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Most Health Care Organizations Unprepared for Precision Medicine

When President Obama announced a $215 million precision medicine initiative in his State of the Union address one year ago, many observers predicted that health care would quickly jump on the bandwagon. Unlike the one-size-fits-all approach to medicine, precision medicine—often called personalized medicine—leverages advances in genomics and analysis of large data sets to personalize care and greatly accelerate medical research and drug discoveries.

But according to a new survey of health care executives in hospitals nationwide, few organizations are moving to adopt precision medicine. The exception seems to be academic medical centers, which have historically led the adoption of new technologies in health care.

Fifty-nine percent of respondents to a survey by Health Catalyst said precision medicine will not play a significant role in their organizations in the next five years. Among respondents from nonacademic hospitals and health systems, the number rises to 68% who say precision medicine will play an average, small, or nonexistent role in their organizations between now and 2020.

The online survey also revealed that few organizations are building genomics capabilities into their EHR systems. Sixty-three percent of respondents overall said their organizations had no plans to integrate genomic data into their EHRs. Proponents of precision medicine envision health care organizations collecting and sequencing patients' genomic data and using EHRs to generate analytical reports that physicians could use to take note of genes related to a multitude of hereditary diseases.

The survey's EHR finding is striking considering that one-half (50%) of the survey respondents believe that DNA sequencing—the source of genomic data—could have a positive impact on their organizations' patient treatment strategies. Recent advances in DNA sequencing technology have made the procedure, which cost up to $50,000 just a few years ago, relatively affordable at about $1,300, leading to broader use and important disease discoveries.

"The disconnect between the recognition that genomics holds great promise and yet the lack of preparation for precision medicine may reflect the fact that technology adoption is often driven by research efforts at major academic medical centers, with others following in their footsteps," says David Crockett, PhD, senior director of research and predictive analytics for Health Catalyst.

Survey results for respondents from academic medical centers were nearly the mirror opposite of those from smaller nonacademic organizations. Seventy-one percent of the academic respondents said precision medicine will play a significant role in their organizations in the next five years, and 64% said they plan to integrate genomic data into their EHRs.

"This survey shows that leaders in academic medicine are already moving to adopt precision medicine but the rest of health care has a lot of catching up to do," Crockett says. "We live in a remarkable era of information, when all that is known about a person—from family history and genetics to location history and environment—can be balanced against all that is known in the medical domain. This big-picture view of medical decision making can allow providers to focus both prevention and intervention on appropriate individuals, while avoiding unnecessary costs and unwanted side effects for those patients who wouldn't benefit."

Survey results reflect the opinions of health care professionals who responded to an online survey by Health Catalyst between November and December 2015.  Eighty-eight percent of the respondents were health care executives, including several chief information officers, chief medical information officers and chief medical officers. The organizations represented included many well-known multihospital and multistate health systems.

Source: Health Catalyst