Precision Medicine: The Approach, Initiative, and Practice


What is Precision Medicine?

Precision medicine is an emerging concept for treating and preventing diseases. It takes into account the variability of each individual in their lifestyle, their environment, and in their genes. Proponents hope this approach will enable researchers and doctors to become more accurate in their prevention and treatment strategies, recognizing that a disease works in a particular way within a certain group of people.

This approach is in stark contrast to the “one-size-fits-all” model most commonly seen today. Currently, disease prevention and treatment strategies are established based on the average person, placing far less emphasis on what differences there are between individuals.

The term “precision medicine” is a new one – you may have heard it called “personalized medicine” or "shared decision making" in the past. But the actual concept behind this innovative new approach is something that’s been part of healthcare for many years. When you need a blood transfusion, for example, you aren’t given blood from a random donor. Instead, the blood type of the donor is matched to yours to reduce the risk of complications.

Even though there are several examples of this approach, precision medicine is still limited within day-to-day healthcare. Experts believe, over the coming years, this approach will become much more common.

The Precision Medicine Initiative

At the beginning of 2015, a research effort focused on bringing precision medicine to a variety of different areas of healthcare was introduced by President Obama. Then, in 2016, $216 million in funding was granted to the Food and Drug Administration (FDA), the National Cancer Institute (NCI), and the National Institutes of Health (NIH).

Short- and long-term goals were introduced in this initiative. The short-term ones are to develop how precision medicine is being used in cancer research. At the NCI, researchers hope new and more effective treatments will be developed for a variety of different cancers by using their increased knowledge on the biology and genetics of the disease.

Learn about Precision Medicine in Cardiology

The Precision Medicine Initiative’s long-term goals are to bring precision medicine to healthcare and health on a vast scale. To achieve this, the NIH has introduced the All of UsSM Research Program, which involves 1 million volunteers from all over the United States. To reflect the population’s diversity, participants will be enrolled from a range of economic, geographic, ancestral, ethnic, and social backgrounds, from all health statuses and age groups.

All the information collated from this initiative will provide researchers with a powerful resource allowing them to understand how diseases occur, better predict the risk of diseases, and find improved ways of treating and diagnosing these diseases. The program with focus on both the disease and how changes to an individual's lifestyle can increase overall health.

The Benefits of Precision Medicine

The approach of precision medicine and the Precision Medicine Initiative holds much promise for improving many different areas of healthcare and health. Some of these benefits will be witnessed soon while others will be more apparent in the coming years.

Short-term benefits of precision medicine include:

• Designing new tools for sharing, analyzing, and building large sets of medical data

• Creating new approaches that protect participants’, in particular, the confidentiality and privacy of their data

• Establishing new partnerships between scientists from a plethora of specialties, alongside people from pharmaceutical companies, universities, patient advocacy community, and more

• Improving FDA oversight of drugs, tests, and other technologies in order to support the innovation of these while making sure these products are effective and safe

• Presenting the opportunity for a million people to be involved in advancing scientific research

Long-term benefits include:

• Enabling doctors to use the genetic information (and other molecular forms) of patients to perform routine medical care

• Improving the ability to accurately predict which patients will benefit from specific treatments

• Increasing the understanding of how diseases occur through underlying mechanisms

• Improving the approach to diagnosing, preventing, and treating a whole host of diseases

• Integrating electronic health records (EHRs) better into patient care, allowing researchers and doctors to access medical data with ease

Precision Medicine in Practice

Dr. Aarush Manchanda is a firm believer in precision medicine. He feels as though this approach offers better care for patients than “one-size-fits-all” instructions because patients aren’t just a standard set of symptoms. That’s why, as a leading cardiologist, Dr. Manchanda has developed what he calls the Artisan’s Approach. This offers a means of empowering and treating patients, recognizing that each patient is an individual with heart issues specific to them.

In his book, Your Heart House: An Artisan’s Approach to Understanding Heart Health, he suggests, “Artisans work at their craft by hand. There’s a personal touch to their creations, and no two are exactly alike. Similarly, no two patients are the same, and as an artisan, I’m not content to follow a cookie-cutter treatment plan. Rather, I think outside the box, looking for ways to effectively address patients’ heart health and involve them in their own care.”

And because the heart is one of the body’s most complex organs, Dr. Manchanda feels it’s important for patients to understand how it works. Using his artisan’s approach, he is able to digest complex information about heart health in order to share this with his readers, and make it much easier to understand. He uses his Heart House analogy to describe the functions of the heart and the problems that can occur.

He explains to readers that, just like your house, your heart can develop various problems. For example, there may be a problem with the “doors” when you have a heart murmur or there may be an issue with the “plumbing” when you have a heart attack.

By providing both patients and cardiologists with this analogy, Dr. Manchanda is removing the disconnect many patients feel when they visit their heart doctors. Making medicine easy to comprehend enables patients to become involved in their own health, and to fully understand the finer details that could lead to better results and treatment plans.

All of this contributes towards precision medicine, as it helps to create shared decision-making between the patient and the doctor. This provides a better outcome for all involved because it removes the standard checkboxes we witness today, and instead creates a personalized approach unique to each patient and their individual case.