Scaling Precision Medicine for Mainstream Adoption

The Power of Precision Health Insight Networks

By Brad Bostic

It’s safe to say the U.S. healthcare system’s inherent flaws and dysfunctions have been on full display over the past year. While healthcare stakeholders recognize the need for high-value care, the pandemic has underscored the urgency of investing in models that optimize coordinated, personalized approaches.

Healthcare’s outdated one-size-fits-all, trial-and-error model was performing unacceptably even before the pandemic, wasting up to $935 billion and racking up the highest rate of preventable deaths when compared to peer nations. Notably, research reveals that more than 128,000 people in the U.S. die each year from taking medications as prescribed—four times the number of people killed by prescription painkillers and heroin combined, as reported by the Centers for Disease Control and Prevention.

The opportunity for changing these dynamics through precision medicine is not lost on today’s healthcare leaders. Yet these models have been applied to just a few patient cohorts—like oncology and cardiology—due to the inability of health systems and payers to access real-time signals that can help activate personalized care decisions.

Why is this access so difficult? The information needed is buried in clinical journals and massive amounts of clinical data—which was projected to increase by as much as 2,314 exabytes in 2020—all of which is locked away in disconnected databases and spread across patient data silos. The good news is that a new category of solutions—precision health insight networks (PHIN)—is emerging to help overcome these barriers and advance mainstream use of precision medicine. With the right infrastructure in place, health systems and health plans can scale delivery of precision care to achieve markedly better outcomes while significantly reducing healthcare costs.

Room for improvement

Lessons learned from the COVID-19 pandemic will inform next-generation strategies for coordinated care models for years to come. Faced with an unprecedented crisis in modern times, the industry failed to reliably compile even the most basic information to inform an effective response.

Rudimentary infection rate reports were published days or weeks after the fact—with questionable accuracy—precluding action ahead of surging localized infection rates. In addition, lack of interoperability and data standardization created a patient identification crisis: An estimated 40% of demographic data was missing from commercial laboratory test feeds for COVID-19, resulting in backlogs and unacceptable reporting delays. In tandem with these shortfalls, social disparities were exacerbated.

Instead of fingerpointing, it’s important that the industry resolutely take steps to address multifaceted problems. Exhausted and overworked healthcare professionals need the tools—in the form of advanced technology that already exists—to access the treasure trove of data and achieve cost and patient care goals. Electronic health records (EHR) were an important step in the evolution of health IT, but they are ill equipped to support precision medicine on their own. Look no further than the epidemic of patients not receiving the right test, prescription, or intervention at the right time, and the shortfalls of these infrastructures are clear.

PHINs: Understanding the opportunity

Of all the lessons learned during the pandemic, healthcare stakeholders can agree on one thing: Broad adoption of precision medicine must become a priority. When care is personalized to the individual, the outcome is a virtuous cycle that keeps people healthier while making healthcare significantly less costly.

Providers and health plans alike striving to execute on this level must have answers to critical questions like:

• When should more extensive testing be ordered?
• How can medication plans be effectively monitored?
• What mechanism will allow for insight, stewardship, and adherence?

In truth, precision health data delivered at the right time in a meaningful format can often be the difference between life and death for a patient. It also lowers costs, which results in an improved patient experience and, ultimately, better overall outcomes. The applications are seemingly endless: Imagine the power of comparing a nephrologist’s diagnostic testing habits against peers nationwide. Consider the benefit of aligning a patient with certain genetic abnormalities to a “digital twin” made up of a composite of data spanning dozens of similar patients across the country to understand what treatments will be most effective and what diagnostic testing is required.

PHINs are delivering this opportunity to the industry by delivering mass personalization in healthcare. These solutions securely and intelligently integrate, normalize, enrich, and transform health data into the signals that identify risk and drive personalized care decisions. Drawing from a repository of data aggregated in real time, including patient health information and clinical guidelines, these networks automatically generate the signals needed to ensure fast and accurate diagnosis and care planning.

The power of PHINs was seen during the pandemic. While much of the industry struggled with lackluster data, PHINs were established to securely ingest, organize, and normalize millions of lab test results—including demographic data—from more than 20,000 ordering lab locations using multiple testing vendors with differing test compendiums for new and evolving COVID-19 viral and antibody lab tests. Agile and flexible, these PHINs could easily have expanded to accommodate all testing in the U.S. if the full slate of testing providers deposited results in one unified data network.

The value of PHINs is found in the efficiencies they bring to the practice of medicine. In other words, PHINs focus providers on the signals that are important to patient care, promote evidence-based standards, and provide the feedback loop to track successful implementations of high-value care initiatives. And the industry has only witnessed the tip of the iceberg in terms of the transformative role PHINs can play through delivery of precision care.

Brad Bostic is CEO and founder of hc1.