Issue link: https://beckershealthcare.uberflip.com/i/1034012
59 Executive Briefing T. Greg McKelvey Jr., MD, head of clinical insights at the Seattle- based software company KenSci. "The hospital should really be a place of last resort. … Part of the reason the healthcare system is so broken is that we are obsessed with heroic last-minute care. We ignore year-over-year, boring, unsexy things that actually preclude the need for heroics." In addition to informing preventive care for patients with chronic conditions, analytics platforms enable providers to augment patient data with information available in the public domain, such as community health data, social demographics and trends in communicable disease, among many other types of information that carry implications for individual health. Analytics platforms that incorporate patient's genomic data can help facilitate early treatment interventions. In 2012, the National Human Genome Research Institute, part of the National Institutes of Health, defined genomic medicine as "an emerging medical discipline that involves using genomic information about an individual as part of their clinical care (e.g., for diagnostic or therapeutic decision-making) and the health outcomes and policy implications of that clinical use." Genomics have already shown promise in several areas of medicine, including oncology, pharmacology and the treatment of infectious disease. As more healthcare organizations incorporate genomics into patient profiles, the field is poised to have a significant influence on the way medicine intersects with population health management. Providers with easy access to comprehensive, actionable patient data can take a more cost- effective approach to care that is likely to yield better outcomes. Genomics and the rise of precision medicine Precision medicine is an essential piece of personalized care — some may even see the two terms as synonymous. However, precision medicine specifically refers to the medical treatment of patients, whereas the term personalized care represents an overarching philosophy for patient care. In the U.S., the NIH-backed Precision Medicine Initiative defines precision medicine as "an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person." While precision medicine is a relatively new term, it has existed in aspects of healthcare practice for years. One obvious example would be blood transfusions: A patient in need of a transfusion is not given blood from an arbitrarily selected donor, but rather a donor with the same blood type. This staple medical practice suggests it is possible for healthcare delivery to naturally evolve toward more precise, personalized care. A patient's genomic profile is a powerful resource for providers. Previously, treatments have been assigned to patients based on what worked best on average among the population as a whole. With genomic information, a provider can tailor a treatment to what works best for individuals with similar genomic profiles. However, for such therapies to be successful it's not enough for providers to collect genomic profiles; they also have to be able to understand the genomic information, which requires widespread collaboration and massive computer power. Clinicians and researchers working with genomic data may find the volume of information exceeds their organization's in-house computing resources. In a 2015 paper published in PLOS Biology, researchers wrote "as much as 2 [to] 40 exabytes of storage capacity will be needed by 2025 just for the human genomes." This is where cloud computing comes in. Cloud technology serves as a democratizing force for precision medicine and genomic data sharing, filling in what only a supercomputer could do before. The further commercialization of cloud services will allow healthcare organizations big and small to leverage genomics in the pursuit of better care. At Baltimore-based Johns Hopkins Medicine, scientists and physicians are relying on cloud computing and machine learning technology to analyze data on patients treated for prostate cancer, multiple sclerosis, pancreatic cancer, cardiac arrhythmias and amyotrophic lateral sclerosis (ALS), among other conditions. The research will help improve treatments, diagnoses and prevention efforts. "Precision medicine focuses on using revolutionary tools in measurement, computation and connectivity to reimagine and reinvent medicine," said Antony Rosen, MD, director of rheumatology and vice-dean of research at Johns Hopkins Medicine. "This really is a moment when the tools are going to allow humans to reclassify disease based on subgroups and totally change the face of disease." Improved care coordination and provider collaboration Over the last 10 years, care delivery has experienced dramatic changes. Medicine looks fundamentally different than it did generations ago. Long gone are the days of house calls. Patients now rely on multiple providers for their care, meaning communication and collaboration among clinicians is now an essential component of care delivery. These changes have occurred simultaneously with the increased specialization of medicine. For patients to truly receive the best care possible, multidisciplinary teams must work together to coordinate care across the continuum. To facilitate effective collaboration, healthcare organizations must find a way to make care coordination as seamless as possible for clinicians. Providers who spend more time mulling over the details of care coordination are at increased risk for burnout. According to a study published in the Journal of Internal Medicine in January 2018, researchers determined "spending more than 8 [hours] per week coordinating care was significantly associated with a 0.21-point increase in reported provider stress compared to spending 8 [hours] or less per week." Technology platforms that allow disparate teams to coordinate care across sites can break down information silos and greatly streamline care coordination. These platforms provide clinicians with quick and easy access to comprehensive patient data, such as information on physical activity and nutritional habits, which inform the coordination of personalized care plans. Also, having the right patient monitoring solutions in place can activate patients in their care and greatly ease the burden of care coordination.