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Dignity, CHI launch precision-medicine program

Two major nonprofit integrated-delivery networks, San Francisco-based Dignity Health and Englewood, Colo.-based Catholic Health Initiatives, have formed what might be  America’s  largest precision-medicine program.

The Precision Medicine Alliance — a partnership formed as a limited-liability corporation between the two health systems — will make genetics-based diagnosis and treatment available at almost 150 community hospitals serving a total of  about 12 million patients a year..

The organization’s initial project  will  focus on diagnostic tumor profiling. Eventually, the program will move into predicting risk of cancer and cardiovascular disease, as well as into pharmacogenomics.

The partnership is  aligned with the  Obama administration’s Precision Medicine Initiative.

Please hit this link to read the whole article.

3 systems to share data for precision medicine


At the precision-medicine revolution rolls on:

Salt Lake City-based Intermountain Healthcare, Stanford (Calif.) Cancer Institute, Renton, Wash.-based Providence Health & Services and precision- medicine firm Syapse, in Palo Alto, Calif.,  have created the Oncology Precision Network.

This will let them share clinical, molecular and treatment data through an advanced software platform to help find breakthroughs in cancer care by leveraging previously untapped cancer data while preserving privacy and security.

The OPN will link aggregated data between these three big health systems, to provide clinicians with previously unavailable information.

“By aggregating all of our real patient experiences, we will rapidly expand our ability to learn how to choose the best targeted treatments for our cancer patients based on the molecular profile of their tumor and our informatics based research,” Jim Ford, M.D., associate professor of Medicine and Genetics at Stanford and director of Clinical Cancer Genomics at the Stanford Cancer Institute, told Becker’s Hospital Review.


Insurers skeptical about precision medicine’s benefits



An example of the results of automated chain-termination DNA sequencing.

Stat reported that insurers are pushing back on requests to pay for “precision medicine,” which is based on heavy use of genetic tests.

Among other things, the  payers worry that the tests could lead to care that won’t improve patient outcomes but will dramatically drive up healthcare costs. Patients and their families are likely to demand them more and more.

But FierceHealthcare reported that Gregory R. Weidner, M.D., medical director of primary care innovation and proactive health at Carolinas HealthCare System, asserted that  precision medicine goes far beyond genetics,  saying that the goal is to “individualize and personalize care based on a variety of factors, which would include their genomic profile as well as various elements of their environment, lifestyle, personal preferences.”

Fierce reported “some organizations have been arranging meetings between insurers and companies working on sequencing cancers to find some common ground.”


Video: On precision and imprecision medicine


An example of a protein structure determined by the Midwest Center for Structural Genomics.

Text and video panel discussion on “precision medicine” and “imprecision medicine” and why precision medicine isn’t just genomics.

Precision medicine: ‘I hope I can’t imagine it’


Gianrico Farrugia, CEO of Mayo Clinic in Florida,  discussed the future of precision medicine at the Individualizing Medicine Conference, in Minnesota.

Mr. Farrugia listed these five things as most worth watching in precision medicine:

  • Pharmacogenomics
  • Liquid biopsy
  • Non-invasive prenatal testing
  • Whole genome sequencing
  • Microbiome

He noted that President  Obama’s Precision Medicine Initiative got enough attention to enroll one million necessary clinical-trial participants. “We don’t need to pitch it very hard. We’ve never had an undersubscription of trials in this space. We don’t need to sell something here.”

He said that  patient engagement and data privacy are  keys  to pushing precision medicine to a more scalable level.

He had a good line about the future of precision medicine.

“I hope I can’t imagine it. If I can imagine it, it won’t be that exciting.”

Will ‘precision medicine’ be strangled in red tape?



Chris Seper writes in MedCity News that the biggest impediment to “precision medicine” is bureaucracy.

“You can have your consumer-driven controversies about genetic testing. Precision medicine has a bigger question to answer, such as: ‘Which lab should get that test so everyone can get paid?”’

“On the front lines of genetic testing — from the doctors who want the tests to the genetic counselors who seek a bigger role in determining the path of precision medicine to the health insurance companies who have to pay for it — the battle is all about the red tape.

“Can we get everyone on the same page when we define ‘medically necessary’ genetic testing?

“Does the doctor know if the lab getting the genetic test has a contract with the patient’s health insurance company?

“’Who, in this age of transparency, is responsible for figuring it out?”’ asked Timothy Moss, M.D., a member of the Cleveland Clinic’s Center for Personalized Genetic Healthcare.”

One question was: Shouldn’t the genetic counselor be able to veto any genetic test?


How hyped is ‘precision medicine’?



An article in The Journal of the American Medical Association says that advocates of personalized or “precision medicine” may have created unrealistic expectations about its promise while leaving many questions unanswered.

“Even though personalized medicine will be useful to better understand rare diseases and identify novel therapeutic targets for some conditions, the promise of improved risk prediction, behavior change, lower costs, and gains in public health for common diseases seem unrealistic,” wrote Michael J. Joyner, M.D.,  of the department of anesthesiology at the Mayo Clinic, in Rochester, Minn., and Nigel Paneth, M.D., of the department of epidemiology and biostatistics,  at the College of Human Medicine, Michigan State University.

The authors say that proponents must explain how personalized medicine will  actually change healthcare and be more realistic about what the public can expect.



‘Precision Medicine’ in hospitals?



The White House has been detailing the Obama administration’s $215 million Precision Medicine initiative to enhance patient care via genomic research.

“Precision Medicine” seeks to use an individual’s  genetic data, environment, and lifestyle characteristics to customize healthcare treatments and prevention strategies.

The bulk of the $215 million would go to the National Institutes of Health and the National Cancer Institute, with the Food and Drug Administration and the Office of the National Coordinator for Health Information Technology (ONC) receiving smaller amounts.

“Participants will be involved in the design of the initiative and will have the opportunity to contribute diverse sources of data — including medical records; profiles of the patient’s genes, metabolites (chemical makeup), and microorganisms in and on the body; environmental and lifestyle data; patient-generated information; and personal device and sensor data,” said the White House.

We at Cambridge Management Group would like to know more about how  the president’s plan would affect research, and use of that research at hospitals, especially at teaching hospitals affiliated with medical schools  engaged in intensive research. Hospital oncology departments would, presumably, be particularly big beneficiaries of the program.

Francis Collins, M.D., who runs the National Institutes of Health, has said the cancer part of the program is “much closer to clinical benefit” than many know.



President pushes ‘precision medicine’


President Obama has proposed a new federally program for research in “precision medicine,” in which treatments are tailored to an individual patient.

This is one of the relatively few areas in which he may get important Republican support in Congress.



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