In an interactive session at Becker's 12th Annual CEO + CFO Roundtable, two leaders from Illumina — Mike Kreitzinger, lead of health system strategy, and Damon Hostin, lead of market access for health systems — facilitated a discussion with Tom Mikkelsen, MD, medical director of the precision medicine program and clinical trials at Detroit-based Henry Ford Health.
The session highlighted Henry Ford Health's progress in precision medicine, which began with a focus on oncology and has since expanded to other areas like cardiology. The panelists also discussed the importance of genomics in personalized medicine, highlighting advancements in molecular diagnostics and their integration into routine care. Opportunities for increasing patients' access to innovative diagnostics and clinicians' awareness and buy-in of new tools were also raised as key considerations for peer leaders.
Three key takeaways:
1. Expanding precision medicine necessitates greater awareness and education among clinicians.
Dr. Mikkelsen described Henry Ford Health's precision medicine program as having "roots in oncology," but it has since evolved — both within cancer testing and diagnostics, as well as genomic medicine, particularly in cardiology.
"The proof points have arisen from oncology through the opportunity to leverage basically a venture model and then to look elsewhere in the system about where this infrastructure can be deployed," Dr. Mikkelsen said
This evolution, however, has come with challenges in physician engagement and promoting alignment on new tests and technical capabilities.
"We have been expanding our offering in pharmacogenomics gene testing for the indication of treatment dosing, and it turns out that many of the tests have actually been on the formulary of our lab for years and it's just been underutilized," Dr. Mikkelsen said. "It's taken a fair bit to engage the clinicians to teach them the value, and then of course, the nuts and bolts of getting it into Epic as an order and so forth."
2. Equity and broad use of guideline-recommended genomic testing are key priorities.
The discussion highlighted population health and equity concerns with newer, guideline-indicated diagnostics, citing that in advanced cancers only 40% of patients are receiving what the National Comprehensive Cancer Network guidelines would consider to be appropriate testing for therapy choice.
"The guidelines are a floor, not a ceiling, and I think it is kind of appalling that despite the fact we have these state-of-the-art diagnostics, they are underutilized. There are equity questions about how that might be and how we can address that," Dr. Mikkelsen said. "Not only do we have to look at those folks that are tested and their outcomes, we also need to find out who is not being tested and why, and make sure just from a pure quality point of view, that it's done — guidelines and beyond."
3. Effectively deploying a precision medicine program "takes a village."
In growing Henry Ford Health's precision medicine program, Dr. Mikkelsen said stakeholder engagement has been the most essential element. "Not just the clinicians that are involved in managing these patients but leadership of the organization," he added.
While there's a laser focus on patient outcomes and innovation in the program, Dr. Mikkelsen highlighted the need to balance these priorities with financial considerations as well.
"The other important point to recognize is that we run a business, and you have to do this in the context of business savvy, especially in the context of value-based care," he said. "We have those experts at the table as well, modeling what the benefits are, what the costs are, to make sure that these are not value neutral. The other thing is that it takes a village. There are experts that are absolutely critical to all pieces of this puzzle — this lab and pharmacy and my team and the clinical departments."