As providers embrace the promise that precision medicine brings to healthcare, their support strategies concentrate on three specific areas ― infrastructure, funding and human capital, according to a recent survey by HIMSS Analytics, sponsored by Intel. The survey was designed to illuminate providers' strategic approaches to precision medicine initiatives. Respondents included business leaders, IT leaders, IT professionals and clinicians from organizations ranging in size from fewer than 50 beds to more than 500 beds.
Seventy-nine percent of respondents reported they have limited precision medicine initiatives in place at this time. The CMIO of an intermediate-size (251 to 500 bed) provider said: "We are not prepared for precision medicine at all. We would have to have a very strong, strategic focus on it and build it, but we're just not there."
Within the next two years, however, the number of providers expecting to have specific strategies in place to develop or enhance precision medicine initiatives will double, from 21 percent to 42 percent. "We're definitely increasing our budget for infrastructure," said the CIO of an intermediate-size (251 to 500 beds) provider. "We are spending a lot more money on our data center and our network to make sure there are no issues with performance, because the size and the amount of data are much bigger in precision medicine."
Only one in five (21 percent) respondents said precision medicine is a current budget item. However, 57 percent expect precision medicine to be a part of their budget in the future. The CFO of an intermediate-size (251 to 500 bed) provider said: "I think we will continue to see improvements [in funding for precision medicine]. Once you start showing what the program is costing and what the return on investment is, I think [precision medicine] is going to thrive and to prosper."
One of five (21 percent) of respondents reported they currently rely on research grants to support precision medicine initiatives. Nearly the same percentage (18 percent) expect to rely on research grants to support precision medicine initiatives within the next two years. The chief quality officer of an intermediate-size (251 to 500 bed) provider said that, although the Obama-era Precision Medicine Initiative, housed in the National Institutes of Health, created momentum in precision medicine research, reimbursement practices have not caught up. "The Centers for Medicare and Medicaid Services doesn't reimburse [for precision medicine], and the patients, generally speaking, are not going to pay for it," he said, "So the cost-benefit ratio is not there yet. ... It's still in it's infancy."
In the area of human capital, nearly one-third (30 percent) of respondents said they have in-house geneticists in place. Thirty-eight percent of respondents expect to have in-house geneticists in place within the next two years. The chief quality officer of an intermediate-size (251 to 500 bed) provider observes a generational gap in the way clinicians approach precision medicine, which can impact the decision to train existing staff versus hiring from outside. "There are not enough doctors who really understand the role genomics plays in medicine. At least guys in my generation - 50 and older - versus the younger doctors who are just coming out of training. I think there is a gap there."
Providers offered varied responses as to how they plan to address challenges related to staffing to support precision medicine. Forty-two percent said they are unsure how they will address staffing challenges. Thirty-six percent expect to reallocate and train existing resources; 30 percent plan to outsource; and 22 percent plan to hire to fill new roles.
With respect to geneticists, 70 percent of respondents reported they are currently outsourcing their needs for geneticists. Within the next two years, the number of providers expecting to rely on outsourced geneticists drops to 62 percent.
The survey revealed that many providers are taking a tentative approach to building the infrastructure, funding and human capital that will support precision medicine initiatives at their respective organizations. Nevertheless, providers also believe precision medicine holds great promise for the future of healthcare. The CIO of an intermediate-size (251 to 500 bed) hospital said: "We hope [precision medicine] is going to be transformative. That's really what our goal is ― to take the entire care delivery system and transform it into one that focuses on the unique characteristics of each patient to get them the best possible quality of life and best possible outcome."