November 26, 2013

GHRI’s next 30 years: Imagine personalized medicine, empowered patients, better health

For Group Health Research Institute’s (GHRI) 30th anniversary, we asked our faculty and staff: How will your work today influence health and health care 30 years from now, in the year 2043?

From averting deadly flu pandemics, to eliminating health inequities, to developing better treatments for diabetes, cancer, HIV, and dementia—their responses were both challenging and inspirational. One dominant theme: GHRI will improve care by tailoring it to the individual. Our practical brand of research will be part of health care’s next new paradigm—“personalized medicine” that empowers patients to take control of their health in an informed way.

With so much talk of “patient-centered” care, you might think American medicine is well on its way to customizing treatment for the individual and engaging patients in their own care. But in fact, most health care today is still based on treating society as a whole. At best, researchers determine which health risks are coursing through the population; then doctors recommend treatments to reduce those risks. If we learn, for example, that 75 percent of people with a certain condition respond well to a particular drug, the doctor recommends that drug, the patient tries it, and everybody hopes for the best. Each patient is treated as if he or she were the same. But in a system built to play the odds, outcomes are often hit or miss.

New studies in genetics and information technology

How can we develop care that’s better matched to individuals’ needs, risks, and values? That question is behind much of GHRI’s research. We expect the eMERGE study, for example, to lead to deeper understanding of genetic causes of illnesses like diabetes and heart disease, spurring discovery of treatments tailored to each patients’ genetic make-up. As one GHRI staffer predicted, someday DNA profiles on newborns may be used to customize plans that prevent illness and enhance life-long health.

GHRI’s research on health information technology may make future health care more personalized as well. Studies have already shown that smart use of electronic health records can help providers get information they need on each patient when they need it, reducing medical errors and improving quality and efficiency. Our research points to the power of sharing real-time biometric data (blood pressure, cholesterol, blood sugar, etc.) online to help patients manage their own chronic conditions. Such monitoring may soon become more sophisticated through the use wearable monitors and self-reported information submitted through smartphone apps that are integrated with patients’ medical records. This seamless monitoring will allow providers to help patients better manage their medications, quickly avert medical problems, efficiently diagnose and treat medical conditions, and reduce visits to the clinic or hospital.

This may sound like science fiction, but GHRI is already working on building blocks to such innovation. For example, we just received a new grant to develop a mobile-enhanced website that facilitates communication between providers and their patients trying to quit smoking. The goal? To personally address medication side effects that often lead to treatment failure.

Matching values and preference also matters

Of course, personalized health care does not necessarily require high-tech solutions. Our research into shared decision-making explores how providers can help patients to make treatment choices aligned with individual preferences and values. And our evaluation of the patient-centered medical home can help to ensure that patients have access to a team of providers who can help them make choices based on the patients’ own health care needs.

By the year 2043, many more people will be living into their 80s, 90s, and past 100 years of age. By being more engaged in care that’s more personalized, they will live not just longer but healthier lives. Thanks to our practical research, more will delay disability and dependency, staying active and vital until the end. One optimistic staffer even forecast that she and her coworkers would still be alive, kicking, and eager to attend the Institute’s 60th anniversary celebration. Sounds good to me. I hope all who read this message today will make it to the party, too!

Eric B. Larson, MD, MPH
Vice President for Research, Group Health
Executive Director, Group Health Research Institute