Practicing with precision: genomic testing is transforming population health
Genomic testing is allowing health systems to better empower patients to take action on their health while providing clinicians with insight into population health. But like any innovation, there has been significant debate over its value and place in the American healthcare system.
As a part of its Healthy Nevada Project, Renown Health is testing thousands of Nevadans in hopes of understanding how to better serve its community. Though it started with an initial goal of 10,000 patients, the system’s direct-to-consumer approach allowed it to eventually expand to over 50,000.
By utilizing a data warehouse and predictive analytics platform that merges the genetic information with clinical records, demographic data, socioeconomic and environmental data, the health system can gain insights into the driving forces behind poor health and chronic disease. The information gathered through the program will help the system better address social determinants and offer a more personalized approach to health and healthcare.
Renown is engaged in several studies to understand chronic disease within its population and is now working on algorithms that can leverage this information to understand when a patient is likely to be at risk of illness and disease, so that it can proactively provide them with services that include advice on how to change their behaviors to modify their risk factors. “If I can efficiently give people back information that coaches them in improving their health, then we’ll be onto something dramatic,” said Anthony Slonim, MD, DrPH, Renown Health’s president and CEO.
The longitudinal perspective that genetic information provides is particularly insightful in Nevada, where families have longstanding roots, Slonim noted. Renown plans to help other systems engage in similar efforts through what it is calling the Healthy USA Project.
In suburban Chicago, NorthShore HealthSystem is on course to complete genetic testing for 10,000 primary care patients by the end of this year. The system is using these tests to evaluate cancer and cardiac risk, as well as pharmacogenomics. Leaders are using it as a pilot to test the applicability of genetic testing as part of primary care practice, understand patient interest and engagement, and determine if it can change care in a meaningful way, according to Chief Administrative and Strategy Officer Kristen Murtos.
In encouraging adoption, NorthShore engaged potential participants through multiple touchpoints, including videos in NorthShore’s patient portal and follow-up messaging, Murtos said.
“Getting your genome sequenced as part of creating a more holistic view of your health is something patients are excited about,” Murtos said. “But success isn’t just about the opportunity, it is about how you make it happen, and the ability to drive action from what you learn.”
Physician alignment was also important. Murtos notes doctors were excited but wanted to ensure testing was supporting care and was seamlessly integrated into their interactions with patients.
“From a patient standpoint, much of their decision to enroll boiled down to that face-to-face interaction with the physician,” Murtos said. “Supporting our primary care physicians and giving them the information to thoughtfully engage in those discussions was absolutely critical.”
While a number of systems are embracing genomics, some attendees at the Medline summit expressed some doubt about its value. It’s not uncommon that with disruption comes debate, as early adopters of genomic testing are negotiating questions and concerns that will articulate the future of this innovation.
Demand for skilled professionals who can work with population health data is incredibly high. That’s why Lehigh University launched its College of Health this year, which will be the first U.S. institution to offer undergraduate and graduate degrees in population health focusing on health innovation and technology, said Whitney Witt, PhD, MPH, the college’s inaugural dean.
Few employees have the experience needed to analyze data and make educated decisions based on the context of the healthcare industry. Lehigh’s College of Health is committed to training the next generation of innovative and diverse scientists and leaders in population health, Witt said.
“Our program is dedicated to using data science to get a 360-degree view of population health,” Witt said. “We want our findings to impact policy.”