When a health network CEO considers how to introduce a precision medicine service into clinical care, the up-front costs can be substantial, but the potential rewards are significant
Hospitals and health networks have increased interest in making precision medicine a routine part of care. But they face important challenges that include putting the right management in place, training clinicians, and contracting with medical suppliers to provide them the equipment and supplies to sequence genes and perform genetic tests.
Another challenge is the upfront cost. Health network CEOs quickly realize that recruiting physicians with expertise in precision medicine who are investing in the information technologies and genetic testing resources needed to support an effective precision medicine program can consume substantial capital. Moreover, poor choices in personnel and lab testing equipment could lead to program delays and mounting costs. A community hospital or smaller health network may not have the resources to start over if they make an error.
Recruitment for New Precision Medicine Positions Can Be Crucial
Much of this was true at St. Elizabeth Healthcare, a five-hospital system in Cincinnati. It recruited Brooke Phillips, MD, from the University of Chicago Medicine system to run its Center for Precision Medicine and Genomic Health.
Similarly, The Gibbs Cancer and Research Institute—part of the three-hospital Spartanburg Regional Healthcare System in South Carolina—beefed up its clinical laboratory by hiring a molecular diagnostics program manager and a regional director for molecular testing. Meanwhile, pathologists at the institute also had to receive additional training to handle specimens to be used in gene sequencing and genetic testing. Next, interventional radiologists had to assess new clinical pathways. That included determining how to best use data from genetic tests and gene sequencing to plan their treatments.
Another necessary step at Gibbs was to create a molecular advisory board. Their job, according to Healthcare IT News, was to develop molecular workflow requirements and create new IT applications.
Gabriel Bien-Willner, MD, PhD, FCAP, Molecular Director, Precision Medicine Program, Gibbs Cancer Center and Research Institute, speaking at the HIMSS Precision Medicine Summit last spring, noted that having physician champions and executive buy-in is equally important when making the changes required to implement and sustain a precision medicine program in a hospital or health network.
Gabriel Bien-Willner, MD, PhD, FCAP (above) is Molecular Director, Precision Medicine Program, at Gibbs Cancer Center and Research Institute, part of the Spartanburg Regional Healthcare System in South Carolina, and President/CEO of the Bien-Willner Physicians Group (BWPG). He says having both physician champions and buy-in from senior executives is crucial for hospitals and health networks to create viable precision medicine programs that successfully use genetic testing and gene sequencing in support of clinical care. (Photo copyright: BWPG Precision Medicine)
Supply Chain, Vendor Decisions Also Important
Although the hospital supply chain is robust, with companies such as Premier streamlining daily purchasing decisions for hundreds of hospitals and health networks around the country, finding the right precision medicine vendors to satisfy medical and clinical staff can be a challenge.
Within clinical and anatomic pathology laboratories, pathologists may prefer specific pieces of equipment or balk at making significant changes in the way they work. A recently issued report by KLAS Research concluded that many hospital managers are at a loss “to determine which of the hundreds of vendors in the market will be most helpful,” Healthcare IT News reported.
The Top Potential Precision Medicine Vendors to Hospitals
According to the KLAS report, in the still-developing field of precision medicine, these 13 vendors have “high mindshare” among hospitals and other relevant healthcare providers:
- 2bPrecise, Pittsburgh. Developed the xCGR platform for both raw and interpreted genomic data. Recently entered into a collaboration with PierianDx to better combine clinical and genomic data, according to Business Wire.
- Fabric Genomics, Oakland, Calif. Rady Children’s Institute for Genomic Medicine in San Diego uses its platform.
- Gene42, Toronto. Its PhenoTips Genomics Suite can analyze next-generation sequencing data.
- IBM Watson Health, Cambridge, Mass. Its genomics platform analyzes testing and a large database of medical literature to guide treatment decisions for oncology patients.
- LifeOmic, Indianapolis. Its Precision Health Cloud platform can merge and analyze genomic, EHR, imaging, demographic, and other data.
- NantHealth, Culver City, Calif. Offers tissue-based molecular profiling, a 26-analyte blood-based molecular test, and a portal to provide analysis and treatment options.
- Navican Genomics, San Diego. Its TheraMap platform analyzes genomic data and provides treatment options.
- N-of-One, Concord, Mass. Offers clinical interpretation solutions for oncology care.
- Philips Healthcare offers cloud and mobile platforms to perform data analyses.
- PierianDx, St. Louis. Provides both next generation sequencing and interpretative platforms.
- Sunquest Information Systems, Tucson, Ariz. Provides testing and diagnostic workflow applications.
- Tempus, Chicago. Provides a platform that analyzes genomic data for oncology patients and provides treatment guidance.
- Translational Software, Bellevue, Wash. Provides interpretations for oncology, pharmacogenomics (adult and pediatric), carrier screenings, wellness, and nutrigenomics.
As more hospital and health networks begin ramping up their precision medicine initiatives, expect hiring of the limited number of physicians and clinicians with relevant genomic experience to become more competitive.
What may help CEOs of health networks and hospitals is to identify the most successful suppliers in the different sectors of precision medicine, such as oncology, pharmacogenomics, and infectious disease, and visit the hospital clients of these vendors who have the most successful precision medicine programs in daily clinical use.