Saturday, September 27, 2014

Healthcare Mass Customization and Personalized Medicine

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?

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. 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:// Crossing-the-Quality-Chasm/Quality%20Chasm%20 2001%20%20report%20brief.pdf.

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