By Arundhati Parmar, MedCity News | January 10, 2018
The founding dean of the nation’s first college of population health explains that precision medicine and population health are in reality synergistic concepts.
Precision medicine is using knowledge about a person’s genetic code to tailor treatments to that individual for the most optimal outcome. Think of sequencing tumors and then determining a treatment regimen based on biomarkers or genetic variants.
Population health is to evaluate ways of improving outcomes for a defined population whether by geography or by disease category or maybe both. One example could be Geisinger’s Springboard initiative in Scranton, Pennsylvania which among other things is addressing the social determinants of health.
On the face of it, they appear to be mutually exclusive and even at odds with one another. You have a n of 1 for precision medicine while n could be in the thousands or more for population health programs.
However, on the penultimate day of the annual J.P. Morgan Healthcare Conference in San Francisco, a well-known population health expert argued that the opposite is true.
“We actually believe at the nation’s first college of population health that [precision medicine and population health] are totally synergistic concepts — they work together,” said Dr. David Nash, founding dean of the Jefferson College of Population Health, Thomas Jefferson University in Philadelphia.
Nash added he believes this to be the case because precision medicine could help to identify those small segments of the population that may be at risk of a rare disease, or who might need education and additional screening so that they don’t become prey to a chronic or fatal disease.
“I know sometimes in lay press there’s a notion that they are at loggerheads — precision medicine and population health. I am so happy to be a part of this panel to say ‘No, we see them as absolutely complementary.’ ”
The JPM panel, moderated by CNBC Reporter Christina Farr, was broadly focused on the promise of precision health and whether it will become mainstream this year. It also sought to make a distinction between consumer-directed genetic tests such as 23andMe and Ancestry.com, which offer genotyping tests with the more comprehensive whole genome sequencing offered by the likes of Color and Helix. Genotyping analysis does not analyze every single base pair of the 3 billion base pairs in a person’s DNA while whole genome sequencing does.
In fact, in an announcement Wednesday, Illinois-based NorthShore University Health System announced that Color, based in San Francisco, has been selected to sequence the entire genome of 10,000 patients. The partnership claims to be the single largest example of a primary care-based genomics program in the U.S.
Previously, a pilot program saw 40 percent of eligible people sign up to be sequenced using Color far outstripping expectations for the pilot, per the news release.
Kristen Murtos, chief administrative and strategy officer of NorthShore Health System, who was also on the JPM panel, explained that the patient data from the Color sequencing tests would be integrated with patients’ medical records.
That is significant.
In many cases, consumer genetic tests are not integrated into a person’s medical record, thereby preventing a more comprehensive and holistic picture emerge for an individual’s profile.