The Precision Decision

As part of my work and discussion around digital transformation in healthcare I am driven by a simple mantra "better access to healthcare, access to better healthcare".

Firstly, this two sided approach seeks to work at the intersection of healthcare delivery and technology to extend the reach and coverage of care teams. Secondly, the aim is to use the efficiency and superpowers of technology to bring better health to the masses.

One example of where both aspects come into play is around precision medicine. When we look at the macro-economics around health we see an ageing population, declining birth rates, and variability of investment as a %age of GDP. These forces converge into a system that has to be cost effective whilst at the same time being able to deliver for longer and increasingly having to address 'diseases of civilization'. Across Southeast Asia we are seeing a shift in cause of death towards non-communicable diseases, heart disease, obesity and type 2 diabetes, cancer, autoimmune disease among others.

With the body of work in pharmacogenomics we have an opportunity to better identify the possible interactions patients will have with their prescriptions, this will only lead to a better targeting and efficacy of treatment. This may be out of reach for many populations today but not for ever.

The Microsoft Genomics team have made great strides in reducing the time and cost of genetic sequencing. Within the context of Dr. Kevin Davies' book "The $1000 Genome" we are on the tipping point of something great that will bring precision medicine within reach of more people than ever before. We have come a long way in the 25 years since the Human Genome Project started. I can see a revenue stream for many private hospitals where they offer to profile you to help manage care over the long term. Something similar to 23andMe. When we roll this up at a population health management level I believe we will start to see patterns that can help even the poorest citizens receive better treatment and matching of big brand pharma and generics.

As we tackle the impact of cancer on society, having a richness of genetic information combined with depth of information on how to treat the specific of the cancer within the context of the specifics of the patient, success rates will increase. In the overlap of molecular and precision medicine tumor boards with care team productivity there are significant opportunities to move forward into the world where access to better healthcare becomes reality.