While many healthcare organizations have yet to realize the full promise of precision medicine, Henry Ford Health's Jeffries Center for Precision Medicine in Detroit has been a leader in providing access to comprehensive tumor genomic testing and associated clinical support for all patients.
During an Illumina-sponsored workshop at the Becker's Hospital Review 12th Annual Meeting, Damon Hostin, Lead, Health Systems Market Access at Illumina, facilitated a discussion with two healthcare leaders from Henry Ford Health's about the system's precision medicine journey:
- Tom Mikkelsen, MD, FRCP©, Medical Director, Jeffries Center for Precision Medicine and Clinical Trials, Henry Ford Health System
- Louisa Laidlaw, Administrative Director (former)
Five key takeaways:
1. System planning and partnering are critical for harmonizing precision medicine with the clinical trial infrastructure. Access to clinical trials is a way to give every patient an opportunity to receive the most advanced care. To make that happen, health systems need knowledgeable experts. "We have partnered with diagnosticians and doctors who want to prove the value of evidence-based therapy via clinical trials," Dr. Mikkelsen said. "It's an integral package that takes system thinking." To bring all the pieces of the puzzle together requires partnering and negotiation among many different system stakeholders.
2. Data is essential to support care pathways. Precision medicine requires administrative, clinical and research care pathways. "It all comes back to the data at every checkpoint and every pathway. You must implement workstreams so you know what's happening for every patient, every time and you can measure the impact. If you can't capture everyone and ensure that you are getting the same standard of care testing, it makes it difficult to meet eligibility criteria and determine whether everyone is getting the same offerings," Ms. Laidlaw said.
3. Data flows must be designed so information is instantaneously actionable. On the front line, providers are confronted with a blur of data and restricted amounts of time to deliver care. "The last thing you want is to be sitting at a computer," Dr. Mikkelsen said. "You need data at your fingertips, ideally with some process and context. It's all in the fit and finish of the user interface."
4. Consent is a huge factor when creating resources from patient information. Patient consent for specific studies is typically very narrow. Some institutions have done a great job at creating broad consents so they can repurpose specimens and data for secondary research. According to Ms. Laidlaw, "One of the biggest challenges is making sure that you can use biorepositories in a way that you can truly give back to the community. It all comes back to the data. The consent process is stage one for gathering rich data."
5. Promising opportunities exist to create value stemming from precision medicine services across the system. Henry Ford Health is looking at forming teams to leverage the value of data in different clinical contexts. "The field is headed toward trajectories of care," Dr. Mikkelsen said. There are already standard of care tests that consist of small gene panels, yet with the advancement of technology we are generating data for 100s of genes “which may be over and above the standard of care” Dr. Mikkelsen said. And how do you make use of the additional information for clinical trials and create a resource from data.
With the right data, it will be possible to safely and compliantly represent populations in clinical trials who have historically been skeptical of medicine. "By making sure that we represent patient populations in the data we are storing and in our research, we can create effective treatments for everyone," Ms. Laidlaw said.
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