Orion Health says precision medicine will throw up dilemmas
Precision medicine is about to shine a bright light people's health risks but will throw up personal and moral dilemmas, according to the country's largest health software firm.
While new ways to harness health information may keep people out of hospital longer, people could learn things they may not want to know, such as whether they carry a genetic variation that some researchers believe is linked to being unfaithful.
Orion Health is partnering with academics and hospitals in an unprecedented $38 million research project which, if successful, will mean medical treatment could be based on a vast amount of data.
That would include:
- People's genomes which determine how susceptible people may be to certain diseases such as cancer. According to a Swedish study, gene-mapping can also show if people have a genetic variation associated with a higher likelihood of them cheating on their partner.
- The 100 trillion bugs that live in human bodies and which outnumber human cells by two-to-one. The make-up of bacteria inside the stomach can be an important indicator of people's health, for example.
- Epigenetics, or family histories which can also influence people's health outcomes. Orion Heath says men whose grandfathers endured famine before puberty are less susceptible to heart disease or diabetes for example.
- Data from fitness apps and sleep monitors, along with information about their social habits and wellbeing.
The Government revived the idea of establishing a comprehensive system of electronic health records for all New Zealanders last year.
But Orion Health chief executive Ian McCrae said the medical histories they might ordinarily contain would only compromise about 10 per cent of the information useful to clinicians.
"It's a great start ... but we need to go further and embark on a programme to create a personalised healthcare system," he said.
Orion Health forecasts the cost of sequencing someone's genes could fall from about $1500 today to about $15 by 2020.
But the company warned in a report discussing precision medicine that people might not like what they might discover.
For example, Swedish research suggested men with the genetic variant "allele 334" were twice as likely to have a "marital crisis".
Knowing the gene was present could become "an excuse for bad behaviour" or a motivation to overcome "genetic shortcomings", Orion Health suggested.
McCrae has had his own genes sequenced and found he was likely to respond well to chemotherapy if he ever had cancer, but had a marginally-elevated chance of dementia.
The process also revealed a genetic trait associated with people who are upbeat and able to handle stress well.
"I guarantee you that if you are brave enough to get your genome done you will be very interested and passionate about it," he said.
McCrae acknowledged some information might only show people had an elevated risk of a condition, but that could be useful, he said.
One way precision medicine could save money was by helping forecast what drugs might work for people, given there were big variations in individuals' response to medications, he said.