Precision Medicine

How Do We Apply Genomics to Patient Care?

For those paying attention, the assertion that precision medicine could turn healthcare on its head comes as no surprise. However, several roadblocks stand in the way of that revolution. One of the biggest challenges for the precision medicine industry comes down to applying genomics to patient care.

For years, genomics has lived in the laboratory as a research-driven field, and for good reason. Unpacking something as complex as the human genome takes time. Now the industry is finally beginning to bring genomics out of academia and into the front lines of patient care. For my work at KLAS, this raises the question, “How will we measure genomics progress?” Our goal, as always, is to help provider organizations make the best and most well-informed investment decisions possible.

In the spirit of KLAS’ mission, I want to help provide health systems with a road map for how to get started on precision medicine. We want to look at where the real applications are today and help providers know how to begin applying genomics knowledge and interventions in meaningful ways.

KLAS seeks to profile numerous types of commercial offerings that address key clinical use cases in our first precision medicine publication, which is set to be published around HIMSS18 time. We will supplement by articulating various health system investment and strategy options. Much of this direction will come from input we will gather from an expert provider panel to be convened next month. This will be KLAS’ first provider panel focused on precision medicine. The providers on this panel will explore and articulate health systems’ investment and strategy options in precision medicine.

It’s exciting to observe how sequencing costs have rapidly decreased over the last 10 years. As access increases, so do the possibilities for applying genomic data. As one CEO I spoke with recently explained, “It’s the last mile for genomics.”

We need to identify the use cases for impacting individual patients and subpopulations so that they can quickly begin to enjoy the early fruits of genetic testing. This will take dedicated adoption and thoughtful integration and management of data; especially as genomic data becomes more common in providers’ workflows.

Going forward, if the industry hopes to successfully apply genomics to patient care, we will need to bring together disparate stakeholders in the space. These critical stakeholder groups will play a massive role in how precision medicine shapes up politically and regulatorily. These groups include the government, academia, health IT companies, labs (both commercial and provider-focused), informaticists, clinical leaders, administrative leaders, and the pharmaceutical industry.

Ultimately, all of these groups will impact the applications of genomics. These applications will take deep collaboration, strategic partnerships, and many iterations. My hope is that, for the sake of innovation and even saving lives, the market does not become paralyzed due to the lack of a grand business case or direct ROI. As I’ve observed in forward-facing solutions in areas such as decision support, exciting and validated use cases drive energy. Just because genomic data is complex doesn’t mean we need to reinvent the wheel.

Many health systems already have infrastructure in place to support early precision medicine applications. Take population health analytics as an example. IT teams are working to incorporate genetic-results plans into patient care and general patient records.

These providers are being smart about cloud hosting and layering research and reference tools to identify patients with clinically relevant and dangerous genetic mutations. In addition, patient engagement leaders are using apps and other platforms to collaborate with their patients about the patients’ genetic heritage and risk factors. Clinical recommendations for innovative therapies and counseling services are embedded and updated in these platforms so that physicians can use the information at the point of care. The horizon lies nearer than many realize, and that horizon is bright. Clearly, the complex nature of genomics shouldn’t scare providers into inaction. Early steps in applying precision medicine are both promising and realistic for many healthcare organizations, and progress in the field will be swift.