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From Reactive to Proactive: How Precision Medicine Transforms the Break-and-Fix Healthcare System

Reacting to an adverse medical event after it has progressed to causing the patient to seek medical help is the least opportune time to address the underlying disease.

One of our healthcare system’s biggest challenges is moving beyond the current break-and-fix model, where physicians’ hands are tied until abnormalities arise. Only when an illness or condition presents itself does the system spring into action. Reacting to an adverse medical event after it has progressed to causing the patient to seek medical help is the least opportune time to address the underlying disease. Today’s science allows far more intelligent approaches that enable interdiction before the disease develops or early in the disease process when it is most easily dealt with. 

 The changing demographics of our society demand a smarter way of delivering healthcare. People are now living longer, and data suggests that chronic diseases (i.e., hypertension, diabetes mellitus, cancer, chronic lung disease, etc.) are on the rise and occurring earlier in life than previous generations. Healthcare could be looking at the perfect storm. In fact, the number of individuals 50 years and older with one chronic disease is expected to increase by 99.5% within the next 25+ years — and that’s on top of the 133 million people already living with one chronic condition. Complicating matters further is that almost half of individuals with a chronic illness are dealing with more than one.  

Improving patient outcomes will be key to relieving the inevitable strain on the healthcare system, and the area that holds the most promise is precision medicine. 

What Is precision medicine?  

Precision medicine is a relatively new approach to preempting, diagnosing, and treating disease. Thanks to human genome sequencing, healthcare data analytics, and an increased understanding of how genetics impact intracellular processes, healthcare teams can now consider a patient’s genetics, lifestyle, environment, and a host of other factors to personalize care delivery, improve patient outcomes, and lower overall healthcare costs. Multi-omics in precision medicine is an emerging field that greatly contributes to this promise by integrating genomic, proteomic, and metabolomic information to provide a more comprehensive understanding of an individual’s health status. 

For example, with cardiovascular disease, much is known about how this disease develops and how to detect it at its earliest onset. This is key because much is known about preempting the condition — or slowing its onset and progression, at the very least. By applying algorithms derived from machine learning (ML) trained on the data sets of genetic variation and outcomes for thousands of people, it is possible to make predictions of future risk of coronary artery disease and events for the individual based on their unique genetic code. This allows physicians to build individualized prevention, detection, and treatment plans that can address heart disease far more effectively than the current system, which waits for the sentinel event, which may be sudden cardiac death or a life-changing heart attack. 

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Autor: William P. Stanford   Quelle: (07.06.2024 - LW)
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Charité International AcademyOÖ Gebietskrankenkasse, Referat für Wissenschaftskooperation Österreichisches Rotes KreuzHilfswerk AustriaÄrztekammer für WienEuropean Public Health Association (EUPHA)Österreichische Akademie der ÄrzteCentro per la Formazione Permanente e l'Aggiornamento del Personale del Servizio Sanitario