Yuan Gao
Blog Submission #5
Healthcare Mass Customization and Personalized
Medicine
From this week’s
reading, customization is where the world is going. It’s happening in almost
every industry to create customization value and reduce production cost. It may
well herald a revolution in health care. One of the biggest trends in
customizing healthcare delivery is really about delivering precision medicine.
So let’s begin with a
healthcare system comic.
This illustrate the different models of the consumer-professional
relationship: a) paternalistic, b) educational, c) Internet-age, and d)
consumer-as-partner, and of course our care delivery are moving from a to d.
Technology and
Internet are really changing the world of healthcare from the prospective of patient,
physician, hospitals, and suppliers. Patient are feeling how strong the
influence of information affects their knowledge of diseases and understanding
of their conditions; Physicians looks at the patient’s medical history and
genome information as well as environmental factors and the patient’s
preferences. All of this information is used to identify precisely the nature
of the illness, give an accurate prognosis, and develop a custom-tailored
treatment plan; Supplier are facing production challenges on personalized
pharmaceuticals and devices.
There are two major
forces driving the development of customization:
1.
Patients want better,
more personalized care. They want to be involved in decisions about their health care.
And many want to be actively involved in managing their condition.
2.
Control rising health
care costs associated with long-term management of chronic diseases.
New technologies have
made is possible to bring personalized medicine to fruition. First things
first, like Amazon's "people like you also bought" feature introduced
algorithms to look at our online buying profile and match us to others so we
could easily find new products we might enjoy. By understanding a person’s
biology and how he will react to a particular therapy, researchers will be able
to develop more targeted and effective treatment options and physicians will
more accurately prescribe those treatments. Next is to include genome analyzing
and "datafication" of tissue within patients’ profile. Telemedicine
and Biosensors can used customize design to actively control and alert the
condition of diseases. Finally, engineering Cells and printing Organs --- 3D
printing will be used in transplant and DNA sequencing!
From my point of view
with healthcare delivery, the major bottleneck of implementing personalized
medicine is lack of standard information technology system across facilities.
There were only less than 30% of hospital and facilities has a complete IT
system that record all appointments, diagnoses, tests, and prescriptions
electronically. One reason why hospitals are reluctant to make the effort to
introduce electronic record system is it cost money but did not get any
additional profit in return. There needs to be policy and operational changes
that facilitate connectivity, integration, reimbursement reform, and secondary
analysis of information. Our healthcare system requires a seamless and rapid
flow of digital information, including genomic, clinical outcome, and claims
data, in order to become more efficient, effective, and truly personalized.
Below it a diagram of
different player in the healthcare system:
There are many
members in the healthcare supply chain, so ethical issue and privacy are extremely
important. Members definitely cannot use the IT system to access the same amount
of information of market, patient, genome, and diseases. To what extent can we
use patients’ information as “meaningful use”? How to promote share of
information and standards electronic record system among healthcare providers
and suppliers?
Reference:
1.
Barnes K, Levy
D, Lutz S. Customizing healthcare: How a new approach to diagnosis, care, and
cure could transform employer benefits in a post reform world. PwC Health
Research Institute. Available from: http://www.
pwc.com/us/en/view/issue-13/customizing-healthcare. jhtml.
2.
Mirnezami R,
Nicholson J, Darzi A. Preparing for Precision Medicine. N Engl J Med
2012;366:489-91
3.
Committee on
Quality of Health Care In America, Institute of Medicine, Crossing the Quality
Chasm: A New Health System for the 21st Century. Available from: http://
www.iom.edu/~/media/Files/Report%20Files/2001/
Crossing-the-Quality-Chasm/Quality%20Chasm%20 2001%20%20report%20brief.pdf.
5.
MIT Technology
Reviewhttp://www2.technologyreview.com/briefings/personalmed/
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