Precision medicine looks set to change both healthcare delivery and health insurance. However, patients might find themselves paying more depending on their decisions and behaviour.
Remember when companies started to shift from mass marketing, where the same advertising message was targeted at a wide audience, to a more precise type of marketing in which the new information and communication technologies are used to achieve a more fine-grained segmentation of the audience and send potential customers far more personalised messages? Now that we are firmly in the era of personalised advertising, next up is precision medicine, a new pro-active, personalised, predictive and precise approach to e-health.
Connected objects have opened the way towards personalised healthcare as wearers have become increasingly accustomed to the idea of gathering data about their health and performance. At first this data was not always very accurate but the technology has been steadily evolving and the level of precision increasing. It does not matter too much that people often give up using their device: in the United States a third of all connected fitness devices are no longer being used by their owners six months after purchase. What really matters is that such devices enable people to obtain a better understanding of their own bodies and take preventative measures to avoid ill health, a first important step towards precision health. In addition to basic tracking such as counting the number of steps you take and monitoring your sleep patterns, many other variables can now be measured, enabling the sort of follow-up preventative action that would have been impossible even just a few years ago. The benefits for diabetics of being able to use connected electronics to measure their blood sugar levels is just one example of the progress achieved.
New approaches to treating patients
Precision medicine is now beginning to conquer hitherto-unexplored territory, hugely boosting the power of traditional medical research. Artificial Intelligence – machine learning using sensor-gathered data – is already being harnessed to enable early detection of cancers, Flatiron Health and IBM
Watson Health being two promising ventures in this field. Biotechnology, the area in which Shorewood, Wisconsin-based startup CyteGen is working, is helping researchers to understand more about rare degenerative diseases and so find ways to combat them. At the same time, additive manufacturing, aka 3D printing, techniques are now being used to ‘print out’ sections of living tissue.
Meanwhile all these technological advances are enabling and underpinning a significant new trend: the arrival of precision medicine in the prevention and treatment of illnesses and in patient care. Initiatives are now underway to incorporate precision medicine into the public healthcare system.
Californian startup Syapse for example provides a platform that aggregates basic information from a patient’s Electronic Health Record with more complex data – such as genetic makeup – so as to enable doctors to make a more precise diagnosis and tailor treatment specifically to that individual patient’s needs. It is worth stressing however that ‘Quantified Health’ tools are not about to replace the doctor entirely but the physician’s role is quite likely to evolve into that of a sort of ‘super aggregator-advisor-hand-holder’ for patients.
“Quantified Health is the result of a doctor’s observation of all the data coming from the patient’s self-measurement activities plus other variables which the doctor adds to the picture – such as epidemiological and environmental data,” explains Elizabeth Ducottet, Chair and CEO of French medical devices manufacturer Thuasne. In contrast to personalised advertising, tailored healthcare requires personal backup, even if only to give patient care a human face and reassure the patient.
Challenging traditional insurance models
In fact the entire healthcare ecosystem is already feeling the effects of the emergence of personalised medicine. One example is the initiative undertaken by designer and MIT engineer Will Patrick. He has recently designed a machine enabling people to produce their own food supplements in the kitchen, opening up the prospect of everyone being able to make their own medicines at home – provided they comply with the legal requirements of course.
Given the many examples of personalised medical treatment today, it is clear that healthcare organisations, hospitals, clinics, plus the pharmaceutical industry, are already being impacted by these changes. However other sectors are potentially affected as well, the most obvious being the insurance industry. Up to now healthcare models have been based on risk sharing, i.e. an insurer agrees to provide cover to a group of people, the principle being that those who remain in good health make up for the claims made on the insurance provider by people in poorer health.
Health Insurance impacted by precision medicine
With the advent of personalised healthcare, won’t patients start to demand personalised health insurance? An approach based on precise individual patient data would certainly be far more sophisticated and it does seem entirely possible from a technical viewpoint. However, it raises several important issues. Firstly, is the patient prepared to share his/her data with the insurer? The answer might be ‘yes’ if the insured patient felt s/he was obtaining a plus-value in return. And of course at the end of the day the patient may have little choice in the matter if the insurer decides to refuse cover for those unwilling to share all their health data. Secondly, does the insurer really want to move away from the risk-sharing model? The answer here could be ‘yes’ if the insurer wishes to attract people with the best health profiles, but then this raises both ethical issues and the question of what is good for society as a whole. So the jury is still out on this new concept.
Reaching out to all groups of people
E-health nevertheless allows us to envisage a new era of personalised healthcare. The United States, which benefits from all the latest technologies, is at one level an interesting playing field to observe.
However, shouldn’t the ultimate goal be to extend personalised healthcare to everyone everywhere – to the populations of developing countries as well as the developed world? The Bill and Melinda Gates Foundation, which has already done so much to bring modern healthcare to less well-off countries, might be a good ally in this regard.
Personalised marketing allows firms to slash their costs when reaching out to potential customers, as they can target the audience more accurately. So let us hope that this personalised model can also work for precision healthcare and be used efficiently for the good of largest possible number of patients worldwide.
This article was originally published on the website of French economic and business newspaper ‘La Tribune’
Edited by Pauline Canteneur