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In the Pursuit of Precision Medicine and Value-Based Care: Are They Dual, Yet Synergistic Goals?

April 26, 2017
by Heather Landi
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Within the healthcare industry, precision medicine often is approached as a research endeavor, while value-based care transformation is framed as a business or operational initiative. However, one bioinformatics thought-leader asserts that precision medicine and healthcare transformation are highly synergistic and intrinsically linked, and are, at their core, data-centric issues. And, to deliver on the promise of precision medicine and value-based care, healthcare leaders essentially need to change how they approach data sharing and analytics, according to Philip Payne, Ph.D., founding director of the Institute for Informatics at Washington University School of Medicine in St. Louis, during a recent webinar presented by Healthcare Informatics.

“For both precision medicine and value-based transformation, it’s about capturing critical data aspects to treat patients as individuals and to improve value, safety and outcomes,” he said during the April 19 webinar. The full webinar can be accessed here.

Payne, previously professor and chair of the Department of Biomedical Informatics at The Ohio State University, shared his perspective on how interoperability and data sharing powers both precision medicine and value-based healthcare and why now is the time to focus on these two data-centric issues.

“How do we look at the very synergistic areas of both precision medicine and value-based transformation of healthcare from the perspective of data integration, data analytics and biomedical informatics? You need a systems-level approach to these problems, which are really driving everything from research through to the operations and financial dimensions of modern healthcare delivery systems,” he said.

Payne has also led the formation of Signet Accel, a data analytics company, and during the webinar he briefly touched on the development of the company’s Avec platform, which is a federated data integration platform.

The ability for the healthcare and life sciences industries to accelerate discovery, improve care to patients and scale precision medicine to a population level is predicated, Payne said, “on our ability to use all the data we produce every day in the healthcare system, data that is often locked away or difficult to access.”

Payne first outlined that precision medicine and healthcare transformation are both change agents and are the primary drivers in advancing treatments, improving care and finding cures. Essentially, precision medicine is about moving beyond “averages” to treating the individual, he said. However, in order to see improved health outcomes from the use of precision medicine, healthcare organizations need access to data beyond what is in the electronic health record (EHR).

“Using data, and doing it at a systems level, this is fundamentally shaping our thinking about high quality, cost-effective and efficacious care for patients. We need data at our fingertips. It’s not enough to have what’s in the EHRs or lab systems. We need to be able to integrate it on demand to make these decisions better, smarter and faster with improved outcomes for patients,” Payne said.

Simultaneously, the healthcare sector is going through tectonic changes in terms of policy, reimbursement and business incentives, described as both value-based care and healthcare transformation. “At its core, it’s really about using the data we have to improve the value, safety and outcomes of care,” he said.

A key part of value-based care is about keeping healthy patients healthy, and more effectively intervening with the high-cost, unhealthy patients, he said. “We know, based on the data, that [high cost, unhealthy] category is around 5 percent for any given disease, but consume up to 90 percent of healthcare expenditures for that disease state. In those patients, how do we understand the ability to give those patients the right treatment first, so they don’t become more costly or unhealthier? These are intrinsically data-centered problems.”

How do leaders within the U.S. healthcare industry prepare for this changing environment? “How do we improve the health of individuals and wellness of communities? How we deliver better, faster, cheaper more efficacious care to individuals?” Payne asked. Reaching that goal of improving value, safety and patient health outcomes will require a new approach to clinical practice, research, patient engagement and the business of healthcare, he said.

What’s more, healthcare provider organizations have a critical role in preparing for this changing environment, he noted. “It’s about rethinking how we approach data sharing and how we share data across borders to bring together these disparate data sources and support precision medicine and healthcare transformation efficiently and effectively. Fundamentally it comes to using the data we have to match patients with best possible prevention or treatment strategies, it’s about marshaling the data we collect but looking at it at a systems level and not transactional.”

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