Digital Health for Supporting Precision Medicine in Pediatric Endocrine Disorders: Opportunities for Improved Patient Care

Abstract

Digitalization of healthcare delivery is rapidly fostering development of precision medicine. Multiple digital technologies, known as telehealth or eHealth tools, are guiding individualized diagnosis and treatment for patients, and can contribute significantly to the objectives of precision medicine. From a basis of “one-size-fits-all” healthcare, precision medicine provides a paradigm shift to deliver a more nuanced and personalized approach. Genomic medicine utilizing new technologies can provide precision analysis of causative mutations, with personalized understanding of mechanisms and effective therapy. Education is fundamental to the telehealth process, with artificial intelligence (AI) enhancing learning for healthcare professionals and empowering patients to contribute to their care. The Gulf Cooperation Council (GCC) region is rapidly implementing telehealth strategies at all levels and a workshop was convened to discuss aspirations of precision medicine in the context of pediatric endocrinology, including diabetes and growth disorders, with this paper based on those discussions. GCC regional investment in AI, bioinformatics and genomic medicine, is rapidly providing healthcare benefits. However, embracing precision medicine is presenting some major new design, installation and skills challenges. Genomic medicine is enabling precision and personalization of diagnosis and therapy of endocrine conditions. Digital education and communication tools in the field of endocrinology include chatbots, interactive robots and augmented reality. Obesity and diabetes are a major challenge in the GCC region and eHealth tools are increasingly being used for management of care. With regard to growth failure, digital technologies for growth hormone (GH) administration are being shown to enhance adherence and response outcomes. While technical innovations become more affordable with increasing adoption, we should be aware of sustainability, design and implementation costs, training of HCPs and prediction of overall healthcare benefits, which are essential for precision medicine to develop and for its objectives to be achieved.

Integrated Digital Health Solutions in the Management of Growth Disorders in Pediatric Patients Receiving Growth Hormone Therapy: A Retrospective Analysis

“…This resulted in the growlink™ patient app, which enables patients and their parents/caregivers to obtain information and resources related to their condition ( Figure 3 ) ( 61 ). Along with injection reminders and an overview of overall adherence, it allows patients to self-report height and weight data ( 62 ) that is transmitted to the HCP via the platform. growlink™ also facilitates patients’ interactions with their care team and patient support services to answer questions or provide supplies such as needles.…”

Adherence to r-hGH Therapy in Pediatric Growth Hormone Deficiency: Current Perspectives on How Patient-Generated Data Will Transform r-hGH Treatment Towards Integrated Care

“…The "one-dose-fits-all" philosophy which was widely practiced in the 1980s and 1990s can no longer be defended and is inconsistent with the current standards of precision medicine. 47 Many children are receiving inadequate doses of r-hGH with a lack of sophisticated dose individualization taking into consideration the known predictive factors. 48 In addition, GH responsiveness may be affected by influences outside the GH-IGF-1 axis such as genetic variants which can induce a degree of GH resistance.…”

Monitoring chronic inflammatory musculoskeletal diseases mixing virtual and face-to-face assessments—Results of the digireuma study

“…In this study, we adapted the Adhera for Rheumatology digital program, which was powered by the Adhera Digital Precision Digital Companion Platform. The platform contains modules for personalized education, behavioral change and mental wellbeing that have been already used across multiple studies and implementations across different therapeutic areas [10][11][12]. The adaptation of the digital intervention program for this study by a multidisciplinary team included rheumatologists, a general physician, psychologists, and digital health specialists.…”