NorthShore University HealthSystem, serving patients in the Chicago metro area, has successfully integrated clinical genomics into routine primary care via its Epic electronic health record system.
The healthcare organization—which partnered with clinical genetics vendor Color—contends that as of last week, it has met its goals of enrolling 10,000 participants at 15 primary care sites, making it the largest U.S. genomics program to date.
“We did a very rapid pilot with NorthShore in 2018 for 1,000 patients in about six weeks—and, then, expanded the partnership last year providing genomic screening and routine care to another 10,000 patients,” observes Caroline Savello, Color’s vice president for commercial.
The program—called DNA-10K—is providing NorthShore’s clinicians with actionable clinical genomic results, including pharmacogenomics, as well as risks for cancer and cardiovascular disease, by integrating genetic test results into the EHR with real-time alerts.
“We are providing back discrete genetic information into the EHR,” says Color’s Savello. “For this to be adopted in primary care, it had to be a really clean part of physician workflows.”
Under the DNA-10K program, Savello notes that 99 percent of NorthShore’s eligible physicians ordered the genetic testing for their patients, with 95 percent of patients receiving their test results in less than 30 days. She also points out that more than half of participating doctors surveyed indicated that DNA-10K has already provided a direct clinical benefit to patients, while 81 percent said it would in the future.
“With these genetic results, we can then alter patient treatment plans to help prevent them from developing a catastrophic disease such as late stage breast cancer or ovarian cancer,” says Mark Dunnenberger, director of pharmacogenomics at NorthShore University HealthSystem.
In addition, Dunnenberger contends that integrating genomics into clinical care has served to “activate” patients to be more involved in their healthcare decisions.
When it comes to pharmacogenomics, he adds that genetic testing helps patients understand how their genes affect responses to medication. “This will lead to clinicians picking safer, more effective treatments and patients being more engaged and confident in their medication and provider,” according to Dunnenberger.
In DNA-10K, 99.8 percent of patients had at least one actionable pharmacogenomic finding in their genetic testing associated with drug and gene interactions.
“We’re embedding genetic counselors in the process because they are key to helping patients understand what their genetic test results mean,” notes Dunnenberger.
Color provided genetic counseling for patients participating in DNA-10K. Of those who took advantage of the service, the vendor reported that 99 percent of patients had access to genetic counseling within 48 hours of requesting an appointment, compared with the industry standard of four to six weeks.
“The whole service level agreement is much higher, and the patient experience is much better,” says Savello, who contends that the “frontline” genetic counseling provided by Color helped enable NorthShore to rapidly scale up its clinical genomics program.
In a survey of patients in DNA-10K, 90 percent indicated that they were satisfied with their experience, and 70 percent said the program enabled them to better manage their personal health.
Going forward, NorthShore plans to expand the genomics program this year to 30 additional clinics—including newly acquired Swedish Hospital—and to integrate more sophisticated information into clinical care including predictive polygenic risk scores for type 2 diabetes and coronary artery disease.
“We’re able to ensure that no matter who you see at NorthShore—and no matter where you see them—if your genetics is relevant, we can deliver information about how it should modify your treatment plan,” concludes Dunnenberger.