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Electronic medical records lead the way to precision medicine

Technology has radically transformed healthcare over the decades to the point that even a pen and paper has given up its position in the exam room to a keyboard and computer. Especially within larger healthcare systems, electronic medical records (EMRs) dominate as the storage platform for patients’ health data and doctors’ notes. This increases the opportunity between providers for collaboration and for patients to monitor their own records.

As NPR explained on January 9, 2017 during Morning Edition, EMRs also provide a large pool of health data that can inform health trends and patterns. For example, if a 40-year-old, African American patient of average weight presents with Type II diabetes, then an analysis of the EMRs of Type II diabetes patients of a similar age, race, and weight can more specifically predict certain treatment outcomes for this patient. EMRs can also create trends showing the emotional states and clinical outcomes of similar patients who chose certain treatment routes. Overall, this type of data analysis can assist patients and providers in making personalized health decisions.

Of course, the quantity of data EMRs can deliver is limited by patients’ willingness to provide information. There comes a point when a patient no longer wishes to answer more questions about his or her treatment. As another obstacle, healthcare practitioners vary in how they enter the data into the EMR or how they describe certain conditions. For instance, physicians could differ on the definition of an “extreme tremor.”

A cornerstone of precision medicine, genetic information in EMRs takes the technology’s power to the next level. Information from genetic testing provides a valuable set of data to predict a patient’s susceptibility to inherited diseases. Currently, some patients have genetic testing data, but many do not because of a lack of immediate need and/or the cost of the test, which can be up to thousands of dollars. However, as the technology improves, the cost of genetic testing will decrease and more patients will take part in genetic testing.  

Even if a patient has genetic testing done, physicians do not always know what to do with the results because not all genetic variants are easy to spot. Only about 3.5% of patients in a study led by researchers at Geisinger and Regeneron had easy-to-determine variants, but the investigators expect that percentage to grow to about 5-10% as more genes are identified.

This use of medical data is on track with the federal government’s precision medicine research program, “All of us,” which seeks to gather lifestyle, environment, and genetics data from a million volunteers to consider individual variability when treating disease. EMRs have yet to reach the pinnacle of their utility  in precision medicine, but research is underway to reach that point.

Read more: http://www.npr.org/sections/health-shots/2017/01/09/508241690/electronic-health-records-may-help-customize-medical-treatments

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