Can patients' genetic data help keep them healthy? Providers invest big to find out

SCOTTSDALE, Ariz.—HonorHealth is a community hospital group, not an academic medical center, but it has nevertheless committed significant resources to its research programs.

Some of its early work over the past several years has centered on finding targeted therapeutics for cancer, and it has had good success. But the five-hospital system is increasingly interested in finding biomarkers that can help predict who might be at risk for illness.

HonorHealth is one of a number of health systems that are investing in genomics and personalized medicine as the next frontier in healthcare. As providers are tasked with keeping people healthy through risk-based payment contracts, they're searching for new ways to target patients who need early intervention. Venture capital funds also have been flowing into the space, as investors expect rapid growth.

“A lot of health systems are looking to be on the cutting edge of that,” said Melissa Bianchi, a partner at law firm Hogan Lovells. “There's also the potential to reduce healthcare costs.”

This work is being done not only by traditional academic research programs, but increasingly by community health systems whose first mission is patient care. While academic medical centers are still at the forefront of such research, large integrated-delivery networks are laying their groundwork through partnerships with companies or laboratories that perform genetic analyses, Bianchi said.

Scottsdale, Ariz.-based HonorHealth, for instance, is hoping to identify biomarkers, perhaps detectable through molecular imaging that can signal the risk of pancreatic cancer up to two years before symptoms develop. Beyond oncology, it is also looking for biomarkers that might indicate an increased risk for ventilator-acquired pneumonia, a dangerous (and expensive) hospital-acquired infection that can increase length of stay.

“Our goal is to learn to move upstream into early intervention and early detection,” said Mark Slater, CEO of the HonorHealth Research Institute. “We already have this in action, but the ultimate promise is to broaden it and have it become routine.”

To that end, it is hiring new staff and reaching out to donors in the community to support its efforts. “We're building that out of our existing program,” Slater said.

In March, Providence Health & Services made a similar move to build its research capabilities in genomics when it acquired the Institute for Systems Biology. The organizations plan to explore new opportunities around wellness, like identifying people who are pre-diabetic and then intervening early enough to keep them healthy.

“Everyone is looking at what is the intersection between personalized genomics and how do you use that to improve care for patients,” said Dr. Rod Hochman, Providence's CEO, in explaining the impetus for the deal. “We're hoping to streamline how quickly we can get things done.”

Providence joins providers like Inova Health System in Falls Church, Va., which last year launched a Center for Personalized Health to integrate genomics into personalized medicine and wellness.

Other systems are taking a collaborative approach to genomics research. Mercy, the Chesterfield, Mo.-based health system, is a member the Guardian Research Network, along with Baptist Health in Louisville, Ky., Spartanburg (S.C.) Regional Healthcare System; Bon Secours Health System in Marriottsville, Md.; and Wake Forest Baptist Health in Winston Salem, N.C.

Together they're aggregating clinical and molecular profiles for thousands of patients, with the aim of accelerating drug development by helping to find candidates for clinical trials.

New technologies and analytics tools that can mine complex, unstructured data from electronic health records are leveling the playing field when it comes to genomics research. Venture capital firms also point to this new set of companies as a promising group they're keeping their eyes on.

“I think population health is very blunt,” said Ian McCrae, CEO of Orion Health, one of the technology companies in this space. “It's a very crude way of looking at things. The promise of precision medicine is going to supercede population health.”

There's so much data available now that health systems can no longer store it within their own systems, and need to move to the cloud, he added. The company is seeing more requests for proposals for precision medicine projects, particularly from large integrated delivery networks that have a critical mass of patients.

“We're still in that phase where we're trying to put together a whole host of data,” said Dr. Rohit Varma, interim dean at the University of Southern California's Keck School of Medicine, which has established a translational research department with the hope of being able to one day predict and prevent illness. “We're still a little ways away but we're beginning to get to that point.”

Patients also are more willing to track and share their data. “More and more individuals, from what we're seeing, have these wearable technologies, where they're willing to upload their information to the cloud to get feedback,” Varma said.

Still, performing genetic analysis across large populations remains a murky area, both legally and ethically. “There's a little more nervousness in some quarters in broader testing,” Bianchi said. “Sometimes you find things in genetic information that you may not want to know.”

Genetic information hasn't been considered identifiable data under the Health Insurance Portability and Accountability Act, but federal agencies have been working to tighten the regulations, Bianchi noted.

“Because the science is newer, the laws haven't caught up yet,” she said.

At HonorHealth, which is participating in the Medicare accountable-care program, investing in personalized medicine is part of its population health management strategy.

Its research program operates more like a clinic than a research institute. It doesn't do any basic science. There are no animal studies or petri dishes.

“Where we think we can make a difference is in complementing the work others are doing,” Slater said. “What I say is that care is our first priority and we wrap around that the science.”