Implementing precision medicine programs presents an opportunity to diagnose diseases and predict patients’ responses to specific medications, but also requires overcoming challenges. Since most medical practitioners lack adequate training in genomics, genetic testing must be easily integrated into doctors’ routine practices. Pharmacogenomics, or genetic testing to assess drug response, may lower healthcare expenses, but putting programs in place can be expensive. Research must also be done on racial and ethnic minorities access to genetic testing and health equity. By finding the proper prescription more quickly, precision medicine has the potential to enhance treatment outcomes and save healthcare costs.
Precision medicine holds great promise for health systems. It offers the potential to diagnose diseases more quickly, predict patients’ responses to specific medications, and improve treatment outcomes. However, implementing effective genomics programs requires health systems to overcome several challenges. This article explores the challenges and opportunities that precision medicine presents to health systems, as discussed by a panel of experts at the 2023 HIMSS Global Health Conference & Exhibition.
One of the key challenges that health systems face in implementing precision medicine programs is the lack of advanced training in genomics among most healthcare providers. “Outside of a few specialties – mother-baby, oncology – most of our providers don’t have advanced training in genomics,” said Jackie Rice, Vice President for Information Technology and Chief Information Officer at Frederick Health. “Yeah, they might have a class of two, but they don’t have that advanced training for how they’re going to treat their patients.”
To overcome this challenge, health systems need to provide healthcare providers with advanced training in genomics. This training should cover the basics of genomics, how to interpret genomic test results, and how to use genomics to develop personalized treatment plans for patients. Additionally, health systems need to integrate genomic testing seamlessly into the physician’s workflow. This means ordering tests within the electronic health record (EHR) where results can be quickly accessed. Physicians also need information on how to interpret genomic test results, as genomics is a rapidly evolving field.
“The physicians may have limited knowledge because it’s changing weekly or every two weeks,” said Rice. “So we also worked with a third-party vendor to put some clinical decision support in there.”
Pharmacogenomics, or using genetic testing to determine how a patient will respond to different medications, is a key focus for many precision medicine programs. “You can see, based on some of those genes, how you would typically respond to a medication,” said Dr. Kristin Conley, Chief Medical Information Officer at Frederick Health. “Do you metabolize it quicker than the average person? Or maybe you’re a slow metabolizer, and we need to have a lower dose to get that effect.”
Pharmacogenomics has the potential to improve treatment outcomes and reduce healthcare costs. It can help healthcare providers select the right medication and dose for a patient based on their genetic profile, rather than relying on trial and error. This approach can reduce the risk of adverse drug reactions, minimize treatment delays, and improve patient outcomes.
However, implementing pharmacogenomics programs can be costly. Health systems need to justify the cost of a precision medicine budget when budgets are tight. But according to Rice, many patients could benefit from pharmacogenomics. Many people know a friend or family member who cycled through several antidepressants before they found one that worked. Pharmacogenomics has the potential to improve treatment outcomes for these patients and reduce the time and cost of finding the right medication.
Looking ahead, health equity will also be important to study. Where do patients who’ve received genetic testing live? Are patients from racial and ethnic minorities accessing the tests? Since some cost is out-of-pocket, Rice said it’s key to look for grants and encourage payers to cover these services.
“We believe that 10 years from now, people are going to say, ‘You took care of people and you didn’t do their genetic testing?'” said Rice. “We’re going to do lab testing, imaging, and your genetic testing. We’re going to treat you for what you need to be treated for and find the right medication quicker and the right diagnosis quicker so that you can get that treatment quicker.”
