Our future approach to health, wellness, and medical needs will be very different. Rather than treatments statistically averaged to the general population, in future we will tailor medicine to each individual’s specific genome and biochemistry, with potential treatments and drug protocols tested first on sophisticated medical ‘avatar’ - a detailed model of the patient’s personal physiology.
People will be able to manage their health with highly customized lifestyle plans – diet, exercise, relaxation – as well as manage acute (sudden onset) health problems with precision. Genomics and genetic analysis will forecast potential problems that may be treated before they arise. When required, medical interventions will create fewer side effects, as drugs will be targeted and genomic and metabolomic interactions between drugs and patients will be modelled and addressed in advance of treatment. Many degenerative diseases will be conquered – but new diseases may arise from emerging patterns of social and technological stress.
What are the major trends in science and technology likely to continue by 2030?
Personalized medicine or PM is a medical model that proposes the customization of healthcare - with medical decisions, practices, and/or products being tailored to the individual patient. It denotes the use of some kind of technology or discovery enabling a level of personalization not previously feasible or practical.
A smart combination of ICT-enhanced monitoring, big data and applied genetic information would enable a really individualized approach of patients or – more in general – people and their health issues.
This could yield huge efficiencies and benefits, especially in regions with an ageing population (see the future ' Super Centenarian Society: more people suffering from combinations of chronic diseases). PM would make medication more effective, while substantially reducing negative side effects from conflicting medication.
Personalized medicine would broaden the scope of current health care practices, with much more emphasis on prevention and early detection of diseases. By taking as a point for departure of (preventive or curative) treatment not the symptoms or mechanisms of disease or complaints of the patients, but a digital "avatar", containing all genetic information, many ailments (or the individual's susceptibility to it, can be early diagnosed and treated, or be controlled, e.g. by reconsidering life-style choices, diets (nutritional immunology approach) et cetera.
What are the early signals likely to emerge in personalized medicine and the major changes/disruptions they can generate?
What sort of policy response is needed to create sciences-and-technology-innovation-friendly "ecosystems" around personalized medicine?
The required ecosystem for PM would be a integer data environment and well developed monitoring and measuring technologies that are needed to generate the big health data at individual level as a basis for PM diagnostics and therapeutics.
What sort of policy responses are necessary to make emergent technologies fitting with broader policy objectives and citizens' expectations?
- A clear and mature legal framework, complemented by regulatory and enforcement practice has to be developed, or an innovative approach to the same effect to guarantee the integrity, confidentiality and quality of personal health data profiles and the exchanges around it. Information transparency is key. Who owns the data (the individual [trust] or the authority [protected data-monopoly]?
- Even if risk-assesment is sorted out, the impact of the choices made based on the outcome of these assessments are often not really well known. More sound research in those areas is needed and the many ' unknowns' should be detected and explored.
- Personalised Medicine is a disruption of the current practice where a medical specialist provides certainty and the therapy or cure needed. It is a shift in the direction of risk-assesment by non-medical specialists, where people will have to make high-impact choices regarding their life-style, medical intervention and others. First issue at stake here: the scientific soundness of the risk-assesment.
- PM is a game changer: the positions of big pharma, health specialists and citizens / consumers / patients will shift. Governement needs to reassess its own role in this field. How to empower citizens, how to tackle their inability to deal with this sensitive information and the complex choices around it? How to prevent that industry backs away from developing medication?
- Health insurance will have difficulty dealing with PM as long as it is based on treatment provided, rather than treatment prevented or health gained.
“GnuBio launches as an open-source genome sequencing startup,” Julie M. Donnelly, Mass High Tech, June 3, 2010, at http://www.masshightech.com/stories/2010/05/31/daily32-GnuBio-launches-as-open-source-genome-sequencing-startup.html .
“Carrots, Sticks and Digital Health Records,” Steve Lohr, New York Times, February 26, 2011, at http://www.nytimes.com/2011/02/27/business/27unboxed.html?_r=1&scp=1&sq=digital%20patient%20data&st=cse .
“Virtual Reality Avatars as Health Advocates,” by Kendra Wyatt, Changemakers, at http://www.changemakers.com/node/1616.