There are some monumental shifts occurring in health care. One of the most exciting is the field of pharmacogenetics. Pharmacogenetics is the field where your personal DNA is evaluated, and it can be determined what medications will work best for you. This evaluation with a precise treatment recommendation is also called “precision medicine.”
Precision medicine is a direct result of the Human Genome project. The Human Genome Project began sequencing in 1990, and by 2002 the entirety of all the genes coded for in a human was mapped and recorded. We discovered that humans have almost 21,000 different genes that make us who we are.
According to the National Human Genome Research Institute: “The Human Genome Project (HGP) was one of the great feats of exploration in history — an inward voyage of discovery rather than an outward exploration of the planet or the cosmos; an international research effort to sequence and map all of the genes — together known as the genome — of members of our species, Homo Sapiens.
“Completed in April 2003, the HGP gave us the ability, for the first time, to read nature’s complete genetic blueprint for building a human being.”
We now know that there are variations in the way our genes make products that influence how we respond to medications. Over 95 percent of people have some variations in how they process medications.
I often tell patients that if you go to a public place like a mall and look around, you will see people of all different sizes, heights, colors and shapes. Just as people appear different, they can also respond to medications (slightly) differently.
In some cases, the genetic differences can cause the medications not to work very well, or cause them to get eliminated from a body too fast, so they are not very useful. In other cases, the differences can cause the medications to remain in our body too long or at levels that are too high and can then create unwanted harmful side effects.
Pharmacogenetics has the promise to evaluate your DNA and genetic profile to suggest the appropriate medicines at the correct dosage and at the exact right time. Pharmacogenetics will enable patients to minimize or even eliminate side effects while taking the most effective and best medication available to them.
Physicians and researchers are continually updating and refining information on human genetic profiles to develop better medicines and recommend the best medications for patients. This process gets better every month.
Almost every disease can be better treated with precision medicine. This includes treatments for cancer (as we discussed in “Good news: We are winning the war on cancer,” Spokesman-Recorder, January 2018), heart disease, diabetes, cardiovascular disease, obesity, depression, and transplantation medicine, just to name a few.
In addition to precision medicine, a revolution is occurring when it comes to doctor visits. This revolution comes from what we call telemedicine or telehealth. As one example, there is a company (Tyto Care) that has developed a small set of medical instruments that can be used by almost anyone with ease to take someone’s temperature, look into their ears, eyes, throat, at their skin and moles, and listen to their heart and lungs.
This information is recorded and directly connected to an app that keeps the data securely in the cloud and is available for a doctor to review. Think about it: When you or one of your children is sick, the last thing you want to do is trudge to and sit in a doctor’s office, around other sick people, waiting for help.
In the future, the system may also be able to evaluate different health aspects like blood profiles (e.g., sugar levels, etc.) using infrared sensors, avoiding the need for blood pokes. The whole exam can be done in your child’s bedroom, and the doctor will have enough information to quickly and conveniently make a correct diagnosis and suggest the best treatment plan.
The medical instrument home kits will have a price point of just over $200, but like all things, the price will come down over time. More information and pictures can be found at Tyto Care.com.
Now, let’s add another player to the mix. Recently there have been rumblings that Amazon may enter the pharmacy arena. In fact, the company has secured pharmacy licenses in several states, but Amazon will not currently comment on this.
A recent FoxBusiness.com article stated, “This is UberEATS for health care,” imagining a future where a patient uses telehealth services (e.g., Tyto Care) to visit with a doctor, and Alexa begins filling the prescription as it is given, using the lowest available price points. Amazon can execute deliveries in many cities within one to two hours, while consumers never leave the comfort of their homes.
“That could blow the entire [healthcare] ecosystem apart,” according to the article.
Access to medical records
Finally, two more exciting developments are occurring. Both Apple and Google have announced that they are interested in developing healthcare record platforms that are uniform so that a patient’s electronic medical records can be accessed anywhere at any time.
IBM has already provided the super-computer, Watson, to both physicians and hospitals to act as a consultant, scanning millions of scientific and medical articles, in seconds, to assist with new treatment recommendations for rare diseases. It’s only a matter of time before Watson will be helping with more common yet challenging medical cases.
I should point out that, first and foremost, we must develop and secure the appropriate consumer protections, privacy, and care protocols for patients. That being said, the future of medical care is both exciting and bright.
Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.