BOSTON--“We ain’t seen nothing yet. What soon will be ubiquitous will be mind-blowing,” said John Mattison, MD, CMIO and assistant medical director of Kaiser Permanente Southern California at the mHealth + Telehealth World 2014 on July 23.
“It’s hard to think of exponential change, we’re used to linear change,” he said. “We can’t even imagine now what it’ll be like in 10 years.”
In this new world, the $1,000 genome, EHR data, predictive analytics, microbiomics and persuasive technologies will take center stage. As such, personalized medicine will become a routine part of care. He cited researchers administering genome tests to select groups, like individuals with autism and schizophrenia, to better understand their causes. This work is just beginning, he said.
While the “science fiction generation” enjoys this rapid evolution in technology, it also presents an opportunity to restore the human touch to medicine.
“People don’t care how much the doctor knows until they know the doctor cares,” he said. While technology and data analytics require preservation, they should be pushed into the background to focus on the “ancient wisdom” of human connection and simplicity. “Stop talking about consumers and patients and start talking about humans.”
If a woman with appendicitis presents herself and a diabetes diagnosis looms, the goal is “how to take her genomic information and knowledge base of drugs, and counsel her on the best course for her objectives,” he said. Risk factors are embedded in genes, thus the outcome of any clinical test will be interpreted based on the genome and other highly personal traits of the patients. That could mean that what constitutes a normal blood pressure is different for everyone.
In the meantime, microbiomics “is finally getting its due” and its impact on research and healthcare is forthcoming. “There is an incredible interaction in biome,” he said. The microbiome of children who are five years old are different if the mother had a C-section versus a vaginal delivery, he noted.
Start-ups looking into micronome to propel personalized medicine are “deeply funded,” Mattison said.
As the future rolls out, mobile health extends will play a greater role in behavioral support. Part of this is patient access to their medical records.
Open notes is having a “profound influence,” he said. “Reciprocal transparency” is a part of the changes afoot.
With more data available, more needs to be done to protect privacy at the federal level, especially to ensure no discrimination takes place based on genome for all industries. Right now “you can’t de-identify data.” These protections are crucial to encourage individuals to share data for research, he said.
Advances in personalized data, as well as granular and analytical information on community and social determinants of health, means a whole new dimension to understanding personal data.
“All sources of complexity of a whole person’s data will grow by leaps and bounds,” he predicted.