“Personalized medicine” conjures different images, depending on your perspective and understanding of the term. For some, personalized medicine is a very precise application of a clinical intervention (often a pharmaceutical therapy) based on the genetic sequence that has been shown to be responsive to that particular therapy for a specific biological dysfunction. Ruling out responsiveness to expensive interventions is equally important, based on genetic factors. Beyond genomics, personalized medicine can include lifestyle considerations and access to healthcare resources, resulting in a clinical care treatment plan that the patient is highly likely to comply with and which still effectively address an issue.
As patient outcomes become more important in clinical care reimbursement and in research, the effectiveness of personalized medicine will take a more critical role in the strategic, business, and operating plans of our healthcare institutions. Personalized medicine seems counter to population health, another focus area driven by changes in reimbursement such that the health issues of the population warrant better understanding if an institution is going to assume responsibility for improving the health of that population. Personalized medicine and population health can coincide, and need to, in the operations of our healthcare institutions.
Putting Personalized Medicine Into Practice
Genetic Research
Personalized medicine is founded on a robust genetic research enterprise. Not every healthcare institution will have a sizable genetic research program; however, partnerships with major genetic research centers can provide access to research and analysis. Partnerships with private industry can help achieve the sequencing capabilities that may be too cost-prohibitive to build. Partnerships with major research centers and private companies can fulfill the genetic investigative work that personalized medicine requires.
Business Intelligence and Analytics
Clinical and research data need to come together in a way that maximizes researching both the genetic sequences and the effectiveness of clinical interventions. Institutions will require business intelligence tools as well as analytic capabilities. An IT infrastructure and data warehouse must incorporate clinical and research data. Analytic capabilities and services that enable translational medicine must be incorporated into clinical and research operations, along with appropriate analytic support.
Clinical Care Protocols
Clinical care protocols need to be standardized enough to test for variations in effectiveness of treatments for different kinds of patients. Standards can be designed and implemented into EHRs to help prompt care protocols from a support and tool perspective. However, practicing clinical care protocols consistently enough to test for variations and incorporate specific patient needs is an important factor. Clinical operations should be able to create information that can be analyzed and improved on to meet specific patient needs – essentially developing the “evidence” to support where changes are needed.
Patient-Centered Care
Culture, lifestyle, and access to resources all contribute to whether a patient will comply with a clinical care treatment plan. Incorporating these aspects into a patient’s care plan is just as important as all of the research and analytics that go into effective translational medicine. In this case, personalized medicine involves a good understanding of a patient’s circumstances and what he/she is able to do. Care plans should address access to care and perhaps facilitate assistance with obtaining resources that are required, beyond what the patient might be able to access on his/her own. Maintaining communication and monitoring for effectiveness of care are elements of health reform, and healthcare institutions should be preparing for them as part of their business operations and infrastructure planning work.
Personalized medicine is measured ultimately by the effectiveness of care delivered for each patient. Through partnerships and collaborations, all critical aspects can become part of any healthcare institution’s operations. However, there is specific planning work that must be done in order to make personalized medicine a reality. This work spans research, information infrastructure, clinical operations, and the specific circumstances of patients. Personalized medicine will become more important, directly correlating with clinical care reimbursement based on improving patient outcomes.