#EAPM - Key messages to modernize and optimize health care

The personalised health-care era is well-and-truly with us, now, but not only is it proving difficult to embed these new methods into the EU’s under-pressure and often out-moded health-care systems, even its preventative side is proving difficult to get across, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

Personalised medicine is based to a great extent on the giant leaps in genetics that we have seen in recent years, which allow for targeted medicines and individualized treatments – putting the patient at the centre of his or her own health care.

Yet there is a huge preventative side to this, also, which involves not only bringing health-care professionals up-to-speed on options available, encouraging them to engage in meaningful dialogue with those in their care, but also educating patients to take more responsibility for their own well-being.

Prevention as a societal need

Certainly citizens ignoring messages is nothing new. After all, there is probably not one person alive in the developed world today who is not aware of the proven dangers of smoking, and that lung cancer is a massive global killer.

We can bombard society with messages in this regard, stick disturbing pictures all over cigarette packets, whack up taxes every year, ban advertising, make puffing away in bars, restaurants and other public spaces illegal, and even take the branding away to make smoking ‘less glamorous’… We can do, and have done, all this. Yet still people smoke.

Nicotine addiction is a hard habit to break and, while all this information is out there alongside e-cigarettes and nicotine gum, for example, for many sheer will-power is not enough. Smoking may be a bad lifestyle choice, but it is still a lifestyle choice – despite the proven dangers.

The jury is still out on what comes next, but there are growing calls to ban the use of tobacco altogether – although the likes of Phillip Morris et al would have plenty to say about that.

Meanwhile, there is growing global problem in respect of obesity. Cheap, unhealthy fast foods are certainly convenient, but when eaten all the time and coupled with a lack of exercise, they can lead to low self-esteem, mental health issues, heart disease and more.

Exercise, or its lack, is now a huge problem, with children sitting on computers and phones rather than taking part in sports. Meanwhile, how many parents who started a diet on New Year’s Day are still on it? Not so many…

What we have in many respects are two or three now-now-now generations indulging in unhealthy lifestyles, and the plain facts are that our health systems cannot cope today, with the issues only set to get bigger as we move into tomorrow.

Some pluses and minuses of health-care advances

Giant leaps in medicine and innovative treatments have meant that most of us will live longer lives. That’s obviously a good thing, but it brings huge problems.

Many of us will spend our latter days suffering from not one but several chronic diseases - diseases that by themselves were often killers in the past, but now can be ‘managed’ in many cases.

The trouble is, this all costs money and, with a falling birthrate, this means we have to work longer and pension systems’, as well as hospitals’, general budgets coupled with over-worked healthcare professionals are creaking under the growing strain.

Keeping patients out of hospitals

Prevention is clearly one way to do this, and screening programmes have shown themselves to be effective in, say, breast and prostate cancer, although many will argue that this can lead to over treatment, which brings both human and financial cost.

But results have shown that screening programmes are largely beneficial – and could certainly improve mortality rates in lung cancer, for example. Despite much arguing and lobbying, however, no EU-wide programme for lung-cancer screening exists thus far.

Screening in its traditional sense aside, we now have bundles of health apps that not only monitor patients at home, perhaps nudge them into better adherence, and gather data all the time for healthcare professionals and the larger research community.

This can lead to more patients being able to stay at home, work longer to put funds into our cash-strapped systems, and free-up hospital beds for the more urgent cases.

Health equals wealth

Alongside slogans such as ‘smoking kills’, which as noted above everyone has heard over and over again, we’ve also often heard that ‘health means wealth’.

This is equally true for the reasons outlined earlier – and is statistically proven. Europe needs its citizenry as healthy as possible to create wealth for the system, rather than lose working days and drain systems by using up precious healthcare resources.

Personalised medicine can certainly help to optimize patient care, but prevention is better than cure, and smarter use of resources can bring down costs.

But these messages are not getting across quickly enough. It is a fact that when a society is squeezed financially one of the first sectors to come under the cosh is healthcare. As shown by the ‘health means wealth’, this is short-sighted in terms of the well-being of citizens and the wealth of a nation.

So, while messages such as don’t smoke, eat more healthily, take more exercise, cut down on alcohol consumption are certainly out there but often ignored by the public, the messages that health means wealth, prevention works and saves money down the line, ongoing education for healthcare professionals is vital, and smart management of limited resources is important going forward…are often ignored by health-care payers.

Moving forward with data and going digital

It’s fair to say that introducing new technologies into healthcare services is complex. Just on its own, personalised medicine shows that every patient and every situation is unique. One-size-fits-all solutions are outmoded in the 21st century.

Unfortunately, despite the explosion of Big Data and incredible moves in digitisation, some information is difficult to put into a digital format in an easily understood and easily usable manner, which could be down to system ineroperability, lack of knowledge on the part of the person reading the information, or both.

Other issues surround the use of Big Data, many of which were addressed by what many think was an overly cautious approach by the European Commission’s General Data Protection Regulation. Yes, patients’ personal data needs to be protected amid fears that it could be mis-used, but research ethics and processes have always been robust and we need to ensure that we can access important data for the benefit of current and future generations.

Most patients will tell you that they are happy to allow their data to be used, under their chosen circumstances and with sufficient safeguards, so at least there appears to be willingness coupled with little or no knowledge-gap in that regard.

If only certain other messages were managing to get through, Europe’s health-care systems would benefit, which can only mean good news for patients and our wider society.

With the European Parliamentary elections coming up in May, followed by a new Commission entering the Berlaymont later in the year, it is also important to ensure that key messages are picked up by Europe’s politicians and policymakers.

There are many stakeholdes involved in health care, and it is paramount that everyone is on the same page, communicates and collaborates, if we are to make the best use of resources, put in place potential preventative measures, and move forward more quickly with the revolution that is personalised medicine.