Let's Get Personal

An article in the Wall Street Journal a couple of weeks ago described a disappointing development in the field called “Personalized Medicine.”  For those who aren’t familiar with this term of art, it is generally used to mean the use of a patient’s specific genetic or other biologic information to match them with specific drugs that are more likely to be effective as a result of the person’s individual genetic/biologic makeup.  Many are familiar with the work that has been done to genetically test breast cancer patients to determine whether Herceptin will be effective in tumor control or not, for instance. In fact, the research described in the WSJ article noted that a tumor’s genetic makeup can vary significantly even within the same tumor sample, rendering the application of Personalized Medicine questionable at best. The article states, “The findings don’t diminish enthusiasm for the idea that genetic knowledge about tumors can transform cancer care, the researchers said. But it could make personalized treatment more complex—and more costly.”

I find it very interesting that the concept of Personlized Medicine has been almost entirely limited to discussions about the combination of genetics and medication. In a world where consumer engagement in the healthcare system necessitates true personalization of the entire healthcare experience, I think it is time for the term to be applied far more broadly and without capital letters.

The goals behind the classic meaning of Personalized Medicine were and are to engage patients in an individualized process that fosters faster, better screening & diagnosis; enables effective matching of illness to treatment to maximize efficacy; and thus reduces the use of unnecessary resources (e.g., lowers cost) by avoiding treatments that would prove ineffective. In fact, these are precisely the goals of a vast array of activities that are more typically in the purview of the fields of healthcare services and healthcare information technology.  We are seeing data-driven personalization happening in delivery systems, care management programs, value-based insurance programs, mobile health and consumer engagement platforms, among others.  The marriage of wearable sensors with electronic medical records and other enterprise data is feeding “big data” analytics systems that drive significant personalization of consumers’ healthcare experiences. Bottom line: personalized medicine is not just for genetics fans anymore.

The health plans of the not-too-distant, kinda-already-here future will (do) rely heavily on personalization to meet the demands of a market characterized by consumer direct purchasing and engagement (as a result of health insurance exchanges) and the essential economic and societal need to get the costs of chronic illness under control.  Such health plans, which are likely to feature integrated payer and provider systems tied up in a high technology wrapper, will:

• Allow for multiple points of access to the healthcare system based on specific consumer preference (clinic, home, office, hospital, assisted living, mobile phone-based telemedicine, you name it)
• Enable tracking/monitoring of exactly the clinical indicators desired and use predictive analytics to predict trends/risks of treatment or it’s absence
• Use those analytic findings to develop and execute personalized treatment plans that are highly tunable based on continuous loop feedback
• Identify people with common symptomology and conditions and foster community around target diseases and behavior
• Rely on a feedback loop from patients and providers to create a fuller and more customized user experience

As an example, the value-based health plan offered by SeeChange Health is already well on its way to providing many of these features (self interest alert:  SeeChange is a Psilos portfolio company). SeeChange’s health plan encourages prevention and a more individualized health care experience by providing a comprehensive health risk analysis of the client population; identifying people with high risk chronic conditions (pre-diabetes, diabetes, asthma, etc.) and matching them with condition-specific and customized Health Action plans; dynamically incorporating highly individualized incentive and engagement programs; and providing an online portal that informs and motivates.  In other words, it is a health plan that looks at individual members, figures out what programs and treatment interventions are best suited to keep each of them healthy, and delivers a personalized experience that results in earlier disease identification and optimized use of clinical resources. This is not one-size-fits-all health insurance and if it’s not personalized medicine, I don’t know what is.

There are similar efforts underway among healthcare companies that focus on personalizing the nutrition/food shopping experience (e.g. Zipongo), the care management/care coordination experience (e.g., Click4Care) and the delivery system access experience (e.g., Walgreens).  Personalization is coming to healthcare and it is about time.

Personalization is a trend that will touch every part of healthcare as the system continues to evolve towards one where consumers are engaged clinically and financially. Healthcare information technology and healthcare services are primary tools in fostering this kind of personalized medicine…and we don’t have to wait for any scientific discovery to utilize it.  Just as with the promise of Personalized Medicine (old school style) , this broader view of personalized medicine affords a significant opportunity to positively impact medical cost and effectiveness.  Even better, the market potential is not limited to a subset of the population, but applies to all Americans who engage with the our healthcare system.

Every industry in America is striving towards greater and greater personalization.  You see it in the automobile industry, the clothing industry, the food industry, every where.  Thank goodness it is finally coming to an industry where personalization can make a meaningful difference in our lives.  And by that, of course,  I mean the couture footwear industry.  No, seriously, it is only by personalizing the healthcare experience that we will begin to effectively engage people in living a life built around health and not around healthcare.