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Practice Transformation

Direct-to-consumer DNA tests are popular, but primary care physicians lack background in genetics testing technology to address issues related to the tests. Mylynda Massart, MD, of the University of Pittsburgh, is changing that. She’s medical director of UPMC’s new Primary Care Precision Medicine Clinic. The clinic provides education to PCPs and fills the gap in services for patients. She notes that pharmacogenomics is especially important to primary care. “If we can do a single panel after someone turns 18…that data would be readily available in the electronic health record and could greatly inform prescribing.” (HealthData Management)

Evidence & Innovation

As part of a National Institutes of Health four-year study to harmonize and standardize clinical genetic reporting, Baylor College of Medicine has created a roadmap for future efforts in precision medicine that aim to deliver personalized care. Researchers balanced the demand for research access to the genetic data with the strict privacy requirements for returning results to patients by creating new methods for shielding sensitive, personal data. The entire project is written up in Cell. Perhaps the most important result? The study accomplished integration of structured genomic results into multiple EHR systems, which will go a long way toward providing clinical decision support to enable genomic medicine. (Cell; Baylor From the Labs blog)
Brigham and Women’s Preventive Genomics Clinic is providing comprehensive DNA sequencing, interpretation and reporting to help accelerate precision medicine research. It offers services to consumers, but only after an in-person evaluation by genetics specialists. Because genetic testing isn’t covered by health insurance, Brigham and Women’s is finding ways to offer free or lower-cost testing where needed, especially for minority patients who have been underrepresented in genomics. Initially, the clinic will focus on disease risks for single-gene disorders, particularly hereditary cancers and heart problems, reproductive risks and genetic markers to help avoid medication side effects. (HealthITAnalytics; announcement)
Eric Topol, MD’s, Deep Medicine is all about artificial intelligence in health care, and that’s what he talked about on a recent Data Book podcast. But his takeaways focused on the humans, not the robots. Improved accuracy and increased efficiency are, of course, devoutly to be wished. But AI should serve our humanity, not the other way around. AI must, first and foremost, enhance humanistic aspects, such as empathy, to strengthen the doctor/patient relationship. (Inside DigitalHealth Data Book podcast)

Policy Solutions

The Sequoia Project, an interoperability not-for-profit, has inked an agreement with the Office of the National Coordinator for Health IT to help implement components of an interoperability framework. The Sequoia Project will develop, update, implement and maintain the common agreement, which aims to create baseline requirements for health information networks to share electronic information. The common agreement is part of the ONC’s implementation of the 21st Century Cures Act. (Modern Healthcare; ONC announcement)
The departments of Health and Human Services and Treasury issued new guidance to delay enforcement of a recent rule that allowed insurers to exclude coupons from an enrollee’s annual limit on out-of-pocket costs only in certain circumstances. The new rule has led to confusion, especially for insurers in the large group market and self-insured group health plans. So HHS will further clarify this policy in a forthcoming regulation for the 2021 plan year. (Health Affairs; new guidance)
Free, Live, GTMRx Institute Webinar
Core tenets to implement CMM in primary care:
Getting the medications right
September 26, 2019 | 1- 2 p.m. EDT
Presented by:
The evidence is clear: comprehensive medication management (CMM) is good for patients as well as for the pharmacists, physicians and others involved in their care. Through CMM services, we have a team-based, systematic approach to ensure medications are safe, effective and appropriate for every patient. Now we need to know how to implement it consistently across primary care teams. This webinar will offer a customizable blueprint for delivery of CMM and demonstrate how it improves work-life balance for primary care providers. It will include strategies learned from practices in the field and showcase evidence-based tools practices can use to implement CMM.

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