Precision medicine comes closer to home

By Tim Charles / Guest Editorial

Precision medicine is a new buzzword in health care, following President Obama’s State of the Union address. More than a fancy name, precision medicine holds the promise to drive research, accelerate new therapies and develop new approaches for millions of people faced with illness.  It now has a place among our top national priorities, but it also has important relevance right here at home, for patients in our own community.

As part of the president’s Precision Medicine Initiative, genetic information would be collected from as many as 1 million Americans, with the hope of developing personalized treatments to prevent and treat disease and to analyze a person’s complete genetic makeup quickly and affordably.

It’s individualized care, with data to back it up.

The topic was of particular interest during the Cleveland Clinic’s recent Medical Innovation Summit, where I had the privilege of listening to Leroy Hood, president of the Institute for Systems Biology and pioneer of the “P4” approach to medicine – essentially the means for moving the nation toward improved health and prevention of future illness. The four Ps of Hood’s P4 approach are: predictive, preventive, personalized and participatory.

Instead of reacting to disease, he said health care systems will soon access a “virtual data cloud” that will help lead the way to disease prevention. This gathering and utilization of highly-technical, predictive data using advanced technologies will help us gain insight into the early origins of disease, family genome sequencing, targeted drug therapies and the stratification of diseases, just to name a few.

At Mercy Medical Center, we are already heading down the path of precision medicine by identifying disease origins. Our oncology genetics program at the Hall-Perrine Cancer Center helps patients and their family members understand cancer risk factors based on genetic indicators and family history. This important information provides the basis for medical management options.

Mercy is also an active participant in dozens of clinical trials, including some with University of Iowa Hospitals and Clinics and the Mayo Clinic, giving local patients access to leading-edge cancer research and the newest treatment options.

When it comes to preventative and personalized care, look no further than the medical home model of care, of which Mercy was an early adopter. It’s a team-based approach to providing coordinated health care, and provides care from a relational perspective, beginning with a primary care physician and extending to affiliated hospitals and specialists.

Physicians, employers, insurance companies, the government, consumer groups and others are increasingly looking at this model as a potential way to make our nation healthier by preventing illness up front, therefore reducing costs and creating more value for the health care consumer. Fourteen of MercyCare’s affiliated clinics have received patient-centered medical home recognition by the National Committee for Quality Assurance.

At the heart of the medical home is a single, electronic medical record (EMR), which helps meet the challenge of managing and collecting health care data. Electronic health information systems, like the Epic system at Mercy and MercyCare Clinics, make it easier to collect, compare and share data by interfacing information collected from all points of care.

Epic manages detailed information with the ability to analyze trends resulting in improvements in care, such as fewer medication errors, shorter hospital stays, reduced infection rates and decreased readmissions. It also enables patients to become more engaged in their care, which speaks to the participatory element of Hood’s approach. Systems like MyChart personalize medicine, offering a secure and convenient tool to access and manage personal health information, such as test and lab results, health reminders and the ability to communicate directly with care providers. To date, more than 26,000 of our community members have signed up.

We know increased access to medical information and transparency is critical to health care consumers and helps support the choices they make. Five years ago, Mercy made a commitment to gather our own quality data, put it in a user-friendly format and offer it as a reference to the community for making health care decisions.

Our 2015 Quality Report has just been released. In it, you’ll find data-driven evidence of our nationally-recognized care. For example, Mercy’s cardiac team has reached a milestone in treating blocked heart arteries, beating the national standard in every heart attack patient requiring treatment for more than five consecutive years.

Access to that kind of data is also significant, in that other health care providers can draw from it to increase our collective “predictive” abilities.

This fresh approach to health care requires buy-in and engagement by patients, with the reward being stronger patient-provider relationships, more targeted care, better outcomes and lower-cost health insurance. With the foundation of Hood’s four Ps already taking shape at organizations like Mercy, there is much to build upon. Predictive, preventive, personalized and participatory medicine is a lofty goal, but it promises great rewards for those who embrace it.




Tim Charles is president and CEO of Mercy Medical Center.