By Assaf Halevy, founder and CEO, 2bPrecise.
Few healthcare leaders doubt that insights made available through precision medicine and genomics have the potential to vastly improve care and outcomes.
But the industry struggles to overcome numerous barriers that, at first glance, seem to obstruct providers’ ability to fully leverage precision medicine. There is no question that obstacles exist, but a well-considered strategy can help providers move quickly down a forward path.
Let us consider the six primary obstacles to leveraging precision medicine to its fullest:
- Provider education and expertise. Precision medicine, as an influencer at the point of care, is a nascent discipline. Few physicians practicing today were thoroughly educated in genomics (the depth of training is increasing, however, according to a 2017 article in the Association of American Medical Colleges News). Physicians find themselves in a position of educating themselves quickly, especially as the FDA approves more targeted immunotherapies and treatments. In addition, because of the rise of direct-to-consumer tests, patients themselves are demanding doctors factor this information into their clinical decision making.
- Slow-to-change standards of care. Without a doubt, delivery of healthcare must be evidence-based. Genomic science has introduced so many advances in such a short period of time, however, that many physicians remain bound by approaches rapidly becoming outdated. The industry must find ways to deliver new findings into the clinical workflow reliably and quickly, so providers can utilize the best approach in each patient encounter.
- Limited time to process new data. Physicians are already presented with more data than they can effectively manage. Genomics represents an entirely new and voluminous data set. To deliver any value, this information must be rendered useful and readily available within the EHR. Access must be smooth and seamless so physicians are not forced to leave their workflow to hunt for relevant insights.
- Foreign nomenclature. Currently, genomic results are returned in PDFs (not as discrete data), rendered in vocabulary common to genomic researchers and scientists. It must be “translated” into meaningful clinical nomenclature and then integrated into the current workflow to be fully useable.
- Regulatory and liability concerns. Genomic results do not represent a snapshot in time the way phenotypical information might. A patient’s genetic variant could impact care decisions well into the future as the individual’s condition changes and genomic science advances. How does a provider store and manage genomic data, making sure that its very existence does not create liability issues in the years ahead?
- Lack of or sluggish reimbursement. Payer policies and guidelines lag behind discoveries related to precision medicine. What reimbursement exists varies greatly from payer to payer and is founded on disparate understandings of medical necessity. While payment is becoming more common, physicians nevertheless must consider the financial impact of ordering a genomic test – and what they will do if the results indicate that an expensive or uncommon treatment is the best choice for a particular patient.
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