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September 07, 2019 01:00 AM

Commentary: Don’t let technology disrupt personal connections with patients

Douglas M. Silverstein
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    Douglas M. Silverstein

    Douglas M. Silverstein is president of Evanston (Ill.) Hospital, part of NorthShore University HealthSystem.

    Technology, scientific breakthroughs and digital tools are changing the way we approach medicine and presenting new ways to inform and advance patient care. As technology improves and our reliance upon it grows, it’s critical that we remember the importance of the personal connection, keeping the provider-patient relationship at the center of effective and compassionate care.

    Finding the sweet spot where innovation brings value to both the patient relationship and the care of the patient, versus becoming a distraction, can be a challenge. Research, such as a three-year review of patient-safety reports in or near Pennsylvania published in JAMA in March 2018, has shown that even core tools such as electronic health records can generate as many issues as opportunities when they are not integrated or designed with a personal focus. A forward-thinking approach to place the patient at the center of science and technology investments is critical to the future of medicine.

    At NorthShore University HealthSystem, we’re working to identify and integrate technology with the approach of enhancing and informing the relationship, and the ultimate goal of adding value to the care delivered. A key area where this comes to life is through the Mark R. Neaman Center for Personalized Medicine, where we have been integrating genomic medicine into both primary and specialty care. By integrating personalized medicine into every step of a patient’s care journey, we create the opportunity for more informed and personal clinical care.

    As the executive sponsor of the personalized medicine program administratively, I am amazed by the science and the technological advances in this new arena. However, not until the insights and experience became personal could I truly appreciate the value of this approach. Recently, I was one of the first patients to engage in our DNA-10K pilot program, created in partnership with Color, a California-based developer of physician-ordered genetic testing and whole genome sequencing.

    Through this program, 10,000 eligible NorthShore patients can access clinical-grade genetic testing and whole genome sequencing during their primary-care visit. The results are then included in our EHR and can guide patients’ care and prevention decisions now and in the future.

    Participating in DNA-10K opened a wealth of insight to inform my care, along with that of my family. However, it was the collaboration with genetic counselors and my own primary-care physician that allowed me to understand and interpret the information in a way that enhanced my care, made me a more educated patient, and provided important information for my family.

    Testing confirmed an increased risk for colorectal cancer, information that will shape my diet and future screening schedule in collaboration with my physician. Pharmacogenomic information provided insight for how I metabolize certain pain medications, which is now noted in my EHR and integrated through clinical decision alerts and will guide dialogue and care collaboration with my current and future care teams.

    Moreover, my results were the motivation for my sibilings to seek testing to confirm their own risk factors. My sister discovered she has the same increased risk for colorectal cancer and also changed medications based on her pharmacogenomic results. This comprehensive approach is extremely valuable as we approach the family as the patient.

    Technology and leading-edge scientific platforms in healthcare settings should not simply be about the latest and greatest, but about finding ways to bring value, insights and enhance all aspects of care, especially the “old-fashioned” patient relationship. Genomic medicine, integrated at a systemwide level with informed providers and genetic counselors, demonstrates an opportunity to deliver that sweet spot of innovation and personal connection.

    As hospital and health system leaders look to the future and the continued adoption and integration of technologies and platforms, it is important that we assess the value these technologies bring in a variety of ways. Not just the role they play in treatment and clinical decisions, but how they can support, and not hinder, the human interaction.

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