We need to focus on precision prevention.

Because reducing risk is the first step

I came across a quote from Leonard D’Avolio, PhD, Assistant Professor at Harvard Medical School, who states:

“In healthcare, policy eats culture and strategy for breakfast.”

What does this mean exactly?

This means that, for any restructuring of the healthcare system, no matter how well the intentions and purpose are, effective actionable change can only happen if it originates from the policy level. Thanks to the past presidential administration, who started Center of Medicare and Medicaid Services’ Quality Payment Program and funded the Precision Medicine Initiative, there has been an explosion of research in these areas. We can truly feel the strong support to shift towards providing personalized quality care with 359,000 clinicians ready to participate in the MACRA implementation.

Today, much of the current focus of precision medicine involves developing new drugs and therapies for personalized treatment of a specific type of cancer and disease. The focus on genomics over the past 5–10 years have shifted from interest in uncommon single gene abnormalities to conditions that are more prevalent in the general population says Gregory Feero, a primary care physician with a PhD in genomics.

Millions of dollars are getting poured into these areas of research, with the first FDA-approved gene therapy treatment to just hit the market this month, but how much will genomic research affect the general population? A valid case can be argued that the public will benefit much more on early detection and prevention — precision prevention. Personalized treatments can help save the lives of the sick, but prevention applies to everybody.

“ By focusing on the health of a broad population, we can eventually have a meaningful impact on the well-being of patients around the world.”
Sanjiv Sam Gambhir, MD, PhD, Chair of Radiology at Stanford and Director of the Canary Center Early Detection.

For precision medicine to succeed, a population perspective is needed. The key to disease prevention has a tendency to be overshadowed by the hype of new technologies in genetics and media representation of the promises of precision medicine. However, we must not forget what we already know about the simple yet powerful prevention habits that revolve around a balanced diet, adequate exercise and not smoking. After all, these modifiable risk factors could prevent one third of deaths in the US.

As we wait patiently for clinical trial results to ripen, data science companies are racing to decode the population health data that already exists; buried in EHR’s free-text form and private patient socioeconomic data.

But what we do know is that we need to do better at fixing the problems that exist in healthcare today.