Mental and Behavioral Health Weekly - Week of February 10, 2020Read more...
Precision medicine starts at home; Healthcare AI to top $34B; More life data needed
We're focusing our brain cycles on precision health and medicine in late September. And as we push forward with this question about how to get to personalized medicine utopia, I've been wondering if this is achievable? It's like pursuing true love or perfect love. Does it exist? Of course, but it's a process that requires ongoing recommitment. Hence, it's imperfect.
To that end, precision medicine will never be perfect. It's a process that requires a person's constant buy-in to making the right decisions about his or her health.
Another way to look at this question about achieving precision medicine, we need to ask ourselves, what exactly does a world in which we have "precise" and "personalized" health and medicine look like anyway?
To answer that, we have to ask ourselves whether we are committed to healthy living? If you have diabetes and you don't manage your blood sugar levels, then no advanced personalized therapy will help. There's no magical precise cure or treatment if you're not helping yourself. If you have a mental disorder, having the right drug isn't going to magically save you from going off the deep end. Ultimately, it's up to you to learn how to manage stress, eat healthy, sleep well, etc.
To this end, as we strive to find more personal solutions, we cannot make it a savior. A lot of what's behind, at least chronic illnesses, has to do with how we behave, and how much we participate in our own well-being.
If you like what I said or disagree, or if you're fascinated with this topic and have some thoughts on the matter, then join our salon to take a deeper dive into precision health. And as I've done in the past, I'll collect some interesting research and information about the topic along with my opinions, so we can prepare ourselves for Sept 27's "SplashX Invent Health - Precision Health"
We'll have executives from UCSF, HP (a big self-insured company), Dignity Health; VCs from GE Ventures, Mayfield, DCVC, as well as tech pioneers from Helix, Virta Health and Bigfoot Biodmedical, and more. This is a mostly curated event, but we do have limited tickets for curious minds who want to join the discussion! JOIN US.
Precision medicine starts at home
Here's an awesome piece, titled "Lifestyle change as precision medicine" that challenges us to think about why "precision medicine" in the 21st century seems so elusive.
It does make me wonder: Why is it we can get a black car within two to five minutes to take us places, and shop online and pretty much find what we're looking for, and get it in a day or two? Why is it we can turn on Pandora, Spotify and Amazon, and find content that's pretty close to what we want and then go online and find the right biased news publication to feed our mostly bias views? Why is it we can achieve quite a bit, on-demand, but when it comes to healthcare, it's not close to what we think it should be?
The big problem, in my opinion, is we don't know what it is supposed to be.
This article written by Dr. Marcelo Campos, actually sheds some light on what it's supposed to be. He writes that a direct cause-and-effect for chronic illnesses rarely exists, unlike infectious diseases which can go away after taking out the bugs (virus, bacteria, parasites). But chronic conditions (cancer, cardiovascular, dementia, mental health) result from a complex set of factors. Standard-based care takes groups and applies treatments for that group. But inside those groups, there'll be a variety of different responses. It's a game of trial and error, not precision. But while scientists strive to understand personalization based on genetics and biomarkers, none of this fully matters. Here's his explanation.
"The reason is simple: we cannot prevent or reverse these diseases without a lifestyle focus. This may not sound as sexy as using the most advanced algorithm from the best artificial intelligence computer out there, but it does work for most of us. A good prescription to prevent and treat chronic medical problems would include: eating a non-processed, colorful, mostly vegetarian diet; exercising daily; getting plenty of sleep; connecting with friends and family; and setting up time for relaxation. Each of these strengthens the foundation of that web of factors that keeps us well. A healthier lifestyle supports and creates the resilience we need to sustain the inevitable exposure to life’s wear and tear.
"And it usually does not require the latest, most technological advancement in science, or the latest health fad trending in social media. Precision medicine starts by spending more time taking a look at what is on your plate, how much you move, and making sure you rest and sleep. I have seen many of my patients creating health and reversing chronic diseases using these tools. The challenge lies in changing behavior." The bottom line: Precision medicine starts at home.
Healthcare AI to top $34B in around five yrs
This just in! There's been an explosion of data. Duh. Yes. We know that. Just look at your phone and the number of photos in it. Collectively, we send 16 million text messages... each minute. Or look at the number of social media posts you wrote, commented on, and/or liked. All that is data collected. Now with Alexa and Siri, we're collecting the countless number of requests and questions, like "Alexa: What should I do if I get a bee sting?" Worthless? A lot of it. But useful woven into our personalized social tapestry to give us a good picture of who we are.
But I digress. We're talking healthcare here. What healthcare records are we collecting?
New genomic data (DNA), biomarkers (measurable indicators of a biological state, like blood pressure, Xrays, CAT scans), medical history (diagnoses, treatments, immunizations, lab tests), administrative and billing data to name a few.
All of this data requires AI (artificial intelligence) to make sense of this all. When I think of AI and data, I'm reminded of that Calgon commercial. "Calgon take me away!"
Research firm Tractica just released a report that estimates on AI spending to organize the data will top $34B in a few years. The top 10 use cases for AI include:
1. Medical image analysis
2. Healthcare VDAs
3. Computational drug discovery and drug effectiveness
4. Medical treatment recommendation
5. Patient data processing
6. Medical diagnosis assistance
7. Converting paperwork into digital data
8. Automated report generation
9. Hospital patient management system
10. Biomarker discovery
The current scope of medical data is too narrow
In healthcare, we're typically given a treatment that is one-size-fits all.
That's because we don't have enough data about a person to provide a tailored treatment or preventative care approach.
This is where more social determinant data comes into play. Some call it "life data." This data answers questions, such as does a patient own a pet, which can reduce stress, studies show. Other life data information includes, how strong are the patient's relationships with family and friends? How long has the patient been single, dating, married, divorced, etc. These are questions that play a role in a person's lifestyle and behavior. They play a role in the decisions about one's health a person makes. Yet, these are often overlooked, simply because we're such a symptom-focused culture.
This article suggests that this data would help fine-tune the interventions. I would have to agree. In my study of mental and behavioral health, the biggest problem with current treatments is that they're more designed for a broad population. They're designed to target a symptom, but not the root cause of a person's mental state.
So what does Sophie Okolo, a Senior Researcher at the Milken Institute say about the life data?
"Incorporating life data into data collection has the potential to create better individual preventive interventions, such as personalized, genomics-based guidance on areas including nutrition and exercise. These, in turn, can increase the human health span over the coming years. The use of life data encourages healthcare that leans more on prevention, wellness and scientific advancement, which are key health themes of the Milken Institute Center for the Future of Aging."
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