Toward achieving precision health

Abstract

Health care systems primarily focus on patients after they present with disease, not before. The emerging field of precision health encourages disease prevention and earlier detection by monitoring health and disease based on an individual's risk. Active participation in health care can be encouraged with continuous health-monitoring devices, providing a higher-resolution picture of human health and disease. However, the development of monitoring technologies must prioritize the collection of actionable data and long-term user engagement.

Fig. 1. Precision health care overview

Many different components of health care can contribute to precision health. A person can be genotyped at or before birth to help determine their unique disease risk. This information allows customization of the health-monitoring devices that a person wears or uses in their home. Wearable and household monitors can measure environmental and physiological parameters and transmit data to the integrated health portal (shaded rectangle). The portal can assist with health decision-making by analyzing data to suggest an actionable response to the appropriate type of health care provider. Simple, low-risk interventions, such as diet or weight change, can be presented directly to the patient along with education and lifestyle guidance. Other interventions may require the involvement of family or caretakers. More complex disease and therapy management involves the physician, hospital, and outpatient centers. Customized monitoring and intervals of surveillance can be adjusted appropriately on a continual basis. Ultimately, precision health aims to engage patients in maintenance of their own health to prevent a return to the hospital.

Fig. 2. Monitoring on the body and in the home

A selection of wearable, implantable, and home devices are shown to demonstrate the variety of physiological and molecular parameters that can be measured using these devices. (A) Physiological monitoring has become ubiquitous but rarely provides the specificity needed for diagnostics. Monitoring of complex molecular parameters, such as biomarkers, is required for tracking specific disease states, but there are much fewer devices available with this capability. (B) Devices in the home or automobile are capable of passively monitoring biological fluids, human behavior, and physiological signs. These measurements range from dietary habits to urine and stool analysis. Passive monitoring approaches permit high-frequency monitoring without requiring a change in user behavior. UV, ultraviolet; ECG, electrocardiography.