The next step in the initiative's precision opioid prescribing strategy is to incorporate patient socio-economic data along with their mental health history to give providers a more accurate picture of the number of opioids they need to prescribe. Kheterpal said the goal is to provide prescribing recommendations based on an individual patient's needs.
"Whenever I leave work I always turn on Google Maps, not because I don't know how to get home, but because it gives me a recommended pathway, tells me how long it will take, gives me an option B and an option C, and gives me information on why it's giving me those options," Kheterpal said. "We're going to offer both the provider and the patient a Google Maps for their healthcare, which is a series of choices to get from point A to point B."
Perhaps the greatest potential for the use of precision medicine toward advancing population health involves the ability to more accurately identify among entire populations the severity of specific health conditions, allowing healthcare providers to concentrate care resources more efficiently.
One of a number of projects conducted by researchers at the UPMC health system over the past year has been the development of a model to collect genomic data from 30,000 congestive heart failure patients. Through the use of a technique called precise genotyping, as many as 1,600 patients were identified as generating more than 40,000 hospitalizations in a year's time, which accounted for nearly half of hospital admissions for the entire patient group.
"We've added more precision to the understanding of who those heart failure patients are," said Dr. Oscar Marroquin, chief clinical analytics officer at Pittsburgh-based UPMC. "Now when a patient comes to our office we can identify who is a patient on the high-risk side of things or on the low-risk side of things, so that we can then more thoughtfully deploy tools we have available to better manage our patients."
Some believe precision medicine gets to the very heart of population health management by allowing clinicians to move away from simply treating a disease to prediction and prevention of disease. "We now have the ability to unlock a number of secrets that we didn't have in the electronic medical record," said Dr. Stephen Parodi, associate executive director for the Permanente Medical Group. As the physician practice arm of Kaiser Permanente, the group has more than 9,000 doctors overseeing the care of more than 4.1 million patients in Northern California.
Parodi said precision medicine lets clinicians see in real time how they are treating people, their health outcomes, and to identify the most effective treatments, something unavailable to most physicians just a few years ago.