In a situation where we have collected a variety of health data from different locations, patients expect to receive more personal and personalised treatment. A personal approach requires a new perspective from healthcare providers.
The seminar ‘Personalised Medicine in Healthcare’ discussed where we have come in the field of personalised medicine and what prevents Estonia from being the flagship of personalised medicine.
During the panel discussion that followed the seminar, the participants thoroughly discussed the subject of personalised medicine from the perspective of different interest groups.
According to Terje Peetso, board member of the North Estonian Medical Centre, the idea of personalised medicine is that the patient receives the best treatment for them, the most accurate diagnosis, the most suitable treatment options and therefore the fastest recovery or healing. From the perspective of the hospital, this means ensuring access to the right procedures at the right time, which is all based on scientific evidence.
“Personalised does that mean that everyone has a 3D printer in the corner and medicines and treatment recommendations come out of it every morning. Phenotype can be taken into consideration to a certain extent and we have relatively few personal preferences that we can take into consideration,” Peetso emphasised.
Tõnu Esko from the Estonian Genome Project stated that better access to health information would be enough to make better use of the potential offered by personalised medicine. “If the information available becomes a compact part of the treatment process, then it becomes personalised. It is the systematic and simple use of data in the decision-making process that is important,” Esko confirmed and also emphasised the use of genetic information in the prevention processes.
Roche’s representative Andre Koit pointed out that, according to physicians, personalised medicine is already being practiced. “The question is, how we can bring the discoveries made in the laboratory to the patient’s treatment process. Patients may not expect personalised medicine, but accuracy, which comes with research,” he said.
During the discussion on how far we have come with bringing a more personalised approach closer to people, the participants found that the situation is generally good, but at the same time, we certainly cannot rest on our laurels just yet.
Tõnu Esko confirmed that there are aspects according to which personalised medicine in Estonia could be placed among the first: “All children born with suspicion of a genetic disease and their parents get full genome sequencing, which is covered by the Health Insurance Fund – this is something extraordinary,” he said. “We have national programmes that test different stratified prevention models based on genetic profiles and an ongoing project to integrate genetic profiles with the digital prescription system at a national level – a large part of the society is involved in this and we are certainly at the forefront in that sense.”
“On the other hand, far too few people have access to new and innovative medication,” he added.
“We have collected a lot of data, but we have not been able to bring it all to practical medicine – this is the part that is unfinished: how can the healthcare provider use the existing knowledge,” Terje Peetso pointed out. Peetso emphasised that the use, standardisation and synchronisation of existing data would bring us closer to personalised medicine.
Andre Koit stated that 30 years ago, breast cancer was just one diagnosis. “From this point of view, we have made a huge leap,” he said. “However, when it comes to the availability of new medications, our patients have received a smaller than average proportion of new medication than the rest of Europe and it takes more than three years on average for treatment to be funded. Certainly, pharmaceutical companies can also put more effort into offering more medication,” he said.
“New scientific knowledge is becoming more and more complex; the world must be ready for this and we must be prepared. For example, the quality of data is important,” he added.
Data plays a key role in bringing innovation closer to the patient. In his presentation, Andre Koit made a comparison that medical data is oil in the future – we need to make data edible or, in other words, structure it.
Koit gave an example from the field of oncology: during the appointment, when the physician talks to the patient, he cannot fill a metre-long data field simultaneously, although there are many data fields that could be standardised. “In patient-physician communication, it is difficult to find a situation where the data could be generated structurally. Another option is to talk about automatic data recognition,” he said. He thinks that in the upcoming years, human intervention still seems to be a more realistic option, so that the so-called writing would keep the data up-to-date.
Terje Peetso suggested that patients could be more involved in data collection. “The consultation is in many ways like a survey and a standard,” said Peetso. “Thus, the input where the patient answers and the physician has to write it down may be given earlier by the patient themselves and the physician only adds the objective findings.”
Esko also proposed the option of preliminary data collection as a fast solution. “The patient can enter some information by themselves, for example, via the selection fields,” he said. “Why not collect data by talking to a speech robot – data collection could become more systematic.”
Esko also drew attention to the question of why the medical history needs to be repeated all the time – it could be centrally clustered together. “If it is machine-readable and systematised, it is easy to develop further innovation.”
During the discussion, the participants had to find an answer to the following questions: what are the obstacles to the active implementation of personalised medicine? When Estonia has the potential to be at the forefront of personalised medicine solutions, we have the knowledge, the infrastructure to build solutions and an understanding of how the solutions should work.
Terje Peetso confirmed that the enthusiasm exists but fulfilling the wishes of physicians and nurses in order to achieve better treatment results requires time in addition to money. It is also a question of coordinating and financing different activities.
Andre Koit agreed that instead of creating a new database for each physician, activities should be coordinated. He also emphasised that once digital investments have been made, we cannot rest because continuous development is important. A shared national vision of IT structures is necessary, also within the hospitals, so that everyone does not move in their own different direction.
In order for us to be one of the leaders in the field of personalised medicine, Tõnu Esko sees the solution: everyone should have access to a full description of their genome and it should be fully integrated in the healthcare system, which enables physicians to use it on a daily basis. That would also create an opportunity to implement new innovations.
“We have to solve the problem of data storage, collection and usage,” said Esko. “The consent system currently being developed will help with that aspect. Also, the secondary use of health data so that it can be used for something other than treatment. The systematic solution of these aspects would help improve us a lot in the field of personalised medicine.”
Terje Peetso emphasised that we should not forget the patient, who should be involved in the processes as an important member.
For good ideas to not remain at the level of thoughts and become actions instead, the cluster is ready to bring all parties to a common table in order to find solutions that support the development of personalised medicine, confirmed Piret Hirv, Head of the Connected Health Cluster managed by Tehnopol Science Park. Contact us Piret.Hirv@tehnopol.ee
The Connected Health Cluster led by Tehnopol Science Park is Estonia’s biggest healthcare tech community, uniting health service providers, health tech companies and all other key interest groups in the field. With the help of the cluster, it is possible to carry out national cooperation projects and export health technology solutions to other countries.
The activities of the cluster are co-financed by Enterprise Estonia.