How precision medicine can fix a broken healthcare system
BOSTON – Hospitals, networks and the federal government can use precision medicine to drive expenses out of the system, better understand disease and prevent people from getting sick in the first place.
“We have a broken healthcare systems and we’re hoping precision health can help reduce costs,” said Megan Mahoney, MD, chief of general primary care in the Division of Primary Care and Population Health at Stanford University, said Monday at the Precision Medicine Summit.
Penn Medicine Associate Vice President Brian Wells agreed. “We think we can reduce costs,” Wells said. “At Penn we can shorten the time to a good outcome for the patients.”
Mahoney pointed, for example, to the ability to identify predictors of disease and move that upstream to advance disease prevention as just one example.
That is an enormous opportunity right now, according to Nephi Walton, a biomedical informaticist and genetics fellow at the Washington University School of Medicine.
“Every single day without exception we are discovering a new genetic disease,” Walton said. “Beyond knowing the diseases, how to manage them is a huge task, a huge amount of information gathering.”
And today’s crop of electronic health records are not ready for that, Walton said.
“In order to do precision medicine you need all the patient’s data in a common repository,” said Beth Israel Deaconess Medical Center CIO John Halamka, MD.
Beth Israel, for instance, has 26 different EHRs across 450 sites of care, so Halamka said that it uses a common data repository for precision medicine work instead of the electronic health record.
Stanford, for its part, undertook a primary care transformation initiative as part of its precision medicine work to move away from a traditional, transactional, catastrophe-based model toward a team-based approach where responsibility is distributed across a physician, an advanced practice provider and four care coordinators, Mahoney said.
“The biggest issue we see in primary care is burnout – 50 percent of employees experience it,” Mahoney said. “Precision health can help shift away from the in-person visit to what is more patient-centered and, I’d argue, more provider-centered. This has really freed up the providers and given the joy of practice back to doctors.”