a separate branch that deals exclusively with the individual and the care provided becomes personalized healthcare. Personalized medicine, personalized health information, personalized reimbursement coverage, personalized clinical interaction- all are prerequisites for authentic personalized care.
For the sake of the discussion, I will focus on “personalized medicine” and genomics in this piece, as it is the primary scope of this article.
Genomics is a multidisciplinary approach comprised of the science of structure, function, evolution, mapping, and editing of genetic building blocks called Genome. It can be considered the golden standard of future medicine as it represents the epitome of personalization of delivery of treatment. I would like to call it the artificial intelligence (AI) or Precision medicine of biotechnology!
Extracting data from the different utility branches of genomics like medicine, anthropology, social sciences and channeling it through optimally designed, validated and quality-proofed artificial intelligence algorithms will unleash personalized medicine and personalized healthcare.
For example, being able to deliver precise treatment for a very precise duration through an accurate method and does not only maximizes the outcome but also minimizes the side effects. Also, you can’t expect to achieve a unique cancer treatment outcome through conventional means like chemotherapy, radiation, and surgery as every individual comes with a different genetic structure.
In the same way, you can’t reduce the tolerance to certain medications which otherwise would have been prescribed at the same rate in spite of knowing that 10 to 20 % among the patients will have no response or even face untoward side effects.
Genomics is a subcategory of technologies that open many doors to personalized care; however, its precision is also determined by complementary technologies like “smart polymers” for tissue generation and controlled drug delivery or Blockchain and machine learning for incorporating social, environmental, and emotional criteria.
As I have said in my previous articles, the value of healthcare can only be determined by the quality of medical service delivered at a given place and time based on available resources perceived by the individual patient and acknowledged by the provider or physician. Therefore, truly personalized healthcare doesn’t only need a village to heal one patient- it has to be reformed, equipped, transparent, and scientifically appropriate! Only then we can even think of delivering quality healthcare with the personalization of medicine.
Genomics is the future and a personalized delivery model is a way to go. But we have to keep in mind that genomics in the context of the population health model and current challenges with reimbursement will not travel down a smooth road. We will encounter hybrid models of personalized approaches which are nothing new, as we have gone through similar experiences in the past. However, One Hundred percent personalization and reintroduction of adapting Hippocratic medicine into 21st-century medical practice by reversing 18th Century population healthcare model are going to be inevitable. Political partisanship and hybrid market structure will only give rise to pushbacks on the cost and delivery standards.
Political partisanship and hybrid market structure will only give rise to pushbacks on the cost and delivery standards.
What is the Solution?
We have to ensure a competitive environment, a high level of government oversight and introduce more options without restricting the driving factors. I don’t want to go into the details of cost as it is out of the scope of this article. But history has revealed time and time again that free a transparent market and technology works well to deliver high-quality, affordable services and products at every industry level only if coupled with “high-level” government intervention.
One downside is that precision medicine and personalization of medicine are only possible through correct implementation and control. You need extreme discipline, quality assurance, and organization for it to function optimally.
As stakeholders of healthcare, we have to embrace the fact and take charge of those designs, validations, and quality assurance. We need a platform to tie all the components of precision medicine together. We need a platform that will combine the multidisciplinary professional efforts and multi-modular technology platforms and channel it towards individual patients, physicians, and stakeholders. The result will not only lead to customization of medical care to individual patients but also create a niche environment. Based on that we can create a healthcare system that goes beyond geographic and socioeconomic boundaries, evolving realistically into more sustainable healthcare for the masses.