Precision Medicine. Presented by:

Transcription

1 Precision Medicine Presented by: Prepared Brendan FitzGerald For:

2 Enabling better health through information technology.

3 Healthcare Information and Management Systems Society (HIMSS) HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology. HIMSS Annual Conference, Corp Membership, Thought Leadership, etc. LOGIC, CapSite, Maturity Models, Insight & Research, Essentials Briefs, etc. Marketing Arm, Healthcare IT News, Local Forums, Content Creation & Syndication, etc.

4 Healthcare s Most Comprehensive Market Intelligence Resources & Advisory Solutions Health IT Market Intelligence Health IT Insight & Research Healthcare Organization Benchmarking

5 Healthcare Delivery Organizations Uniquely Positioned to Deliver Actionable Intelligence Health IT Solutions

6 Early precision medicine efforts at larger organizations Is your organization currently conducting precision medicine to provide disease treatment and prevention to patients? Precision medicine was defined as an approach for disease treatment and prevention that takes into account individual variability in genes, environment and lifestyle for each person Unsure 37% No 34% Yes 29% Roughly 29 percent of respondents indicated they conduct precision medicine within their organizations. The limited adoption of precision medicine programs across the U.S. hospital market is understandable as very few organizations have the funds, technology or expertise to conduct precision medicine on site. Many precision medicine programs are in place at larger, research-based organizations such as academic medical centers (35 percent) or multi-hospital health systems (25 percent), or at organization s with over 500 beds (41 percent) Source: 2016 HIMSS Analytics Precision Medicine Study (N=137)

7 Current focus has been primarily on cancer In which of the following areas are you conducting precision medicine? (please select all that apply) Cancer Neurology Prenatal screening Cardiology Unsure Epidemiology Other 10.3% 10.3% 10.3% 30.8% 28.2% 38.5% 79.5% Most organizations conducing precision medicine have been focused on cancer for a number of reasons. First, cancer is a genome disease and work can be done on tumors to understand genetic changes that go along with an individuals specific cancer. Second, President Obama launched the Precision Medicine Initiative and a large amount of the provided funds have gone to the National Cancer Institute (NCI) for the development of cancer treatments. However, precision medicine is being conducted in other areas such as neurological disease and cardiovascular disease. 0% 20% 40% 60% 80% 100% Source: 2016 HIMSS Analytics Precision Medicine Study (N=39)

8 Disease diagnosis and prevention are top of mind Which of the following best describes your organization s primary driver/incentive to conduct precision medicine? (please select all that apply) Disease prevention 23.1% Early disease diagnosis 20.5% Clinical drug trials 15.4% Patient risk assessment 12.8% Drug therapy monitoring 12.8% Unsure 10.3% Other 5.1% 0% 5% 10% 15% 20% 25% There are a number of facets to precision medicine, but the top driver or incentive to of those conducting precision medicine is disease prevention. The clinical effects of precision medicine drivers are focused on identifying a disease in the early stages and preventing diseases from moving further, and other clinical initiatives can be positioned to support those drivers. With patient risk assessment and disease prevention, organizations may be able to focus on incorporating precision medicine data to further population health initiatives. From an IT perspective, the recent uptick in analytics platform adoption should help organizational ability to manage large data sets, which is essential in precision medicine.

9 Not all precision medicine processes done on site Which of the following best describes how your organization is conducting precision medicine? Unsure 15% In-House 21% Other 5% 3rd Party 26% In-House & 3rd Party 33% There is a high level of reliance upon outside entities to provide the services needed to conduct precision medicine. Academic medical centers and multi-hospital health systems both use substantial in-house AND 3 rd party services to meet their needs. Some of the 3 rd party labs mentioned included FoundationOne, GeneDx, Genoptix, and LabCorp. Definitions In-House & 3rd Party: organization relies upon an outside clinical testing laboratory to provide clinical specimens from which we can run sample and sequence analysis in house 3rd Party: organization relies upon an outside clinical testing laboratory to provide clinical specimens AND sample and sequence analysis In-House: organization houses a bio bank that allows for access to clinical specimens from which we can run sample and sequence analysis in house

10 Processes too sophisticated for some organizations Does your organization have plans to take clinical specimen and/or sample and sequence analysis in house? Unsure 26% No 44% Yes 30% Academic medical centers and multi-hospital health systems are currently the only organization types looking to bring specimen and sample sequence analysis into their facility. These organizations have the funding and the expertise to leverage these services in-house As organizations become more sophisticated across their clinical and analytical platforms, it is possible they could harness these tools to manage larger data sets and conduct more thorough analysis.

11 Limited future plans but potential room for growth Does your organization have plans to conduct precision medicine to provide disease treatment and prevention to patients? Unsure 66% Yes 16% No 18% Future plans to conduct precision medicine are somewhat limited among the organizations without a current program in place. Roughly half of the organizations with plans are multihospital health systems. The level of uncertainty around future precision medicine plans could contribute to the potential increase of precision medicine programs. Nearly half of the organizations that are unsure of plans are multi-hospital health systems and stand-alone hospitals and have greater than 250 beds. These organizations could have the resources and expertise to initiate a program. These details, combined with the Precision Medicine Initiative could lead to increased growth in developing programs.

12 Laboratory capabilities and infrastructure Nearly 92% of US hospitals utilize a Laboratory Information System. Microbiology is the only other lab technology deployed more than half of US hospitals. Less than 1/3 rd of hospitals have deployed 4+ laboratory technologies. Number of Hospitals per Lab Tech 5,004 4,090 Number of Lab Techs per Hospital 1,487 1,319 1, ,207 1, ,005 LIS: Laboratory Information System Microbiology Specimen Collection Management System Laboratory - Outreach Services Laboratory - Molecular Diagnostics Data from HIMSS Analytics LOGIC

13 Varying laboratory capabilities The most common laboratory configuration in the US is LIS & Microbiology. 39% of hospital labs utilize LIS & Microbiology or LIS, down from 43% in % of hospitals utilize the other configurations below. Over the last three years; 15% of hospitals with LIS & Microbiology added additional components but only 2% of LIS only sites added additional components. Common Laboratory Configurations 1,492 1,340 1, LIS & Microbiology LIS LIS & Microbiology & Specimen Collection System LIS & Microbiology & Specimen Collection System & Outreach LIS & Microbiology & Specimen Collection System & Outreach & Molecular n=4,093 Data from HIMSS Analytics LOGIC

14 Increasing sophistication in hospital laboratories While the focus has been on precision medicine there has been significant activity across laboratory systems. 3% of hospitals deployed these advanced laboratory capabilities in the last 12 months. Deployment since 2014 has increased 30%. US Hospitals Deploying Advanced Laboratory Capabilities 39% 32% 33% 35% 34% 27% 26% 22% 19% 15% 16% 17% Precision Medicine - Molecular Diagnostics Transfusion Management System Laboratory - Outreach Services Specimen Collection Management System Data from HIMSS Analytics LOGIC n=2,131

15 Comparing hospitals that have or have not expanded laboratory capabilities Hospitals that expanded lab capabilities, on average, have higher patient volumes and more assets that those that did not. Total Fixed Assets $114,434,384 Total Staffed Beds 191 Total Hospital Inpatient Days 44,704 37, ,966 Total Acute Days 34, Total Fixed Assets $75,004,265 Total Acute Beds 150 Total Discharges 7,897 6,716 Lab Expansion No Lab Expansion Data from HIMSS Analytics LOGIC n=4,093

16 Precision medicine usage limited to specific hospital type Primary specialty-type is the key distinguishing feature of Precision Medicine users. 80% of Oncology hospitals deployed precision medicine more than 5 years ago was the first year more than 50% at academic hospitals were using precision medicine. Less than 50% of hospitals with more than 500 beds have deployed precision medicine. Precision Medicine Usage by Primary Specialty 80% 70% 60% 50% 40% 30% 20% 10% 0% Academic Cardiology Oncology Pediatric Pediatric, Women's Health Women's Health n=5,460 Data from HIMSS Analytics LOGIC

17 Precision medicine usage limited to specific hospital type Primary specialty-type is the key distinguishing feature of Precision Medicine users. 80% of Oncology hospitals deployed precision medicine more than 5 years ago was the first year more than 50% at academic hospitals were using precision medicine. Less than 50% of hospitals with more than 500 beds have deployed precision medicine. Precision Medicine Usage by Bed Size 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Under Data from HIMSS Analytics LOGIC n=5,460

18 Questions around the future of Precision Medicine Standards Medical Technical Policy Data Management Volume Interoperability Cost and Payment Misaligned incentives Unfamiliar reimbursement methods

19 HIMSS Analytics Toolkit Health IT Actionable Insights

20 We drive the health IT market in the direction it needs to go EMR Adoption Model Outpatient EMR Adoption Model Analytics Maturity Adoption Model Improved Patient Care and Health IT Insights Continuity of Care Maturity Model Digital Imaging Adoption Model