During Becker’s 16th Annual Meeting, healthcare leaders discussed opportunities and challenges associated with precision medicine and genomic testing. They explored how Providence has strategically incorporated these capabilities across multiple clinical areas.
The session, titled “Driving Community Impact: How Providence Is Integrating Precision Medicine,” featured:
• Carlo Bifulco, MD, Chief Medical Officer, Providence Genomics; Medical Director, Cancer Genomics and Precision Oncology, Providence Cancer Institute (Portland, Ore.)
• Angie Cahill, Associate Director, Healthcare, Illumina
• Pierre Del Moral, PhD, Senior Director, Healthcare, Illumina
• Damon Hostin,Global Head, Market Access, Illumina
Here are three key takeaways from the session:
1. Molecular diagnostics go hand in hand with clinical and system strategiesPrecision medicine, genomics and molecular diagnostics are no different than other determinants of health. As a result, health systems must take a strategic approach to addressing them for patients.
Mr. Hostin explained that while previously genomics were not very actionable, now they are. “Molecular diagnostics are ordered every day in clinics,” he said. “We’re starting to see a sort of clinical quality utilization gap where eligible patients are undertested.”
When solutions are brought in-house, it brings the care team closer to patients and closes clinical quality gaps. This democratizes the availability and use of precision medicine.
“Illumina’s mission is to improve human health by unlocking the power of the genome in partnership with healthcare practitioners,” Dr. Del Moral said.
2. The genome is the foundation of medicine
Providence is the second-largest nonprofit health system in the United States and has 50,000 patients with new cancer diagnoses annually. It’s no surprise that oncology was the initial focus for Providence’s genomics program.
In focusing on integrating precision medicine into care, Providence has developed an entire ecosystem that emphasizes a holistic vision of patient care, including cancer prevention, patient monitoring and pharmacogenomics.
When cancer patients see oncologists, the physicians need access to genomics data. According to Dr. Bifulco, cancer care that’s not driven by genomics equates to malpractice. “There’s no way you should treat cancer patients without this information,” he said. “Cancer is a genome-driven disease.”
3. A genetic understanding of risk is key for disease care and prevention
For cancer care, Providence uses pathology-initiated testing, which occurs as soon as possible after diagnosis. This reduces complexity and provides oncologists with relevant results at the time of the patient meeting.
Genomic data is also crucial for enrolling cancer patients in clinical trials for experimental therapies. “If you want to select patients for oncology clinical trials, genomic findings are a sine qua non,” Dr. Bifulco noted.
For its cancer prevention program, Providence leverages whole genome sequencing to screen patients for high-risk genetic drivers at the germline level. Today, these drivers are identified primarily through human medical record reviews, but AI holds promise for the future.
Thus far, Providence’s program has resulted in sequencing around 2,000 patients and has identified alterations that affect clinical care in about 20%. Those alterations weren’t predicted by family history.
“Genomic data can completely change your whole strategy around patient care in terms of prevention, screening and therapeutic interventions,” Dr. Bifulco said.
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