Personalized medicine and public policy

The most obvious intersection between IT and the Obama Administration's health care policy agenda lies in electronic health records, a technology of whose importance they seem well aware. But IT has at least a peripheral connection to a second change of similar magnitude – personalized medicine. To his credit, then-Senator Obama seems to have been all over this subject. I hope Obama and his team maintain their commitment to personalized medicine post-election.

Since the dawn of medicine, there have been relatively few therapies for any given disease or other condition. Physicians have chosen among that limited range based on what they could observe about the patients symptoms, general health, etc. The promise of personalized medicine is to add huge amounts of important new data to their decision-making, such as genetic analysis.

One reason I'm mentioning personalized medicine in an IT publication is that the whole prospect is driven by Moore's Law. Indeed, the Harvard Medical School researcher who first brought home its importance to me tends to frame it as "research tools moving into clinical use." Basically, what was once affordable only for research will soon be used in production as well, mirroring the path followed by many other technologies (such as scientific workstations, to name just one).

A second more specific connection between IT and personalized medicine lies in the area of electronic health records. Think of what you want to do with EHRs anyway. Now add in genetic information. Now further consider how hard it will be to evaluate the efficacy and safety of customized therapies. The EHR challenge is even bigger than it at first might seem.

As a first pass, public policy challenges I see related to personalized medicine include:

  1. When you start tracing people's genetic information and the medical implications of same, privacy issues get really important. Or, rather, government needs to ensure protection against the misuse of very personal information even as it is ever more widely held.
  2. Personalized medicine will accelerate the trend away from blockbuster drugs. Policy regarding drug companies needs to deal with that.
  3. Regulatory agencies will need to have more gradations of approval, in terms of which therapies are approved vs. experimental vs. utterly forbidden. Insurers will have to be more supportive of experimental therapies as well.

Related links

Are there any other policy points we should call out? Please comment, whether below, or else directly to http://www.change.gov, or in some other venue of your choice! More ideas about how to participate in the discussion are outlined in my overall healthcare discussion introduction post.

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