The Shift from Personalized Health Care to Precision Medicine

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The health care system as we know it today may experience fundamental changes over the coming decade. Personalized health care and its underlying preconceptions regarding treatment procedures and protocols are being challenged by a new way to approach health care. This fundamental mindset shift is referred to as precision medicine.

Personalized Health Care

Differences between Personalized Health Care and Precision Medicine

When first coined, the terms “personalized medicine” and “precision medicine” were relatively interchangeable. [1] However, shifts in health care over the years have necessitated a distinction between the two terms. Personalized medicine or personalized health care has come to refer to the one-on-one nature of a patient’s experience in the health care setting. While health care is arguably always personalized because it must be administered individually from health care provider to patient, “personalized medicine” invokes today’s status quo in which a medical professional develops a patient’s treatment plan based on their individual case guided by available research and precedent. Precision medicine, on the other hand, would involve developing treatment plans for individuals based on much larger catalogs of stored and synthesized biological information against which individual cases could be quickly measured. [2] Precision medicine may provide the means to predict or prevent diseases or health problems. As precision medicine develops, this distinction will sharpen.

Current Outlook

Though currently in its infancy, trends indicate that the development of precision medicine is gaining significant traction. In 2005, a PubMed search for the term “precision medicine” would have provided just one result, and “personalized medicine” just 74, but 10 years later, the same queries provided 1737 and 1529 results, respectively. [4]

Advocates of precision medicine hope its effects will inspire foundational changes in our current health care system’s approaches to patient care, nonetheless adopting these measures and making them widely available will take time. In fact, some argue that the entire health care system would require significant overhauls before precision medicine could make the kinds of impacts many think it will. According to the NEJM Catalyst, a publication made available by the Massachusetts Medical Society, real advancements won’t be made until an entire mindset shift occurs not only among the medical professional community but among the patients utilizing the system. [3] To accomplish this, patients must be educated (and proactively seek screening) and medical infrastructure must be developed to accommodate such activity.

A growing number of advocates and professionals are investing in precision medicine and its potential uses, as demonstrated in labs and peer-reviewed research nationwide. The development of precision medicine has also been recognized in America’s political arenas. An endeavor enacted by Barack Obama in 2015 magnified a growing interest in precision medicine. The Precision Medicine Initiative drafted in 2015 [5] will involve over 1 million U.S. participants submitting biological, genome and medical information for long-term compilation and study by researchers. Stakeholders hope that this initiative, as well as myriad studies and explorations of precision medicine will allow great strides towards its use in preventing and proactively treating a host of diseases and conditions. The prevalence of precision medicine could quickly expand as medical professionals graft its advantages into an ever-widening slew of applications.

How Medical Professionals Can Prepare

So how do professionals in the medical field prepare for this shift? By keeping well-informed of advances made within precision medicine and its increased capabilities to prevent and treat medical conditions.

Further proactive patient care protocols are being instituted to achieve precision medicine. A sample protocol to accomplish this has been developed by the Duke Center for Research on Personalized Health Care. Dubbed the “Personalized Health Planning” [6] model, this methodology encourages proactive actions on both the part of the patient and the medical care provider to ensure health education, monitor any predispositions the patient may have towards certain health conditions and facilitate early discovery of diseases or conditions in order to form robust treatment plans and provide the best possible outcome.

When medical institutions utilize patient care plans or models like this one, they make it possible to capture and contribute more comprehensive data to the growing knowledgebase that will power precision medicine. They also help develop infrastructure necessary for the future, allowing precision medicine to become more widespread.

Legal Ramifications of Precision Medicine

Large-scale changes in health care will significantly affect professionals that work in health law. Term distinction will become increasingly important from a legal perspective as precision medicine becomes more prevalent in health care literature, contracts, proposals, and more. The National Research Council (NRC) has encouraged the consolidation of these phrases in an effort to standardize “precision medicine” as the operative jargon. The NRC believes this will avoid any misconceptions that this type of medicine would necessarily require or imply an exhaustive study of any person receiving care. In fact, the concept refers to more comprehensively utilizing a larger database of collected biological information that can be applied to medical treatment but does not necessitate that every person who receives care undergo extensive study before being helped. [7]

Precision medicine also introduces a number of other complex legal and ethical issues that will require exploration and expertise as it increases in prevalence. [8] Financial concerns including increased costs of new technology, clarity of payment responsibility for procedures, and clarity of accountability for injury or unsuccessful treatments will require law personnel who can keep apprised of a quickly-developing legal landscape. Lawyers and health law professionals should also anticipate legal development over issues including ownership of biological material or test results, ethical concerns, and questions of identity and incrimination as precision medicine gains traction in the medical community.

Learn More
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[1] Centers for Disease Control and Prevention – Shift From Personalized Medicine to Precision Medicine
[2] NEJM Catalyst – To Adopt Precision Medicine, Redesign Clinical Care
[3] National Institutes of Health – Precision Medicine Initiative
[4] National Institutes of Health – Precision Medicine Initiative
[5] National Institutes of Health – The difference between precision medicine and personalized medicine?
[6] National Institutes of Health – Challenges facing precision medicine