Thoughts on health IT, personal medicine & tech convergence

06 Aug Thoughts on health IT, personal medicine & tech convergence

The topics in this MedTech futures column have been fairly wide-ranging. Last July, I wrote about the GE-Abbott deal falling through “Analysis: Why the Abbott Deal With GE Healthcare Fell Apart” with a suggestion that a lack of synergy between the Abbott Diagnostics unit (sans Molecular Diagnostics) and the GE Healthcare IT framework led to a disconnect in agreement over the transaction price.
That article also proposed the admittedly radical suggestion that the vast information carnivore, Google (or one of its affiliates such as 23andMe.com could even be considered as a possible acquirer of Abbott Diagnostics. (I agree that may have been a stretch but feel free to read the article to understand more of the reasoning behind that). Back in April, I wrote an article focusing on personalized medicine “Personalized Medicine, Tech Convergence Decisive Trends” where I highlighted how personalized medicine, in operational terms, implies a convergence between diagnosis and therapeutics (hence theranostics) as well as a convergence between drugs and devices for personalized (in the sense of being more precisely localized) treatment.
So what’s the connection? There’s indeed another area of technology convergence implied by personalized medicine and that is with respect to the melding of information technology (some call it more precisely medical informatics) with clinical medicine (whether this be pharmaceuticals, devices, surgery, or a combination). This was the underlying message of the Abbott-GE article in July (as well as its predecessor article in February – “What’s More Important in Medicine: Diagnostics, Therapeutics or Prognosis?”)
Personalized wave
Everyone has been talking about personalized medicine. It is considered a “wave of the future,” the “holy grail of medicine” or another one of a number of monikers. For a somewhat more prosaic, but hopefully informative definition of personalized medicine, feel free to hear the four minute podcast: “Personalized medicine: An Audio (.mp3) Podcast.”
The irony is that right now one could say that we have medicine that is too personalized. How could this be? As many know, healthcare delivery in the U.S. is highly fragmented. If you happen to visit an emergency room on one day and are unfortunate enough to have to visit another one on the other side of town another day, you can be pretty well sure that neither of them will have access (or even be aware) of your respective medical history at each. Patients have even complained about this complete lack of information interchange even between departments in a single hospital! Of course, that is changing, but by-and-large the availability of integrated medical records across populations is still a dream. A notable exception is the Veteran’s Administration (VA) system, but even that has a ways to go before true seamlessness has been achieved.
Of course, there are advantages of such a system. Privacy is one of them. If you go to a private doctor’s office in Kankakee, Ill. and they still use paper records, it is almost impossible for anyone to know about it save a court order and an army of detectives to find it. When it comes to saving your life, however, privacy may be a feature that is not necessarily so important.
The purpose of this column is not to debate these privacy issues. They are important and there are controversial laws like the Health Insurance Portability and Accountability Act (HIPAA), which aim to uphold privacy and other laws such as gun control regulations that seek more openness in records, particularly psychiatric records.
Medical mission impossible
What, I’d like to point out is that healthcare right now, is in a sense, intensely personalized (in the sense of being fragmented) and to the extent that we do not have an integrated pool of information across the population, then the true implementation of personalized medicine as defined by the ability to absolutely and accurately pinpoint the exact medicine and dose, for example for a particular patient – say you – is impossible. Hence technology convergence between information technology and clinical medicine is inevitable if the personalized medicine revolution is to really take off and bear fruit. The reason I write this now, is that just this past week a Reuters report exposed just how far behind the United States is in true information availability and integration.
As the report writes:
“The ultimate success of such personalized medicine projects depends on having thousands of people contribute health information to be digitally stored according to a standard format that makes it easy to share.”
The report continues with a discussion on not just how personalized medicine becomes a distant dream but also that high costs and medical errors also raise their ugly features in the context of an information sparse medical system. Hence, summarizing a report from the Commonwealth Foundation:
“… the United States — which had a key role in the creation of personal computers, the rise of the consumer Internet, the mapping of the human genome, and using technology to cut costs, lags Denmark, the Netherlands, and some other industrialized nations when it comes to moving medical records into the digital age …”
So guess how the report concludes? The last words are quoted from Esther Dyson – a director at 23andMe.com – the personal genetics site co-founded by Anne Wojcicki, the wife of the Google co-founder Sergey Brin. Dyson says: “The real problem is that everything started on paper and it was local and you had one primary doctor. The system is breaking down now.”
Tongue-in-cheek prediction
My April column proposing that Google could be a potential suitor for Abbott Diagnostics was partly intended, tongue-in-cheek to raise eyebrows (why would a column be worth reading if it stated the obvious anyway), and partly out of true seriousness.
Technology convergence – namely IT and clinical medicine – in ways that we cannot even imagine now will happen. It’s only a matter of time. Whether that will be expressed in terms of Google (or one of its affiliates) acquiring Abbott… probably not. But you never know.
Previous articles by Ogan Gurel
• Ogan Gurel: Crazy like a Google? With GE-Abbott deal scrapped, could Google be next buyer?
• Ogan Gurel: Reforming FDA: Focus on safety, let market judge efficacy
• Dr. Ogan Gurel: FDA: Tortoise, hare, or something else?
• Dr. Ogan Gurel: Who is minding the Innovation Gap?
• Barriers will not stop convergence of medical technologies