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Published On January 24, 2018

Second Opinion Winter 2018

Experts reflect on the state of eldercare and questions of genomic privacy.

Better Care for Elders 

Special Treatment” (Fall 2017) is a compelling article about the benefits of specialized care for older adults. The piece highlights the Acute Care for Elders (ACE) unit, an evidence-based model that reduces functional decline, which can lead to prolonged stays, nursing home placements and even death. As the story correctly points out, the ACE model has yet to reach its full potential, but should it be widely implemented, it could dramatically change the quality of care older patients receive.

Clinicians understand that functional decline is often an avoidable complication of hospitalization. But a clear vision and strong leadership at all organizational levels can fundamentally redesign inpatient services to maintain older adults’ physical abilities.

For more than 25 years, the ACE unit model has been a key component of the Nurses Improving Care for Healthsystem Elders (NICHE), an education and consultation program in more than 700 hospitals and long-term care facilities around the world. We work each day to ensure that acute and long-term care facilities prevent complications and provide quality, person-centered treatment. The time is now to adopt innovative models of care so that older people can receive the dignity and compassion they deserve, when they need it most.

Mattia Gilmartin // Executive Director, Nurses Improving Care for Healthsystem Elders, New York University Rory Meyers College of Nursing, New York, N.Y. 

Fueling the Miracle Machine

It is an incredibly exciting time to be a human geneticist and data scientist. As “Is Genetic Privacy a Myth?” (Fall 2017) suggests, we may have approximately two billion human genomes sequenced by 2025, and the most important question facing us today is who controls this massive trove of data.

New advances in data science, such as applying blockchain technology to safeguard digital information, promise new means of addressing this question. But the solution is not just about technology or just about policy. It will come from the deeper conversation we need to have about the global supply chain of biomedical data that is essential for fueling the “Miracle Machine,” also known as our wondrous biomedical research engine.

The integration of electronic health records and genomics data will be key to precision health and increasing patient access to affordable care. By using data to identify individuals at risk and improve drug discovery and delivery, we take this crucial step forward.

But patients and consumers need to be put first, and should be included in these conversations. We need to ensure that their trust in our use of their most valued asset is not broken.

Carlos D. Bustamante // Department Chair and Professor of Biomedical Data Science, Stanford University, Stanford, Calif.