UCLA Health will soon begin a pilot project with Seattle-based startup ActX that will integrate genomic patient data into its Epic EHR system, with the eventual intent of applying precision medicine to a large-scale patient base.
ActX, founded in 2012 and just out of stealth mode six months ago, collects a patient’s genetic information by way of a saliva sample, and then analyzes the information in real time. The data is integrated into an EHR – already, ActX is working with Allscripts and Greenway Health – and physicians will receive an alert about a medication and possible side effects, or warn of potentially serious risks for cancer.
Think of it as a 23andMe that is integrated into an EHR and available to the patient.
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Molly Coye, chief innovation officer at UCLA Health, which operates four hospitals, said that’s precisely what intrigued the academic health system.
“Our goal is to try to bring precision medicine to a much larger proportion of patients,” she told MedCity News. “Right now it tends to be focused particularly on people with cancer, and even then on a low number of patients.”
She added that genomic data combined with an EHR could have “real clinical meaning for a larger number of patients than we could have known about five or 10 years ago.”
The pilot will begin in the coming weeks on 50 patients that the health system thinks will be a good fit, Coye said. Depending on initial success, it will be expanded to a greater number.
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“If successful, and our physicians are enthusiastic about it, we’ll rapidly make it available more widely,” she said, adding that most UCLA Health pilots range from three-to-six months.
ActX co-founder and CEO Andrew Ury, a physician who has worked extensively in the EHR space, said up until now, few if any genomic data collectors have been integrated into an EHR. Dr. Ury previously worked for Practice Partner, which was acquired by McKesson in 2007.
As he sees it, EHR integration is the only way to harness genomic data on a large scale while at the same time providing the results for patient.
“We believe the way to do that is to build it into the everyday tool, the EHR,” he said. “The consumer factor is because we have to get the patient’s genomic data in order to make it work, so we offer access to affordable DNA sequencing. In order to that, we involve the patient.”
Given that UCLA Health uses an Epic system, which dominates the hospital market, Coye said the potential to reach a mass of patients is significant, and that such an EHR add-on could someday be a standard feature if it proves successful.
“They’re actually working with Epic, so decision support means a lot more if it pops up in the EHR,” Coye said. “This is going to be a game changer, I think. That’s the real promise that everyone recognizes about genetic testing, that this will become a standard. It’s just a question of how you do it early on.”
Importantly, Coye cited the autonomous nature of ActX in how it’s available to both patient and physician.
Dr. Ury elaborated on the potential of precision medicine and EHR integration from a clinical standpoint.
“What this means is that if a patient’s genetic data is on file, because we’ve analyzed it, each time the physician writes a prescription in the EHR, it’s going to see if a drug is going to work, or if there’s an adverse reaction,” he said. “If there is an issue, the physician will get an alert.”
The data, and its use within an EHR, can also help physicians better determine if a patient is at higher risk of a genetic disease or a certain type of cancer. With that knowledge, more effective medications and treatments can be determined far earlier than before.
Coye said UCLA Health hopes the pilot can bring precision medicine to primary care and a further breadth of specialists “across a wide variety of clinical conditions.”
ActX is so far privately funded and has about 25 employees and independent contractors, including scientists, pharmacists, genetic counselors, physicians and software developers, according to Dr. Ury.
Dr. Ury noted that it’s “the dawn of precision medicine,” referring to the $235 million initiative championed by President Obama and overseen largely by the NIH.
“While genetics can’t predict everything, genetics can predict more and more and whether a patient has a side effect,” he said. “We think this is the future.”
