Precision Medicine at the Point of Care
By: Andrew Ury MD, Chief Executive Officer, ActX
In the clinical setting every patient is unique, no one patient is truly an “average patient.” Up until now, our healthcare system has largely focused on treating the “average patient,” without the ability to fully consider what makes us unique from a medical perspective. Innovation in healthcare is essential if we want to stop treating patients as averages of a population, and instead treat them as unique individuals. For example, by personalizing which medications to prescribe, medications that will not work for the patient or could cause adverse side effects can be avoided. Today, Americans are taking more prescription medications than ever before, an average of four per adult and individualizing medications to the patient is becoming even more paramount. Likewise, if we could better individualize preventative screening of patients based on their personal risks, we will be more effective at preventing serious illnesses.
Precision medicine, which takes patient genomic and molecular data to provide targeted therapy and prevention, is now becoming a reality in the clinical setting. Aided by rapid advancements in technology and lower costs of genetic sequencing, there has been an explosion of medical knowledge worldwide. In 2003, to sequence the first human, it cost $2.7bn, but today the cost has been reduced by a factor of 100,000.
Even though our medical knowledge has rapidly expanded, we have to find a practical way to include precision medicine in routine medical practice. The most effective way to do this is to build precision medicine into the normal physician workflow at the point of care. What that means more specifically, is that genomic decision support should be embedded inside the electronic health record (EHR).
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I was one of the early EHR pioneers at a time when most people thought EHRs were not yet feasible. I saw first-hand how a well designed and implemented electronic record could substantially increase preventative screening and improve care.
Today, it is practical to embed decision support based on genomics into the EHR. Prescriptions can automatically be checked as they are written for efficacy, adverse effects, and dosing based on the patient’s genetics, and physicians can be alerted for evidence based, actionable genomic risks like certain cancers and cardiovascular diseases.
With precision medicine at the point of care, we can fully embrace the notion that every patient is unique and should be treated as such. The end result will be a healthier population and a new standard of medical care.
About the Author:
Andrew Ury MD, Chief Executive Officer, ActX
ActX was founded in 2012 by Dr. Andrew Ury. Dr. Ury founded and was CEO of the first commercial Electronic Medical Record (EMR) company, Practice Partner, in 1983. Practice Partner became one of the most widely used EMR’s in the United States and received multiple TEPR Best Electronic Medical Record (EMR/EHR) awards. Practice Partner was acquired by McKesson, a Fortune 15 company, in 2007. Dr. Ury initially was a VP/General Manager at McKesson and then became Chief Medical Officer at McKesson Provider Technologies. Dr. Ury left McKesson in 2009 to found Aucolla.
Dr. Ury is the co-founder of one of the leading practice-based research networks, PPrNet. He has served on advisory panels for the Agency for Healthcare Research and Quality (AHRQ), the National Quality Forum (NQF), and the Joint Commission. He helped found and was twice Vice-Chair of the Electronic Health Record Association (EHRA). He was one of the first Commissioners of the Certification Commission for Health Information Technology (CCHIT). He was the Ernst & Young Northwest Healthcare Entrepreneur of the Year in 2002.
Dr. Ury did his Residency at the University of Washington and is a graduate of Stanford Medical School and Yale University. He has practiced medicine on Vashon Island and in Seattle.