Precision medicine is a hot topic. It should be. It’s no longer a concept. Multiple drugs are now available that are more effective in patients with a specific genetic profile. And drug research targeting highly specific patient populations promises to increase the effectiveness of drugs in many diseases.
Genetic testing is becoming mainstream. It’s becoming the standard-of-care to diagnose certain diseases, and it’s never been easier for patients to turn an at-home cheek swab into a full genetic profile by mail. It seems like every day, you hear of a new startup with the ostensible goal of nothing short of transforming health care as we know it based on profiling at the genetic level.
But even as the technology emerges to deliver an increasing degree of hyper-personalization in care, one data source stands alone as the primary driver of both high-tech and high-touch care tactics: Conversation.
“We’ve spent too much time in healthcare addressing everyone the same,” says Harry Greenspun, M.D., partner and Chief Medical Officer at Guidehouse. “We tell them, ‘You gotta take this medicine because we, as doctors, told you to take this medicine. And that’s really not a basis for a relationship.” And while genetic testing might be a valid route to that personalization, it’s not the quickest. The quickest is a conversation. “The real precision is understanding for that individual, what is it that’s going to make that difference [in behavior]. For some people it is, ‘I want to be healthier.’ For some people, it is, ‘I want to live longer.’ For some people, it is, ‘I want to do that thing I couldn’t do before.’ And that thing varies dramatically from person to person.”
"The real precision is understanding for that individual, what is it that’s going to make that difference. For some people it is, I want to be healthier. For some people, it is I want to live longer. For some people, it is, “I want to do that thing I couldn’t do before.” And that thing varies dramatically from person to person."
Here are three simple reasons that genetics will never outshine the oldest data-mining approach in the book—conversation—when it comes to figuring out the precise thing that is going to drive healthier outcomes.
Genetics shine at identifying predisposition. But they don't necessarily identify behaviors.
Genetic markers alone don’t typically drive patient disposition. They drive odds (we call this risk). But like the gambler who hits an inside straight when they’re all-in, every once in a while, you can win when the cards are stacked against you. Sometimes. Data mining through conversation identifies risk too, but it also assesses social determinants of health, gives insight into ancillary indications, and can illuminate potential contributing factors.
Social determinants of health aren’t (technically) inherited.
Behavior informs health. But external forces, like those found within the umbrella of social determinants of health, often drive behaviors, both good and bad. And the answer to, “Do you have a healthy friend group that helps you relieve stress” will never show up in results from a swab.
The conversation doesn’t just gather data—it delivers it.
Genetic testing is a one-way equation. Data in, results out. But precision medicine only starts with data gathering. It also requires translating that data into actionable insights. Then, it requires data delivery in the form of conversation.
As 2020 brings more and more data into the healthcare fold, it becomes more and more important to know how to gather and process that data into action. That’s why our platform has been so successful, because it connects parts of the care continuum that typically haven’t exchanged data or messaging effectively. Now they can. And patients benefit.