One of the country’s largest rural health systems is tackling the challenge of providing precision medicine in integrated health settings. Sanford Health, a 43-hospital, not-for-profit health system based in Sioux Falls, South Dakota, announced this week it has contracted with Bellevue, Washington-based Translational Software to provide pharmacogenomics services to its hospitals and nearly 250 clinics in nine states.
Sanford, which employs 27,000, is expanding its genomics program — called Imagenetics — throughout the organization’s Epic Systems electronic health records. Sanford Imagenetics integrates genetics and genomic information into primary care for adults, providing drug and gene information, as well as clinical decision-making and prescribing support.
Translational Software CEO Don Rule said that with clinical reporting data now available for nearly 40 genes, his company’s platform can be adapted to target clinical specialties like cardiovascular health, psychiatry, pain management and oncology. Rule said that digitizing biology is driving his company’s efforts to tailor medicines for individual patients.
“What we do is take data from labs that have performed genetic testing and apply what we know about individual patients and show their physicians that certain drugs are unlikely to be useful and may even be toxic to someone with their profile,” he explained.
He said that there now is much evidence to be gleaned from Food and Drug Administration drug approval testing data, information that Rule’s company inputs to form recommendations.
“Rather than giving a patient a common drug and knowing it is probably ineffective in 20 percent of patients, genetic tests will tell patients and their doctors when particular drugs would not be useful and suggest the physician switch to an alternative drug,” Rule said.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
He said that Sanford will look for patients in its population who will benefit from this knowledge.
“They’re going to be able to scale it in two dimensions, involving many more people and doing this in in an automated way. It is architectured into their EHR, which will be easy to update with new information. And we can send warnings and alerts about prospective problems,” Rule said.
Rule said five-hospital, Fairfax, Virginia-based Inova Health System was the first to implement Translational Software’s program. But the Sanford deal represents a new step for the vendor.
“This is our opportunity to democratize the use of genetics data in a clinical setting: to provide data that is safe and easy and reliable. This is closer to common use than people realize. The labs are willing to do it. There is now good data on drugs,” he said.
Dr. Cornelius Boerkoel, executive director of the Sanford Imagenetics Research Center on Genomic & Molecular Medicine, offered the organizational perspective on this precision medicine program. “[T]he new pharmacogenomic software enables physicians to efficiently and effectively take the genomic detail of patients and interpret that through Translational Software to provide guidance around prescribing,” Boerkoel said.
“Pharmacogenetics as implemented around the country is the beginning of the arrival of precision medicine, where we can recognize the individuality of the patient and prescribe medication accordingly,” he said.
Boerkoel said he expects to find more appropriate prescribing system-wide and fewer adverse side effects.
“Reducing those should save the system money and lower morbidity in patients,” he predicted. “Will it save patients money in the long run? One would hope so. If it reduces adverse drug reactions, that should lower the costs of insurance.”
Photo: Alexander Rieber/EyeEm
