The “sizzle” of personalized medicine – treatments and medications customized to our unique genetic makeup – is pretty powerful. There are a wave of new consumer genetic testing services – like Family Tree DNA, Ancestry, and MyHeritage. And the price of more sophisticated genetic testing is dropping (see Soon, It Will Cost Less To Sequence A Genome Than To Flush A Toilet — And That Will Change Medicine Forever). The global genetic testing market is expected to reach approximately $60 billion by 2020 (see Global Genetic Testing Market – Industry Analysis And Market Forecast 2014-2020), and some estimates have found that 6.3 million Americans (2%) have participated in some form of genetic testing (see Growth of Molecular Diagnostics and Genetic Testing in the USA, 2008-2011). Additionally, the whole concept got a big boost when the Obama Administration announced their $215 million “precision medicine” initiative earlier this year (see Personalized Medicine Gets A Push), a further development of the 13-year, 3.8 billion Human Genome Project initiative.
But for all this new science, how do we get beyond the seventeen-year science-to-service gap (see Science To Service: Implementing Evidence-Based Mental Health Services) and bring new treatment to consumers? A recent IBM Global Business Services executive report, The Evolving Promise Of Genomic Medicine, offered an interesting perspective. The authors envision a new “genomic health record” as a key to bringing new personalized treatment protocols to consumers. This genome-based electronic health record (EHR) would be a parallel to the current EHR platform – integrating relevant EHR data with a person’s genome data. It is likely that this will first be information from consumers’ specific genetic tests and ultimately will include consumers’ genome sequence.
This can become a reality because of the increasing sophistication of EHR deployment within health care provider organizations, health care interoperability and data exchange, and advances in cognitive computing. But, the path to this personalized medicine future will not be without its bumps. The major impediments to widespread adoption are likely to be:
- Lagging adoption of full EHR functionality (see From EHR Function To Functional EHR and EHR ‘Square One’)
- Impediments to interoperability and health information exchange (see HIE – Essential For Integrated Care Coordination & Population Health Management and Interoperable Electronic Data Exchange Is Non-Existent Among Long-Term Care Provider Organizations)
- Cultural and competency impediments to the use of metrics and health data in clinical and administrative management (see Stop Integrating Data & Start Liberating Data and Creating A Culture Where Metrics-Based Management Can Succeed)
- Lack of clinical decision support tool adoption (see Taking Decision Support From Concept To Practice and No Decision Support Tools? You’re Not Alone)
These are impediments that can and will likely change – the question is, at what pace? For more on the future of EHRs in clinical decision support, don’t miss these sessions at The 2015 OPEN MINDS Strategy & Innovation Institute: Becoming The Urgent Care For Behavioral Health: Leveraging Your EHR To Empower A New Service Delivery Model, with Jason Cagle, HIT Manager and Chris Thompson, Senior Clinical Operations Director, Monarch; and Amazon-ification of the EHR, with Gerry Miller, Chief Technology Officer, Cloudticity, and David Lischner, M.D., Chief Executive Officer, Valant Medical Solutions.