Survey Quantifies Precision Medicine Awareness Among Health System Leaders

A new survey conducted by The Health Management Academy has identified a rapid investment by leading healthcare systems in precision medicine programs, with significant expectations of the impact of real-world outcomes on physician decision making.

The survey saw participation from 21 chief medical officers and oncology leaders from healthcare systems that operate or own 296 hospitals that average 2.9 million annual admissions. The respondents were queried on their awareness, integration, and operationalization of precision medicine at their respective institutions.

The most significant takeaways from the survey results were:

• The majority (60%) of health systems indicated that developing a precision medicine program was a high (25%) or essential (35%) priority for their organizations’ aims.
• While 43% of respondents reported that they are currently implementing a precision medicine program, 19% said that such a program had been implemented in their health system in the last year. A precision medicine program was at least a year old in 10% of responding health systems.
• The leaders expect real-world outcomes data to have a significant bearing on physician decisions for the most complex oncology cases. Along those lines, 60% of respondents indicated that their health system is involved in a cancer data-sharing collaboration.

With a primary focus in the oncology space, 89% of respondents said that they expect precision oncology to improve patient outcomes, help enroll and retain patients in their program, and also assist clinical trial accrual.

When asked specific questions, such as the use of next generation sequencing panels for stage IV patients with cancer, 65% respondents reported a frequency of 40% or less. However, 69% of respondents indicated a slow growth in the use of these panels and 23% reported a rapid increase in use; 8% indicated the frequency of using these panels has remained the same.

The use of molecularly targeted therapies is low (40%) in stage IV patients with cancer, according to 57% of respondents, but is slowly (77%) or rapidly (15%) increasing, according to the survey results. Nearly 80% of respondents also indicated that off-label prescription of targeted therapies has also increased.

With respect to software use to implement a precision medicine program, while 70% believe they need to invest in such technology, only 30% indicated they had allocated a budget for such software. The decision on which vendors to choose was driven by:

• Clinical trial matching
• Clinical decision support
• Molecular tumor board support
• Data sharing across networks
• Data warehousing and analytics.

The leaders who responded to the survey did express concern that their oncologists did not always order the most appropriate molecular diagnostic tests (73%) or may lack in ability to accurately interpret the molecular information from these tests to guide their choice of the targeted treatment for the patient (63%).

When queried on reimbursement policies, half the respondents indicated the need for automation of prior authorization to improve use of molecular diagnostics and targeted therapies.

Discussing the results of the survey, Ken Tarkoff, CEO of the technology company Syapse, wrote in his blogpost, "Precision medicine is complex and it presents entirely new types of data and treatment protocols to the oncologist. To scale precision medicine, we need to make it easier for oncologists to access and interpret the information they need." Tarkoff recommends more widespread data sharing at the point of care to help oncologists decipher and connect the dots between the clinical, molecular, treatment, and outcomes data that is available on his company's data-sharing network.