Providers are still in the early stages of applying genomics to patient care. However, at least among providers that can afford the investment, clinical genomics programs are beginning to become far more common, and as a result, we’re beginning to get a sense of what’s involved.
Apparently, one of those things might be creating a new IT infrastructure which bypasses the provider’s existing EMR to support genomics data management.
KLAS recently spoke with a number of providers about the vendors and technologies they were using to implement precision medicine. Along the way, they were able to gather some information on the best practices of the providers which can be used to roll out their own programs.
In its report, “Precision Medicine Provider Validations 2018,” KLAS researchers assert that while precision medicine tools have become increasingly common in oncology settings, they can be useful in many other settings.
Which vendors they should consider depends on what their organization’s precision medicine objectives are, according to one VP interviewed by the research firm. “Organizations need to consider whether they want to target a specific area or expand the solutions holistically,” the VP said. “They [also] need to consider whether they will have transactional relationships with vendors or strategic partnerships.”
Another provider executive suggests that investing in specialty technology might be a good idea. “Precision medicine should really exist outside of EMRs,” one provider president/CEO told KLAS. “We should just use software that comes organically with precision medicine and then integrated with an EMR later.”
At the same time, however, don’t expect any vendor to offer you everything you need for precision medicine, a CMO advised. “We can’t build a one-size-fits-all solution because it becomes reduced to meaninglessness,” the CMO told KLAS. “A hospital CEO thinks about different things than an oncologist.”
Be prepared for a complicated data sharing and standardization process. “We are trying to standardize the genomics data on many different people in our organization so that we can speak a common language and archive data in a common system,” another CMO noted.
At the same time, though, make sure you gather plenty of clinical data with an eye to the future, suggests one clinical researcher. “There are always new drugs and new targets, and if we can’t test patients for them now, we won’t catch things later,” the researcher said.
Finally, and this will be a big surprise, brace yourself for massive data storage demands. “Every year, I have to go back to our IT group and tell them that I need another 400 terabytes,” one LIS manager told the research firm.” When we are starting to deal with 400 terabytes here and 400 terabytes there, we’re looking at potentially petabytes of storage after a very short period of time.”
If you’re like me, the suggestion that providers need to build a separate infrastructure outside the EMR to create precision medicine program is pretty surprising, but it seems to be the consensus that this is the case. Almost three-quarters of providers interviewed by KLAS said they don’t believe that their EMR will have a primary role in the future of precision medicine, with many suggesting that the EMR vendor won’t be viable going forward as a result.
I doubt that this will be an issue in the near term, as the barriers to creating a genomics program are high, especially the capital requirements. However, if I were Epic or Cerner, I’d take this warning seriously. While I doubt that every provider will manage their own genomics program directly, precision medicine will be part of all care at some point and is already having an influence on how a growing number of conditions are treated.