Advanced genomic information has the potential to expand access to personalized medicine and generate better patient outcomes. Incorporating genomic-based insights into patient care, however, requires thoughtful processes and a system-wide strategy.
During a virtual featured session sponsored by Illumina as part of Becker's Hospital Review 11th Annual Meeting in May, two healthcare leaders discussed Weill Cornell Medicine's and New York-Presbyterian Hospital's partnership to expand patient access to advanced genomic technologies:
- Phil Febbo, MD, Chief Medical Officer of Illumina
- Theresa MacDonald, director of strategy at the Englander Institute for Precision Medicine at Weill Cornell Medicine in New York City
Four key takeaways:
1. The Weill Cornell Medicine and New York-Presbyterian Hospital advanced genomics collaboration is patient centered and disease driven. Qualified patients have the option to consent to genome sequencing so physicians can incorporate genomic information into their care. The partnership brings together clinical expertise from the hospital and research expertise from Weill Cornell. These efforts go beyond translational research, paving the way for the use of whole genomes in day-to-day clinical care.
2. Whole genome sequencing has the potential to transform personalized medicine. Whole genome sequencing can identify all the potential genetic variation in a patient with a single assay, which can affect genes overlooked in targeted panels and even whole exome sequencing. "We want to demonstrate that whole genomes provide an additional layer of information with clinical utility that can be used to personalize medicine more effectively," Ms. MacDonald said.
Outside of cancer, genome sequencing has identified known variants, such as mature-onset diabetes of the young. It can also uncover unexpected results. For example, a patient in the program had a known mutation and a novel mutation in two alleles of a specific gene that changed the diagnosis and recommended medication. The standard, targeted panels wouldn't have identified this information.
3. To incorporate genomic information into patient care, stakeholder engagement is essential. The Weill Cornell Medicine and New York-Presbyterian project team has identified clinic champions and is working to get support from executive leadership, nursing, compliance and regulatory. "You need to be thoughtful and strategic about what will make it easier to use this data for patient care," Ms. McDonald said.
This means considering how advanced genomics information will be implemented in the clinic setting and how actionable information is integrated seamlessly into the EHR. Because of the breath of information that whole genome sequencing provides, "One challenge is that genomics often raises more questions than it solves problems," Dr. Febbo said. "For today's time-pressed clinicians, that's not always welcome. It takes systems like Weill Cornell Medicine and New York-Presbyterian to come together and create a vision that says this is where medicine is likely to go."
4. Successful programs rely on project champions and collaboration with external partners. For other healthcare institutions that would like to launch a similar initiative, Ms. MacDonald shared several recommendations: Learn from others' experiences and failures. Let physicians drive the process. Identify champions on the operational and education sides. Pursue collaboration with external partners, especially when specific expertise is needed. Partnerships are critical when establishing or expanding a successful program.
To learn more about this session, click here.