A good friend of mine, a physician, once told me “healthcare would be great, if it weren’t for the patients.” She’s a remarkable physician, well respected in her field, caring, compassionate, and clinically brilliant. There’s a reality, however, that as we go from bench to in vivo trials to full scale clinical deployment, outcomes are more and more a confusing function of multiple factors, including the most mysterious and confusing of all . . . people! What my friend meant was that in the translation from clinical research to clinical practice, to reliably produce the best outcomes, we need a much more expansive view of what constitutes “best care,” in a way that accommodates environment, social support, behavior, habits, and the myriad factors that influence the effectiveness of a selected course of treatment.
As I write this article, I am sitting on a terrace in Cambridge, overlooking the Charles River. Google is three blocks away. Pivotal is six blocks away. And almost every major pharmaceutical company in the world has a major commercial center or technology outpost, either right here or within a 30 minute drive. Why?
I would argue that our focus has shifted from the microscopic to the macroscopic. Genomics and advanced diagnostic technologies have enabled personalized medicine that offer the right treatment to the right patient at the right time. Yet, there is still an immense opportunity for transparent communication with patients to enable holistic treatment approaches. Patient support and engagement models create avenues for a quantum leap in treatment effectiveness for therapies.
We expect to see a fundamental shift in our relationship with clinicians, patients, and insurers, in which the focus shifts from the molecule and its performance in research to the total patient care solution and its performance in practice.
What drives this shift in thinking, and enables us to approach our partners, patients, and customers in a new way is the innovation that you, as the healthcare informatics community, have participated in and driven, dating back to Larry Weed and Clem McDonald. Using the power of the computer to store, organize, retrieve, connect, mine, interpret, and predict, along with the power of the network to transmit, and innovations in devices and mobile communications to monitor and engage, you have created the information environment for vastly improved patient monitoring and support.