Pathologists are leveraging data in ways that truly advance the promise of precision medicine. The evolution of the term precision medicine was a direct reflection in the progression in clinical accuracy that was taking place. Now, through increasing volumes and varieties of clinical data, pathology informatics has taken flight as an emerging discipline that can further add to the potential of precision medicine in the laboratory setting.
The current definition of precision medicine refers to “a revolutionary approach for disease prevention and treatment that takes into account individual differences in lifestyle, environment, and biology.” So, how does the inclusion of all of these different datasets allow us to deliver a more precise diagnosis and treatment to patients? First, it is important to fully understand the difference between the definitions of precision and accuracy to fully comprehend the importance of precision medicine and the goals of the health system.
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Accuracy refers to a specific measurement, or how close something is to the truth. Precision, on the other hand, describes a measurement system — or the ability to consistently deliver the same result over and over again. A measurement system can be:
- Accurate, but not precise
- Precise, but not accurate
- Neither
- Both
So how does the definition of precision reinforce what precision medicine should be?
It can be difficult to think beyond the aspirational concept of precision medicine. However, by focusing on the incremental improvements that occur on a daily basis, we are able to move from hype to reality. As the industry gains a better understanding of more effective ways to provide care through these data-driven insights, clinicians can be more precise in their care. A great example of this can be seen in the behavioral health sector. A large percentage of clinical interaction in this setting is through verbal communication about how a patient is feeling or what they are thinking. This is why the ability to mine the unstructured data of clinical notes is essential to analyze predictive indicators.
In other large organizations, precision medicine is being applied to address the challenge of big data analytics by providing clinical relevance and improved data presentation to clinicians based on illness type. Patient-specific analytics are driving a new level of precision in mining, manipulating and presenting the volumes of available data to clinicians in ways that can be readily interpreted and leveraged. In short, more relevant data and better presentation of that data is helping to make clinicians more precise.
Precision medicine is also making headway in diagnostics, with radiologists noting the need for expanded clinical context in order to improve the precision of their work during RSNA 2016. As stated by the VA Maryland Healthcare System’s Chief of Imaging and University of Maryland School of Medicine Vice Chair of Radiology Dr. Eliot Siegel, reimagining how radiologists consume information from the electronic health record (EHR) and other sources is precision medicine:
“I want to be able to combine genomic data and personalize the way I take care of patients, and have that information in front of me, information from the EMR but also from other sources. And I want that information available in real time. As I go to read a study, I want all that clinical information available at that moment. It’s that ‘mission briefing’ concept that was mentioned a few moments ago. And I want to be able to deal with the complexity and volume of information systems right now.”
A very similar future is evolving for laboratorians as they move to change the model of “order in, result out.” As noted by my colleague Martin Wilkinson:
“The urgency for change is critical, particularly now with the increasing demand on our healthcare services. To achieve this we must take laboratory systems away from being islands, a back office function and a support for clinicians, to a more clinical, front of house, engaged clinical service. And by creating this change, pathologists can be provided with the information they require, along with clinical indicators, to make decisions as to when appropriate tests are required for patients.“
It is this exact need that will make precision medicine in laboratories a reality.
In each of these sectors, precision medicine is taking shape with clinicians being able to deliver more precise care as a result of expanded information. For laboratorians looking to expand their view of the patient beyond the lab, the ability to see how expanded holistic patient information fuels precision medicine is a critical next step. Precision medicine in the laboratory setting is more than just lab results and genomic data; it is all of the data that can be obtained about a patient from their lifestyle and demographic to their genome and clinical record. That is what will drive the idea of precision medicine and more precise laboratory decisions forward.
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