Personalised digital medicine and the behaviourome: the next stage of tailored care
By Dr Hakim Yadi, CEO Northern Health Science Alliance
Adopting a personalised medicine approach to the discovery and delivery of new drugs has become the gold standard in healthcare – so why is digital medicine being offered in the same ‘one size fits all’ way of yesteryear?0In the past ten years we have seen a shift from the traditional one size fits all view of medicine to a more tailored approach with patients now receiving medicines based on treatment decisions that take into account individual variability in genes, pathogen, environment, and lifestyle for each person.
To help with this seismic shift in the delivery of new medicines we have seen significant investment both here in the UK, with £100m invested in to the Genomics England 100,000 Genome project, and in the US, with the NIH investing £215 million in the Precision Medicine Initiative Cohort Program.
But up until now the precision approach hasn’t been considered for the rise in Digital Health. That’s about to change with Google this week investing £40m into Quartet Health, a US behavioural health start-up.
This should be welcomed with open arms – as a community we have been making the same mistake that less informed health practitioners made in the past – assuming the same digital solution will work for everyone.
In the past few years we have seen an explosion in new digital health solutions from biometric monitoring with commercially available wearables to apps that help record everything from a person’s mood to their blood glucose. These also introduce an element of ‘gamification’ to encourage you to eat less and be more active.
As the NHS and other healthcare provides get ready to test, validate and adopt these solutions we need to ensure that we are learning from the past.
Currently we use information on the gene expression profile of a cancer to determine what drug we prescribe or information on a patient’s genome to determine what dose of a medication to give.
We know that behaviours are clustered with diseases, for example new research from Newcastle University published in the BMJ has shown that people with CVD or Type 2 diabetes behave differently (the behavioural phenotype) – they sit more, move less, and have poor diet and sleep. The group showed for the first time that these behaviours are interlinked. This work shows that behavioural understanding is going to be important if we are to treat and manage disease.
So we need to look at someone’s psychometric and behavioural profile before prescribing digital health solutions. For example, if you are more competitive person who is constantly driven by targets and goals then you might respond better to a more gamified app than someone who is less competitive.
Quartet’s platform is powered by advanced data science algorithms that identify patients and physicians, matching the right patients with the right healthcare professionals. This helps to free capacity to meet the needs of a greater number of patients at the same time monitoring how effective treatments are.
In the future having information on the genome, proteome and metabolome will not be enough, we are going to need a way of understanding a patient’s behaviourome if we are to prescribe the most effective drug, device and digital solution to help manage or treat a patients condition.
The UK needs to act to make sure we’ve got the innovative computing companies, machine learning companies and psychologists to develop a new way of understanding the Behaviourome so that we can to use and prescribe digital health in the most effective way.