Genetics and genomics represent a huge opportunity for health systems, but they also bring considerable challenges related to patient access, physician workloads and precision medicine program implementation.
During a September webinar hosted by Becker's Hospital Review and sponsored by Genome Medical, three experts from Genome Medical discussed best practices for deploying genetic and genomic care programs:
- Lisa Alderson, co-founder and CEO
- Steve Bleyl, MD, PhD, chief medical officer
- Erica Ramos, vice president of population genomics
Four key takeaways were:
- Genetic testing is becoming ubiquitous, yet many at-risk patients still go unidentified. Genetics and genomics are now integrated into most medical specialties. Yet, fewer than one in five people at risk of hereditary cancer are identified and referred for genetic services. "Access to care is a big challenge. Those one in five people are typically localized to big academic institutions and health systems with robust cancer and genetics programs. Screening is much lower in traditionally marginalized communities," Ms. Ramos said.
- Genetic and genomic screening makes economic sense for health systems. A good example is BRCA1 and BRCA2 testing for hereditary breast and ovarian cancer. Genome Medical analyzed the downstream revenue impact of this type of screening. "For every 10,000 women tested, a health system would realize about $1 million per year and almost $5 million over the first five years," Dr. Bleyl said. Beyond BRCA testing, hundreds of conditions exist where actionable mutations can affect patient outcomes, improve the quality of care and reduce costs. "The good news is that advances in genetic sequencing technology allow us to bundle groups of actionable genes and screen them at the same time for virtually the same cost," Dr. Bleyl explained. "This is where we start to talk about population genomics."
- Genomic and precision medicine programs must be tailored to each health system's needs. Genome Medical sees a broad spectrum of requirements across health systems. Some want basic, indication-based diagnostic testing using established guidelines, while others want a population-based approach. "Many organizations find it hard to realize these programs due to inertia and a lack of guidance and guidelines," Dr. Bleyl said. "Others have homed in on a particular area where they see potential ROI and they want to focus there." Genome Medical's Precision Insights Group works creatively with health systems, providing support from concept development to program design and implementation, training and measurement of clinical impact and ROI.
- To support health systems, Genome Medical leverages technology, genetic services and precision insights. Genome Medical delivers genomic care to patients and clinicians nationwide. When the company implements genomic services programs, it integrates tools to increase provider efficiency. "In terms of technology, our Navigator solution identifies patients who meet criteria for genetic services," Ms. Alderson said. "Our just-in-time reports give clinicians access to the latest guidelines on-demand, so they can make the right call about the best next step in care." In addition to its technology tools, Genome Medical has over 100 clinicians who offer direct consultations to patients and provide peer-to-peer support to providers via telehealth.
"The utility of genetics and genomics for patients is neither futuristic nor theoretical," Dr. Bleyl noted. "It's here today. Genetics is a predictive field, so we can improve patient health before conditions arise and we can also use it effectively once conditions have arisen. We think there's room for cost savings by shifting the spend earlier in the disease progression process."