We often think of medicine as an exact science. A certain medicine taken at a certain dosage for a certain amount of time will cause an ailment to go away. A splint will set a broken bone, allowing it to heal, a root canal will alleviate tooth pain.
With some exceptions, this tends to be true. But what happens when it doesn’t?
How is precision medicine different from traditional medicine?
Precision medicine, also called personalized medicine, is a new way of providing patient-specific medical care and treatment. In traditional medicine, generalized approaches are taken. Symptoms are examined, diagnoses deduced and treatments prescribed. Traditional medicine looks at the bigger picture, identifying trends by looking at large sample sizes and understanding how to treat illnesses and injuries from this information. “
A new iteration of medical care, precision medicine takes a patient-specific approach to attempt to achieve the most optimal outcome. Precision medicine is really about considering individual differences in the course of prevention, diagnosis and treatment,” according to Claire Biot, vice president of Life Sciences at Dassault Systèmes.
Understanding a specific person’s anatomy and physiology, their behavior and the environment in which they live, the way their unique genome works and interact with drugs and therapies, all of their idiosyncrasies: this can be the difference between pain and peace. It encapsulates everything that makes up a patient’s health and lifestyle.
Having patient-specific protocols, devices, prescriptions, treatments and more can drastically improve patient outcomes and success rates of therapies and surgeries. While the concept is still relatively new, it has the potential to be life-changing.
Traditional vs. Precision medicine: A case study
Here’s a story about the limits of traditional medicine.
In December 2023, I underwent surgery for a knee injury. The MRI results, taken from a scan two months prior to my operation, had shown full ruptures of several ligaments in my knee, but for my meniscus, they were deemed “inconclusive.” While surgery was a given, this knowledge gap meant the doctors wouldn’t know exactly what needed repairing until they opened up my knee, and I wouldn’t know what operation I was really undergoing until I’d woken up after it had been performed.
At my post-op follow-up appointment, my doctor reviewed the procedure with me, detailing what went right and what didn’t. As it turns out, the anatomy of my knee isn’t standard. During the surgery, the doctors had attempted to locate what’s called the pes anserinus, the meeting point of three tendons that attach to the knee. Mine were “not encountered in the expected anatomic position,” meaning the surgeons were left to poke and scrape around my knee looking for them. While this didn’t prevent them from being able to complete the procedure, it did complicate it. The risk of additional tissue damage is heightened by unnecessary surgical movement, and the extra time required made the surgery less efficient.
Had my doctors had access to a more precise model of my knee, they would have been able to adjust the surgical plan accordingly. They might have been able to see that a necessary graft from my hamstring muscle would be impossible, as the tissue had been so severely damaged I would require a donation from a cadaver. The procedure for thawing, cleaning and preparing that tissue could have been done prior to the surgery – rather than during it, which it was – thus reducing the time the procedure took.
This surgery is a prime example of the limitations of traditional medicine and care. Had my surgical team had the necessary tools to leverage precision surgery, they could have approached the operation differently, ensuring a more favorable outcome.
How can technology enable precision medicine and personalized care?
When it comes to an orthopedic surgery like mine, the stakes are relatively low. While my operation came with unexpected complications, they didn’t prevent my surgical team from repairing my knee. But with higher-risk operations, such as those on internal organs, having a virtual twin of an individual patient can enable physicians to make the most informed decisions possible. And for other types of higher-risk medical cases, like treatment of serious diseases and infections, this type of care could provide patients with significantly better outcomes and quality and life.
A virtual twin is a digital 3D replica of a physical entity, be it an object, individual, or an entire system. But virtual twins go beyond shape and size and use real-world data to replicate the function of the original. These virtual twins can simulate, predict, and provide insights in real-time, allowing for proactive decision-making, combining all the available imaging and information into a functional, interactive 3D model. Over time, having this complete representation can enable physicians to make more precise medical decisions and to prepare for complex procedures before ever entering the operating room. In many instances, current medical information systems aren’t any more sophisticated than they were 100 years ago; and in some cases, medical files can be compiled solely of sheaths of paper, seemingly complete, yet filled with disconnected data.
Were a virtual twin of my knee available, my surgery might have gone differently. With a virtual twin, my doctors would have been able to diagnose my atypical anatomy and could have made adjustments to how they would operate and even have had the opportunity to practice the surgery in advance on my virtual twin.
Revolutionizing patient-specific care
But precision medicine doesn’t only apply to surgeries, and virtual twins are just one tool in the kit. For patients undergoing different types of therapies or treatments, virtual twins can improve patient outcomes, reduce the risk of complications or injury or even help prevent a medical incident before it ever occurs.
After my own surgery, I left the hospital in a brace that was locked in a fixed position. My knee was bent ever so slightly, meaning that it never reached terminal extension. At my two-week follow-up, my surgeon was alarmed at my lack of progress. Those early days between my surgery and my check-in were crucial, but they weren’t being monitored in any way. It was weeks before I was able to fully straighten my leg, meaning I was progressing slower than what someone in my situation should have experienced. It was, in short, another unnecessary, preventable complication.
So where does precision medicine fit into this scenario? Up until recently, patients have only been able to alert medical providers to issues once they’ve already become a problem. People who have a heart attack don’t know they’re about to have one, they’re only aware once one has begun. In general, patients don’t always know how to describe their pain, what hurts and how and when, and this problem is especially tricky with younger patients. But slowly, devices and applications are beginning to emerge that allow physicians to remotely monitor patients for any number of ailments and issues.
Innovation in the approach to individualized healthcare
Recognizing gaps in some of these approaches, a number of companies have begun to develop personalized medical devices to provide more optimal outcomes. Two of the major areas companies are beginning to tackle are implants and take-home medical devices, like braces.
Biomotum, a start-up in the 3DEXPERIENCE Lab accelerator, develops patient-specific exoskeletons for those suffering from impaired mobility. The devices, worn externally, are designed to provide assistance to joints, and are outfitted with a monitor that records real-time feedback on stability, control and other metrics. That data can then be leveraged by physical therapists and healthcare providers to address issues that may arise on a case-by-case basis.
In my case, a brace similar to Biomotum’s would have fed data back to my surgical team on the lack of progress in my knee’s flexion and extension. Changes could have been made on day 2, rather than day 12, and my rehabilitation journey could have gone more smoothly.
On the surgical side, more and more companies are producing custom implants, which solve a number of problems for patients and providers alike. Patient-specific implants require less time in operating rooms, since they don’t need to be trimmed down or expanded, the risk for post-operative complications are lower and the prospects for long-term rehabilitation and pain can be reduced.
Lucid Implants, another start-up in the lab, is innovating precision medicine by providing a variety of personalized titanium, polyether and bioresorbable tissues and implants, largely for bone and tissue reconstruction.By providing custom implants for surgeries, Lucid has helped reduce operating costs by 30% and hospital stays by 40%, when compared to procedures using mass-produced implants. By using personalized devices, the recovery time for patients is also drastically reduced, indicating better outcomes for both patients and providers alike.
Harnessing technology and data to be able to provide on-the-fly adjustments to patient care can be revolutionary in the medical field. No matter the diagnosis, whether it’s high blood pressure, or a bone break or anything in between, having dozens of data points on a patient’s journey – as opposed to a single data point when they make an in-office visit – enables healthcare providers to make more precise decisions and protocols when it comes to providing care.
What are the barriers to implementing precision medicine approaches?
The phrase, “if it ain’t broke, don’t fix it” applies well here. For decades, physicians have honed in on how to best treat patients, and for the most part, those approaches have worked well. They’re rooted in science and in successful outcomes, and they’re fine. From one-size-fits-all blockbuster drugs to implants to generic diagnostics and treatment plans, these responses can be limited, and they’ve been created and tweaked based only on previously-available technologies. Now, new technologies are emerging that can further enhance the care patients receive and their outcomes.
Human nature, though, is skeptical, and in particular, those in the scientific and healthcare communities may be wary of significant change. But over time, the way we approach problems has shifted massively, especially in healthcare. Inflammation was once treated with leeches and cocaine was a commonly used medicine; as times have changed, so too, have our approaches to healthcare. Surgeries which were once maximally invasive are now done arthroscopically or with the assistance of robotic technology. Slowly but surely, the medical field is shedding its skepticism. When it comes to precision medicine, the variety of applications and use cases are vast, and starting small, gradually adopting new techniques, will likely be the way to go.
Beyond some level of uncertainty, there’s the fact that technology, whatever type it may be, presents a burden. Those using it in the healthcare field must dedicate time to learning the required skills to accurately leverage it. The more time spent understanding how to properly build, test, train on and diagnose a virtual twin of a patient, for example, means less time actually treating them.
In the long-term, though, these barriers, though challenging to overcome, represent the foray into a new approach to medicine. Taking a holistic approach to medical care can both improve patient outcomes and provide benefits for doctors, too. For orthopedic surgeons, for example, robot-assisted surgeries can extend careers, as these doctors tend to spend long hours doing exhaustive, physical operations. Less time on their feet in the operating room can mean more years they’re able to work. For patients, it can mean hospital stays and rehabilitation times are shorter. Across the board, a precision medicine methodology can be a world of difference.
The future of precision health
Dassault Systèmes is committed to a future where healthcare is accessible, affordable and personal. The 3DEXPERIENCE platform is already being leveraged by professionals around the globe to develop groundbreaking solutions to delivering personalized medicine solutions that are tailored to individuals. At the 2024 Consumer Electronics Show, Dassault Systèmes showcased the innovative ways in which our technology can be deployed to create virtual twins of the various human organs, including the heart, lungs, gut, brain and eyes. Creating virtual twins of these vital organs can enable a revolution in the way that patient care is provided, and even in the way physicians approach healthcare.
It’s possible to say that the future of precision medicine is already here. This area of healthcare has seen significant progress and innovation in the last several years, and appears to be continuing on this trajectory. Its adoption on a wide scale, however, hinges on a number of different variables.
Perhaps a significant change for the future will be a shift in the way technology is viewed in the medical field. While it may currently be seen by some skeptics as an unnecessary addition, in time, it may come to be viewed more as a tool to achieve outcomes with greater accuracy and speed.
From the ability to adapt a treatment to a specific patient’s cancer diagnosis to the ability to embed an implant complete with sensors to monitor a patient’s post-surgical progress, the use of innovative technology in progressing the industry towards precision medicine is vital.
Given the odds for positive outcomes, precision medicine may just be the standard of the future.
Shoshana is a Senior Communications Manager on the Corporate Publishing team here at Dassault Systèmes. With experience in journalism, marketing, and PR, her work has been published around the world and across the internet.