How some major health systems are overcoming the barriers to launching precision medicine programs

Illustration of three DNA helices
Major health systems, such as Providence St. Joseph Health, have cracked the code to solving some of the barriers precision medicine programs face, according to a new study. (Darwin Laganzon)

Health systems that have rolled out precision medicine programs have had to tackle many challenges—including a lack of physician engagement around genomics and the need for new tech tools—before seeing the efforts pay off.

A study published this week in the latest issue of Health Affairs dives into the precision medicine journeys of three major health systems: Providence St. Joseph Health, Intermountain Healthcare and Stanford Health Care.

Researchers said the challenges faced by these providers could offer guidance for others looking to give personalized medicine a try.

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For example, providers who don't understand precision medicine will be less likely to embrace or take advantage of precision medicine programs, said Daryl Pritchard, Ph.D., senior vice president of science policy for the Personalized Medicine Coalition and one of the study's authors, said at a briefing to mark the study's release on Tuesday.

Limited use means limited access for patients, which sustains the lack of knowledge for clinicians, he said. 

RELATED: Geisinger officials explain the business case for making DNA sequencing 'routine' 

So each of the health systems took some similar steps to improving adoption by providers.   

Stanford, for example, built its own genomic test called the Solid Tumor Actionable Mutation Panel (STAMP), so that it did not have to outsource the testing to an outside laboratory and that it could tailor the approach to its clinicians. 

Providence St. Joseph also began conducting its genomic tests internally, according to the study, which makes it easier for physicians to access the data and take advantage of what it can show.

To further push docs to buy into precision medicine, the system encourages genomic testing for patients early on instead of waiting until they need oncology care for a cancer diagnosis. 

Intermountain's program is the farthest along, and the researchers were able to analyze both their protocols and how effective they've been to date. It also uses an internal testing approach, which has led to lower costs in addition to tighter control over the system's precision medicine program, according to the study. Internal testing has also led to quicker turnaround times. 

The precision oncology program at Intermountain led to $733 in savings per week per patient, according to the study. Survival rates also improved, with patients in the program living for 51.7 weeks after diagnosis thanks to targeted therapies, compared to 25.8 weeks for patients who were not enrolled in the precision medicine program. 

"The hope here is that other systems can learn from what they're doing," Pritchard said. 

RELATED: Primary care doctors need help talking to patients about genetic tests 

While these three systems have hurdled some of the barriers to precision oncology success, challenges remain for these programs, according to the study. Getting payers on board and clarifying coverage of these options is a crucial step. 

"Payer policies that include coverage for broad genomic testing panels would support the broader application of precision medicine, deepen research benefits and bring targeted therapies to more patients with advanced cancer," the researchers said. 

A clear set of payment policies would better define funding opportunities for precision medicine research, and could make some other providers more likely to jump into the genomics fray, the researchers said. 

In addition, national programs like the National Institute of Health's All of Us research project could spread the word more broadly about precision medicine, addressing concerns about a lack of knowledge or understanding about what genomics can, the researchers said.