Harvard Medical School’s Department of Biomedical Informatics hosted Precision Medicine 2018: Assembling the Puzzle, a forum to address the implementation and dissemination of precision medicine, in collaboration with Harvard Medical School, PIC-SURE, Amazon Web Services, Novartis, Datavant and Verily Life Sciences.
Tell me more about “precision medicine.”
In his welcome address, Professor Isaac S. Kohane, Chair of the Department of Biomedical Informatics, highlights, “…we mean taking an explicit multidimensional view of patients: not just one data modality such as genomics or environmental exposure. We argue that this perspective allows for more precise matching of humans to disease states (diagnosis), future disease states (prognosis) and appropriate therapies.”
And this mindset fueled the fire behind the day of discussion, with panels addressing:
- How Do We Overcome the Disconnect Between Patients, Clinicians, Insurers & Educators?
- Is Patient Leadership Critical?
- How Is Technology Empowering Precision Medicine?
We at HealthTech Venture Network took special interest in panel #3, regarding technology empowering precision med. Discussionists Andrew Beam of Harvard Medical School, Keith Dunleavy of Inovalon, Calum MacRae of Brigham & Women’s Hospital and Paul Varghese of Verily Life Sciences lit up the panel with knowledge and a refreshing back & forth. In introducing themselves, the panelists each brought enlightenment to the table, thereafter offering their input on inquiries from moderator and audience, regarding the current (and future) role of artificial intelligence (AI) in medicine.
The question which prompted the start of the session nodded at data collection, data curation, analysis & analytics and physician behavior, surveying each member on which aspect they feel serves as the “stock point” in advancement?
For Varghese, it’s about behavior. “I think changing behavior is going to be the hardest challenge,” he said, referencing the importance of (yet often lack of) following up with data after technology is released into the world. Take the Apple Watch, he highlighted, in that “50% of Apple Watches are sitting in someone’s drawer somewhere.”
“It’s not enough to show up with a device; we need to pay attention to how that person is using it,” he said. According to Varghese, you need to make the value “as transparent as possible. Then, you have to show that it’s trustworthy… We need to tie it [the product] closely to people’s motivations,” he addressed.
Shifting the mic to MacRae, he was quick to agree. “Fundamentally, the behavior aspect is hard to change… almost everyone, I think, fails to realize the behavior that most needs to be changed is physician behavior… it can be tough to convince the professional that something is worth testing.”
“We’ve based our system on the idea that ‘health is the absence of disease,” he said, and the nods of approval from the audience reiterated the core purpose of the conference. “I think the problem is that once we have the evidence, we tend to resist it… We have almost an artisanal care,” said MacRae.
And Dunleavy’s mindset is not far off. He highlighted the patient/provider disconnect, pointing to the issue of mixed leadership – in that many leaders of the most powerful entities in medicine are not actual physicians, they’re CEOs.
“Is there a different way that a physician thinks than a CEO?” he asked. As a physician himself, he attested, the concept of the null hypothesis – above all else, do no harm – is too often at play. “I don’t know if we innately feel that way or we were taught that way… A room of physicians will turn down an approach if it does good for 99 people, but doesn’t solve it for one,” he said.
“The healthcare system at large needs to go through a massive behavioral change.”
“How many times does a physician treat a viral infection with an antiobiotic? How many times do they find nothing in a head CT?” he surveyed. He highlighted that physicians are too often OK with dramatically poor specificity of healthcare, “yet if someone walks in with an analytic solution that solves something 83% of the time, they’ll ask about the other 17%,” he said. “The healthcare system at large needs to go through a massive behavioral change.”
Last up, Beam stood in general unison, yet highlighted how “changing behavior is difficult, but not all behaviors are difficult to change.” He encourages the powers that be to leverage “the way people move through the world and how they work” as a way to mold new behavior – which served as a refreshing way to wrap the topic, addressing the apparent need for modification while providing actionable steps to boot.
And upon our reflection and recapping, we feel enthused to see such motivated individuals in the sphere, helping bridge the gap between patient and provider, educating the network in need. We send huge thanks to all involved in this day of innovative and progressive discussion, as we look forward to fostering further advancements in the use of technology to constantly enhance the medical space.
For more information on Precision Medicine 2018: Assembling the Puzzle visit the event page here.
Photo coverage by Oussama Ourich