Wednesday, February 2, 2011

Personalized Medicine & HIT

The question is how do we handle the enormous influx of genetic and medical data plus financial information and then incorporate this data into medical histories. In the future, personalized medicine will offer better targeted treatments, provide for health system cost savings, and help produce a better understanding of care options.

The 21st century healthcare model will use technology to incorporate information into large databases. By using this massive amount of information, medical professionals will have many ideas and choices as to what types of therapies will work for specific people.

A Brookings event held on January 28, 2011 brought forth discussion and ideas on the challenges involved in handling enormous amounts of data and properly utilizing IT to meet future health needs. Darrell West, PhD, Founding Director of the Center for Technology Innovation (CTI) at Brookings and Vice President and Director of Governance Studies, centered the discussion on the just released CTI paper “Enabling Personalized Medicine through HIT”.

Experts in the field such as David Brailer MD, PhD, Chairman, Health Evolution Partners and the first health information czar during the Bush Administration, Mark Boguski Associate Professor, Center for Biomedical Informatics, Harvard Medical School, Emad Rizk MD, President, McKesson Health Solutions, Donald W. Rucker, MD, Vice President and Chief Medical Officer, Siemens Medical Solutions, and Paul Billings MD, Chief Medical Officer, Life Technologies Corporation all offered their valuable ideas and thoughts on the subject.

Dr. Brailer started the discussion by saying that the public does not really recognize or understand the value and benefits of combining health IT and personalized medicine but enormous benefits would result. The health community could use genetic information to shape diagnoses, genetic testing could be used to enlighten patients on what their tests really mean, physicians would be provided with even more knowledge on the patient then they already have, and this in turn, would reduce or prevent unnecessary tests and provide for better treatments.

As Dr. Boguski pointed out, patients want to take an active role in their healthcare and be empowered patients. This means that in order for medicine to move forward, patients have to be co-managers of their healthcare.

Some of the challenges and issues discussed by the panel regarding the incorporation of personalized medicine into clinical practices would mean:

• Reshaping privacy and security needs since privacy is always a concern when combined with genetic information. A 2009 Institute of Medicine report concludes that the HIPAA Privacy Rule does not do the job and calls for a new approach to privacy

• Demonstrating the value of integrating personalized medicine into the payment systems. It is very important to emphasize the value of personalized medicine and this has to be demonstrated to CMS

• Interoperability will be even more important since a tremendous amount of data from many different sources will be incorporated into data bases. This means that as more and more information is available on diseases and treatments, even larger data sets will be needed so that interoperability will be an even more important factor than it is today

• Handling the documentation on tests from laboratories will greatly increase since 70 percent of clinical decisions are based on laboratory information. This means that in the future, pathologists will play a bigger and more important role which will necessitate that the profession be upgraded

• Enabling people to use social media to spread medical and health information to where it needs to go. Although today, many people use social media, it is still underutilized for medical data. Social media could be an invaluable asset to get information circulated worldwide on rare diseases

• Making certain that electronic health records play an important role in connecting genomic, other personalized information, plus drug information to genetics. EHRs with the right coding information could not only link treatment information with outcomes, but could also provide reimbursement based on the end result.

• Developing differentiated billing codes for various molecular or genetic conditions and tests so that researchers will be able to link genomic information to disease diagnoses and treatment

• Reducing the isolation of health research and genetic research information since this valuable information will need to be introduced into medical records and clinical practices

• Producing decision support tools especially for younger providers. HHS hopes to add decision models to the last stage of providing incentives to providers

Go to to view the CTI report “Enabling Personalized Medicine through Health Information Technology.