By Joel Diamond, MD, FAAFP, chief medical officer, 2bPrecise.
Patients are becoming more engaged in (and financially responsible for) their own care. As such, they are increasingly interested in information about their health risks and which courses of treatment have the best potential for success. In my practice, I have seen a sharp rise in the number of patients asking about genetic and genomic tests.
Healthcare consumers are drawn to the idea that this information can unlock answers to persistent health problems, or reveal risk for future issues. They want genetic information to lay out a clear path forward for prevention and treatment, perhaps indicating which medications will be most effective for their profile. It’s one of the reasons why direct-to-consumer genetic testing, such as 23andMe, has become so popular.
The precision medicine learning curve
Soon we will move from individual gene tests and panels to exome and full genome testing, some of which is happening today. As the concept of applying genomics and precision medicine gains momentum, physicians are enthusiastic about the potential of personalized care plans to improve patient outcomes.
But are physicians equipped with the right tools to put precision medicine into practice? For example, can we identify which patients might benefit from genetic testing? Do we know what test to order? How do we interpret results? How do we incorporate this information into the patient record? And of course, cost is always an issue: Who pays for these tests?
These are some of the many questions physicians are wrestling with today. If they have a clinical-genomic solution within the electronic health record (EHR) workflow, they can get some of the support they need to meet rising demand for personalized medicine and care plans.
3 trends to watch as consumers drive precision medicine into the mainstream
Consumer interest shows no signs of slowing, which will continue to bring new challenges and opportunities into the physician’s office. Trends include:
- Search for genetic destiny.I’m seeing more patients who believe precision medicine will resolve every health issue, especially when diagnosis or treatment is difficult. There is ample reason to hope, but it is up to the physician to educate consumers and set realistic expectations. There are multiple factors that have a bigger impact on health than genetics. Patients are concerned about familial inheritance for diseases, when environment and lifestyle often have a greater influence.
- Prescriptive patients. We’re going to see more consumers demand specific courses of treatment, based on the genetic or genomic information they have. For example, someone who finds out she is at risk for cardiovascular disease may request a stress test. Physicians will need new kinds of educational support to assess and stratify risk. They will need to be well informed about which tests will bring the most benefit, so they can educate their patients, too.
- Data outpacing science. Genomic knowledge is growing at an exponential rate, at times generating more questions than answers for researchers and physicians. We recognize many variants in DNA codes, but don’t yet know what they all mean. We still have much to learn about the data we are generating. Cloud-based repositories of genomic data, with continual updates and notifications for providers and patients, will be essential.