Personalized Healthcare

By Zeyu Xia

Introduction

    What is Personalized Healthcare?

    Personalized health care is an overarching framework for proactive, personalized health care that provides individuals with a personal health plan to maximize their health and minimize disease. It utilizes predictive technologies to establish each individual’s health risks and facilitates patients’ engagement in their health along with the development of plans and a care delivery system designed to achieve the best health outcomes.

    Why Is Personalized Healthcare Important?

    The personalization of healthcare offers a wide range of benefits for both healthcare providers and their patients. These benefits include: 1) Improved disease detection; 2)Lower health care costs for patients; 3) Better clinical outcomes and patients' quality of life; 4)Increased patient activation and engagement.

    There are three time periods concerning the trajectory of disease. The right portion of the curve is what we hope to avoid; it is when the burden and cost of poor health takes its toll on individuals and society. 

    At the left of the curve, before a disease begins to develop, individualized healthcare could quantify someone’s disease risk based on an individual’s characteristic, genetics and environment. At this point, engaging the individual in lifestyle changes to minimize their disease risks can have the greatest impact.

    Individualized healthcare also could be conducted at the middle of the curve where primary prevention is most important. If an individual’s health risks are known, their providers can begin working with them on what is preventable like continuously monitoring risk markers for disease progression, and medications to minimize disease development. For those, disease development is unavoidable, personalizing therapy and disease management can substantially improve health outcomes. 

    Momentums

        Increased Market

        The global personalized medicine market was valued at USD 529.28 billion in 2023 and is projected to grow at a CAGR of 8.20% from 2024 to 2030. 



        Developed Programs

       UK Biobank; Singapore's National Precision Medicine Strategy;  US's All of US research; program; GenomeAsia100K, etc.


Challenge

    Data Dilemmas

        Privacy risks

        A study analyzed 90 direct-to-consumer genetic testing companies and found that 23% shared user data with third parties (pharmaceutical firms, researchers, etc.), often without explicit consent. DNA data was among the shared categories.

        Interoperability gaps

        Some studies show that EHRs are not yet ready to send accurate, coded, and appropriately granular clinical history, signs, symptoms, family history, and other broad sets of clinical genomics data. 

        Another fact is achieving interoperability among different EHR platforms is so difficult, especially since there are 16 distinct electronic health records platforms, according to statistics from HIMSS Analytics. Most hospitals have at least 10 EHRs in place and only two percent are down to just a pair of platforms.


    Equity Gaps

    A 2009 analysis revealed that 96% of participants in genome-wide association studies (GWAS) were of European descent in. Seven years on, some findings indicate that the proportion of individuals included in GWAS who are not of European descent has increased to nearly 20%. Much of this rise, however, is a result of more studies being done in Asia on populations of Asian ancestry. The degree to which people of African and Latin American ancestry, Hispanic people and indigenous peoples are represented in GWAS has barely shifted. There even occur a term "eurocentricity" to point out the imbalance in genetic data.

References &  Image citation
1) https://www.grandviewresearch.com/industry-analysis/personalized-medicine-market#:~:text=What%20is%20the%20personalized%20medicine,USD%20909.80%20billion%20by%202030.
2) https://www.england.nhs.uk/personalisedcare/what-is-personalised-care/
3) https://personalizedhealth.duke.edu/our-work/what-personalized-health-care
4) Popejoy, A., Fullerton, S. Genomics is failing on diversity. Nature 538, 161–164 (2016). https://doi.org/10.1038/538161a
2) https://www.england.nhs.uk/personalisedcare/what-is-personalised-care/
3) https://personalizedhealth.duke.edu/our-work/what-personalized-health-care
4) Popejoy, A., Fullerton, S. Genomics is failing on diversity. Nature 538, 161–164 (2016). https://doi.org/10.1038/538161a
5) Laestadius LI, Rich JR, Auer PL. All your data (effectively) belong to us: data practices among direct-to-consumer genetic testing firms. Genet Med. 2017 May;19(5):513-520. doi: 10.1038/gim.2016.136. Epub 2016 Sep 22. PMID: 27657678. 
6) https://www.healthcareitnews.com/news/why-ehr-data-interoperability-such-mess-3-charts
7) Carter AB, Abruzzo LV, Hirschhorn JW, Jones D, Jordan DC, Nassiri M, Ogino S, Patel NR, Suciu CG, Temple-Smolkin RL, Zehir A, Roy S. Electronic Health Records and Genomics: Perspectives from the Association for Molecular Pathology Electronic Health Record (EHR) Interoperability for Clinical Genomics Data Working Group. J Mol Diagn. 2022 Jan;24(1):1-17. doi: 10.1016/j.jmoldx.2021.09.009. Epub 2021 Oct 15. PMID: 34656760.



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