Precision medicine growth hinges on electronic health records

Precision medicine growth hinges on electronic health records

By leveraging the historical data included in the records, healthcare providers can target patients, populations more than ever.

Advancements in genomic research have given medical professionals the ability to create highly detailed physiological profiles of individuals as well as a baseline for predicting the impact of genes on disease. And the catalyst for putting genomic principles into practice is the electronic health record, says researcher David Crockett.

As senior director of research and predictive analytics at Health Catalyst in Salt Lake City and assistant professor of pathology at the University of Utah’s School of Medicine, Crockett has spent considerable time and effort analyzing the link between electronic health records and precision medicine.

In course of his research, he focused on bioinformatics, biomarker discovery, immunology, molecular oncology, genomics and proteomics. Within that framework, he secured various predictive modeling patents as well as developing algorithms and computational models.

Over the past two years, he hit upon the EHR epiphany thinking about the potential for both electronic records and precision medicine.

“Moving from paper to electronic records was quite a leap, but now we have to think about where to make the next leap,” he said. “It’s not just about combining data sets in the warehouse environment, but how to combine the data sources. It’s not enough to have EHR data, but to think about what other factors impacts a person, such as zip code or weather.

“What is the analytics value beyond the warehouse and what is the most cost effective way to treat patients?” he added. “There is a ton of historical data and we need to leverage that.”

The thrust of precision medicine is to go beyond one-size-fits-all treatments for the average patient, Crockett said. The precision medicine model aims to use specific biomedical details to create customized treatment options that are most appropriate for each individual.

“To put it more simply, precision medicine understands each patient’s individual illness and delivers the right treatment at the right time,” Crockett said. “It is taking population health principles one step closer. If you can do it at both levels, that’s the Holy Grail.”

Both medical and information technology have taken great strides forward, but for precision medicine, the onus is mainly on the healthcare culture and willingness of providers to intervene and take action, Crockett said.

“The math and data input are relatively straightforward,” he said. “To sort people by risk from top to bottom and determining what to do is the real issue. It’s not technology — it’s culture.”

Exerting leverage

Wanda Health is a San Francisco-based predictive analytics firm that focuses on specifics of chronic disease and develops formulas to efficiently leverage precision medicine. By concentrating on the most important and expensive chronic diseases, providers can maximize the quality of life for patients while minimizing the amount of costs they present to healthcare systems, says CEO Steve Curd.

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