A 72-year-old woman is found to have breast cancer on a screening mammogram. Her primary care physician refers her to an oncologist, and the cancer – which expresses estrogen receptors (so-called ER+) is found to have spread to axillary lymph nodes. She will be seeing the oncologist in a few weeks to discuss treatment, however today she is seeing her primary care physician to discuss the findings, and the question is: What is the optimal treatment for a 72-year-old woman with node-positive, ER+ breast cancer?
For decades, the journey toward superior health outcomes has been defined by the quest for greater scientific specificity. This drive led to the rise of precision medicine, a powerful paradigm that uses genomics, proteomics, metabolomics, and other “-omics” to tailor diagnostics and therapeutics with an accuracy previously unimaginable.
Biological precision is critical; however, biology alone is not enough. To realize the ultimate goal of personalized medicine and individualized treatment, we must understand the unique life circumstances of the individual and use that information to tailor our clinical approach, treatment, and communication. This concept is called “personomics”: the personal characteristics that influence how an illness is experienced and how the individual responds to treatment.
Personomics: The Missing Link of Personalized Care
While precision medicine offers biological insight, personomics provides the crucial human context, including a patient’s personality, preferences, values, goals, health beliefs, social support network, financial resources, and specific life circumstances. This psychological, social, cultural, behavioral, and economic information is as critical to patient care as the biological data, helping to determine how a disease reveals itself and the way the patient will respond to a recommended treatment regimen.
Reclaiming Time and Restoring the Human Touch
Unfortunately, getting to know the patient as a person is challenging for today’s clinicians. The extraordinary amount of data at their fingertips can be overwhelming, and along with the burden of clinical documentation, the immense time pressure can make it impossible for clinicians to know their patients as people. Research shows that a physician working nearly 60 hours per week spends less than half their time on patient care, with the rest dedicated to administrative tasks.
Can Artificial Intelligence Help Make Things More Human?
The good news is that artificial intelligence (AI) can actually allow for more compassionate, personalized, and most importantly, human care.
There are over 1.5 million scientific articles published in PubMed each year, and without help it is impossible for clinicians to keep up with evolving knowledge. Not surprisingly, the majority of primary care clinicians use clinical decision support tools on a daily basis, and the right AI clinical decision support solution can provide trustworthy information rapidly at the point of care. In this way, AI not only supports the highest quality care, but also provides additional time for clinicians to get to know their patients as individuals.
While 61% of physicians worry AI will reduce human interaction with patients, it actually can have the opposite effect. AI ambient listening can reduce the burden of clinical documentation and AI clinical decision support can accelerate expert-curated evidence retrieval and reduce the burden of clinical documentation. The reclaimed time is key to unlocking the power of personomics. When clinicians are no longer rushing through a visit, desperately seeking confirmation for a diagnosis or treatment plan, or finding information about an unfamiliar problem, they can dedicate their focus to what only a human can do: engage the patient as a person.
Pairing Innovation with Empathy
The future of care lies in the important marriage between our most advanced scientific capabilities and our deepest human capacities. When we pair the biological specificity of precision medicine with the human context of personomics, we move beyond treating a disease as a biological entity and begin caring empathetically for a unique individual.
Evidence only truly matters when it can effectively be customized to the person in front of the clinician. Only through genuine interaction, facilitated by time-saving innovations, can clinicians understand the individual’s values and apply medical evidence in a way that authentically fits that person’s life. The purpose is not only to provide a more precise diagnosis, but a more meaningful, and ultimately, more effective course of action.
Back to the Question
What is the optimal treatment for a 72-year-old woman with node-positive, ER+ breast cancer?
The answer is: it depends.
It depends on the gene expression profile of the tumor and her overall health. However, it also depends on her personal preferences, which in turn relate to her prior experiences, her social support, her personal values and goals, and likely her religious or spiritual beliefs.
Since the primary care physician can obtain an answer to the question posed above based on the highest-quality evidence within seconds using a trustworthy AI clinical decision support tool, the clinician now can take the time to have an informed discussion with the patient, develop an understanding of the patient as a person, and engage in a person-centered discussion that demonstrates empathy, compassion, and humanity. That is the power of AI.
