Can precision health transform primary care? Look to Stanford's Humanwide pilotI talk to a lot of different audiences about the idea of precision health-creating healthcare that's technology- and data-driven, highly personalised, and focused on predicting and preventing disease before it strikes. Through a promising demonstration programme called Humanwide, Stanford Medicine has taken important steps to realising that vision in a clinical setting. Based out of the Stanford Primary Care 2.0 clinic in Santa Clara, Humanwide incorporates medical research, biomedicine, technology, and data science into individual patients’ primary care. The programme recently completed its pilot phase, working with a diverse group of 50 patients facing a range of health concerns and risks. The youngest Humanwide patient was 24 years old, and the oldest was 86. Two-thirds were women, and half were minorities. Sixty percent of participants had a major cardiovascular risk, while 50% were obese. Three patients were undergoing cancer treatment, and one was awaiting a kidney transplant. For each patient, the Humanwide care team carefully documented factors that we know influence health, but which often aren’t incorporated into primary care today, including stress levels, sleep habits, and environmental exposures. Patients also received genetic screenings and pharmacogenomic testing (which looks at a patient’s genes to predict how they will react to a variety of medicines). In addition, each patient was given four digital health devices—a pedometer, a digital scale, a blood pressure cuff, and a glucometer to measure blood sugar—to track and measure their health and progress throughout their daily lives. All of this data was fed into patients’ electronic health records and discussed at regular check-ins with their physicians. Humanwide also emphasised an integrated team approach to care. In addition to their primary care providers, patients saw a behavioural health specialist, nutritionist, and clinical pharmacist, as well as other specialists as their conditions required. Care teams regularly met to discuss the progress and needs of individual patients; and team members accessed electronic health records that provided a comprehensive view of patients’ health data, including test results, behaviors, social determinants, and personal preferences. If this sounds time-intensive, it was in some ways, but patients and clinicians said Humanwide was worth it. At the end of the pilot phase, both groups reported higher satisfaction scores — they said they enjoyed a care process that was cutting-edge and focused on promoting well-being rather than simply treating illness. And to give a snapshot of the clinical difference this approach made:
Source: Stanford University Medicine About the authorLloyd Minor is the Carl and Elizabeth Naumann dean, Stanford University School of Medicine |