Precision Medicine as a Standard Part of Primary Care
As genetic information becomes more accessible with Epic, a new model for care emerges
NorthShore University Health System’s “advanced primary care” model starts with a basic questionnaire, but its outcome is anything but basic—healthcare in which precision medicine is the norm instead of the exception.
“We’re always focused on what’s next,” said Dr. John Revis, VP of Patient Experience. “And that starts with the most advanced primary care.”
Patients complete a Genetic and Wellness Assessment questionnaire in NorthShore’s MyChart portal prior to their PCP’s standard diagnostic assessments. Their answers appear in Epic and help providers decide whether to order tests for established indications or to proactively test for a condition. Test results can guide providers to understand the conditions a patient is at higher risk for, allowing them to create a personalized care plan before symptoms even appear. As of January 2019, more than 100,000 patients have completed the Genetic and Wellness Assessment questionnaire.
In one case, a provider used a gene panel test for a patient with little known family history information to determine she was at elevated risk for Lynch syndrome. The provider recommended more frequent screening for colon and other Lynch-associated cancers as part of the patient’s care plan, along with other preventive measures.
A personalized care plan is just the beginning. After genetic information for a patient is in Epic, the system can warn providers of possible gene-medication interactions, so they can adjust doses or switch medications.