Personalised healthcare: the information challenge
18 May 2010
There is one game-changer that can turn the promise of personalised healthcare into a reality. It is healthcare IT, says Alan Davies from GE Healthcare.
Around the world, the idea of personalised healthcare – broadly speaking, a combination of preventative, diagnostic and therapeutic procedures to provide more precision to healthcare management and clinical outcomes – is gaining ground.
In principle, the idea has been around for a long time. Since the Egyptian Imhotep first codified healing 4.5 thousand years ago, medicine has always taken notice of presentation and symptoms.
Today, though, the preventative and diagnostic elements may be anchored in one of a number of rapidly developing scientific and technical fields: genetics or proteomics (the study of an organism’s complete set of proteins). They ensure better imaging, improved searching of patient databases or identification of biomarkers to predict health risk, provide targeted earlier diagnosis or monitor disease activity.
Dr Alan Davies is Chief Medical Officer, EMEA, for GE Healthcare
The genomic revolution allows us to understand the increasing complexity of diseases we once thought of as single conditions. In the 1920s, for example, there were only two diagnoses for patients with bruising and fatigue: leukaemia or lymphoma. Today we know of around 38 types of leukaemia and 51 types of lymphoma, and the number is increasing each year.
Each type is characterised by its distinct molecular profile, and this exquisite diagnostic guidance enables more specific personalised treatment. But if the promise of personalised healthcare is to be fulfilled, the explosion of knowledge and the pace of innovation can only be managed by a convergence of technologies driven by information technology.
At GE we think that healthcare IT (HCIT) will be the game changer for personalised healthcare – increasing consistency, advancing protocol-driven evidence-based and delivering knowledge and healthcare at the bedside. An HCIT infrastructure of comprehensive electronic health records tied into patient-specific care will improve healthcare productivity and reduce medical errors.
We know that the potential gains of fully integrating HCIT as the backbone of any healthcare system are enormous. Take Intermountain Healthcare, based in Salt Lake City, for example. It found that by optimising processes it was able to streamline operations, improve clinical quality, and achieve 80 per cent evidence-based care across its facilities, compared with a USA national average of between 10 and 20 per cent.
Currently, however, most HCIT is deployed in isolated systems and settings that do not interface well (the so-called “interoperability challenge”). This makes the systematic evaluation and enhancement of care across medical cultures and practices difficult, to say the least. Standardisation of information exchange between differing vendors and computer systems is a key challenge. Vendors and payers recognise interoperability as important, and vital and detailed work and good progress has been made over the past 10 years with the development of global standards.
But although complex, interoperability is not the really tough challenge for HCIT. Much harder is the “semantic problem”: how to interpret a diagnosis, preventative methodology or treatment in one culture and use the information in a different medical culture or language.
Evidence base
With all these challenges, healthcare presents perhaps the most complex application of IT in any industry. Its intricate workflow interactions make digitisation more than just a technical or financial issue. That is why there is a compelling need for evidence-based evaluation of these HCIT systems to define their net benefits.
Politicians talk of “meaningful change”. Healthcare systems will offer it not by simply setting out to replace paper, but as a first step towards higher-performing practice – improving healthcare productivity at an appropriate cost for as many patients as possible. If we are going to make the change, the insurance companies and reimbursement agencies that meet the health bills, and government, have no choice: they must work with industry throughout the world to provide a consistent regulatory framework and incentives for healthcare providers to adopt broad-based and integrated HCIT.
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