In-home healthcare is easy to understand. But a second major trend, often called Precision Medicine, is a bit more abstract and potentially troubling.
If in the future, healthcare will be more precise and customized to each individual, does that mean our current healthcare system is often inaccurate and sloppy? Consider that most of the medicines on the market today were tested only on white men, and some are known to be ineffective for women or for African-Americans. Consider also that relatively few rural hospitals have doctors with leading-edge expertise in interpreting today’s high precision CAT scans or MRI scans, and that almost no doctor—even specialists—can keep up with the torrent of medical research, so as to apply the latest knowledge to a patient’s troubling condition.
Precision medicine will mean that virtually every patient diagnosis and treatment plan will start with that patient’s genetic make-up. It now costs less than $1000 to analyze and record your genes, and with newer automated sequencers that cost is expected to drop to $100 in the near future. Insurance companies will pay for it, because it will enable better preventive measures for any health conditions that you are susceptible to and more accurate prescribing of medicines or therapies for your genetic makeup. New databases will contain detailed maps of which genes are turned on—producing proteins—in which cells of your body, so medicines can be tailored to attack only where they are needed. Artificial intelligence tools will help any doctor not only read scans more accurately, but interpret and apply your genetic data, presenting symptoms, and the most recent medical literature to suggest further tests or guide treatments. New types of sensors will be able to non-invasively monitor blood sugar or detect subtle changes in the biochemistry of your sweat and relay that data to your smart phone and hence to your doctors (or their digital assistants).
Precision medicine then will be all about data—your data, along with that of millions of others. Will privacy controls be adequate to insure that data is not mis-used by insurance companies (who might like to screen out people with a genetic predisposition to, say, heart disease) or by potential employers? Will pharma companies do the extra work to test potential new drugs on people with many different genetic make-ups—and will they be required to share all of that data with regulators? At the same time, better diagnostic tools with AI (artificial intelligence) may help to point out possibilities or concerns that your doctor or your home-care visiting nurse might miss, and suggest medicines that might work better for you. All this will hopefully bring better care to all, including those who live in rural areas such as the Eastern Shore of Maryland.
Title image: Sunset at Eastern Neck National Wildlife Refuge, Kent Co. Photo: Jan Plotczyk