Embracing a Smarter Future in Healthcare
By Brian Patty, MD
Brian Patty, MD is senior clinical advisor of HC1 of Indianapolis, IN.
A principal issue stalls the mainstream use of precision health in the US. Despite substantial national investment in strategies aimed at advancing high-value care, the industry struggles to establish a standardized and effective manner of bringing data together and sharing it.
Consequently, the healthcare industry continues to suffer from the lack of interoperability of data systems that should be achieving significant ROI through personalized care delivery. Instead, low-value care continues to rack up substantial waste associated with unnecessary services, low-value, high-cost drugs, and missed prevention and therapy opportunities.
Precision health provides immediate relief to this unsustainable course. Yet with the exception of certain specialties, these effective and efficient models of care have remained elusive for the vast majority of providers due to lack of timely data within the provider workflow. There is good news emerging on this front, though, amid rapid technological breakthroughs that enhance access to the unique genetic makeup of individual patients.
Precision Health Insight Networks (PHINs) are advancing personalized medicine by drawing on the latest technological advancements to transform previously disconnected health data into actionable information that drives specific optimal care decisions targeted to each individual patient. This type of infrastructure demonstrated its promise on a focused national scale during the pandemic, when COVID-19 data was leveraged to organize and normalize hundreds of millions of lab test results—including demographic data—from more than 20,000 order locations.
Enabling massive volumes of critical data to flow into a single dashboard, PHINs equipped public health agencies and healthcare organizations with detailed hyper-local lab testing insights that were simply unavailable or excessively delayed through government reporting. Healthcare authorities accessing this dashboard were able to drill down to real-time state, county, and sub-county views of COVID-19 testing rates, de-identified test results, key demographics, a side-by-side view of viral and antibody testing, as well as local-risk and age-group trending.
Similar to the concept of personalized medicine, PHINs enabled optimal decision making and promoted proactive, effective response on the local level by equipping public health officials with granular information such as where local hospital and ER resources would likely be overwhelmed in the coming three to six-week period. Precision Healthcare is now positioned to launch off this initial success by using PHINs to unearth the insights from siloed data (including individual gene mapping) that already exist across multiple EHR, laboratory, and pharmacy systems.
Consider the potential impact of precision prescribing alone:
- Trial-and-error and one-size-fits all prescribing results in more than 2 million adverse drug reactions (ADRs) a year.
- 15.4% of hospital admissions are attributed to drug-related adverse reactions
- 26% of readmissions are drug related (and preventable)
Plavix perfectly illustrates how precision prescribing can improve patient outcomes and contribute to highly effective, high-value care. The antiplatelet medication is a frequently prescribed post coronary intervention for its ability to reduce clotting, strokes, and recurrent cardiovascular events. However, up to one-third of the population has a genetic makeup that changes how it is absorbed or metabolized, so there is wide variation in its efficacy. Depending on someone’s genetics, dosing may need to be doubled or even tripled the normal dose, or Plavix may not work at all. In others, lower doses are required to prevent life-threatening bleeding, which may occur as a side effect specific to an individual’s genome and the subsequent cellular production of enzymes that metabolize the drug.
PHINs bring together data and deliver patient specific insights to frontline physicians at the point of prescribing. These providers simply don’t have the time to research or access the massive volumes of new data that is continually emerging. Providers also may not know that genomic testing has been done on their patient by another provider, or that those results impact the drug(s) they are planning to prescribe.
When knowledge is infused into the patient care process at the right time to inform physicians, medical outcomes are improved and patient satisfaction increases. Clinicians are likewise relieved of the impossible task of individually staying on top of the latest pharmacogenetic or testing protocols. The data organized by PHINs deliver the right care insights at the right time for the right patient.
Of all the lessons learned from the COVID-19 pandemic, one rises to the top: keeping critical patient and public health data locked away in disconnected databases and data siloes is not only ineffective and inefficient, but potentially deadly. Present-day care models are no different. The good news is that US healthcare can change its unstable trajectory by embracing the power of PHINs and mainstreaming precision health practices.