← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Making Precision Medicine Routine: How Genomics Is Transforming Health Systems
00:11:32
Loading summary
Transcript23 lines
- [00:00]
A
Hi, everyone, this is Lucas Voss with Becker's Healthcare. Thanks so much for tuning in to the Becker's Healthcare podcast series. An exciting conversation today, from data to delivery, how precision medicine is reshaping health systems. And joining me for today's discussion, very excited to have him, Dr. James Lu, CEO and co founder of Helix. Dr. Lu, thanks so much for being here today.
- [00:21]
B
Lucas, thanks for having me.
- [00:23]
A
Yeah, it's great to have you. To kick us off, could you introduce yourself to our audience and just tell us a little bit about your work in healthcare?
- [00:30]
B
Sure. Thanks for having me again. My name is James. I'm the co founder, CEO of Helix and I guess by training, physician, scientist. By training, I come to the precision medicine space, into the medical space, with a couple of different perspectives I think are relatively unique. The first one is obviously I was trained as a physician scientist. So I have this view of the world, really adopting precision medicine at scale and leveraging the genomic data in particular to influence all parts of our care. Inevitably, thinking genetics is going to be part of the standard of care, certainly from a training perspective, as well trained as a computational scientist, as an engineer, much earlier in my career. So a lot of the questions I think we think a lot about, particularly in the health system space, is not just the clinical application, but how do you engineer a system and a workflow to enable you to really capture that value at the systematic level? Then Helix as an organization is really kind of animated by three major principles. The first one is we really do think genetics, which historically has been a little bit esoteric and a little bit used just in the specialty areas, is really starting its trajectory to be part of the standard of care or part of everyday care and primary care. I think we think it's going to really follow a trajectory that looks a little bit like radiology, which is that inevitably it gets practiced in all parts of medicine, not just in the specialty. The second piece, what I think is pretty unique to precision health, but genetics specifically, is that if you think about the sets of data that really help us influence how we manage patients, genetics is probably the only thing in healthcare. It doesn't change with time. And so it's often thought about as a chemistry problem. So how do I generate this data, how do I sequence this data? But I really think at this point, the best way to think about it and encapsulate it is really that it's a data stream that's going to sit on top of the whole operating system of healthcare. And the question then becomes, how do I transform that into a digital resource, a resource that you can use on the point of care that's going to have much better turnaround time, obviously queries being much faster than chemistry, but certainly a much more interesting cost curve in terms of how do I access that digitally versus having to generate a new test every single time.
- [02:41]
A
Yeah, absolutely. I think again, because of your background, I think that's so interesting. You have a unique perspective on all of this, a very versatile perspective. All of this in the last few years have sort of underscored that the value and complexity of using genomics in mainstream healthcare, as you've outlined there. What are some of the most important lessons you think health systems should take away about precision medicine today? Especially in light of those ongoing conversations about data security and privacy?
- [03:10]
B
Yeah, happy to. I mean, I think the first thing to think about when you, when you're thinking about precision health is that it's really a complementary capability to everything else you do. Right. So if you look at just the world of health determinants and you say, what are the big things that drive disease progression or health span? There's three big buckets of risk. The first one is social determinants of health, which every major health system has major efforts around. The second one is really around behavioral management. And how do we think about making sure people make the right decisions, whether it be smoking or eating well or exercising or just changing their behaviors. The third big bucket is around genetics and biological data. The literature suggests that each of those buckets encapsulates 20 to 40% of the risk. For simplicity, we think about it as a third. A third? A third. If you're thinking about, hey, how do I best achieve my population health, my community health and my patient health, it's going to be a key part of how you practice. I think the first piece is that it's really complementary to all these other things you're already doing. In that light, it's just another set of data that helps you achieve the outcome. I know there's a lot of very technical things in the space, but I think really, if you think about it, is, hey, I'm going to be able to deliver better care, I'm going to be able to manage that community health much better because of it. And because of that, I'm also going to be able to reduce cost. I think that's the right encapsulation versus getting really caught up into what the ATGs and Cs look like, right?
- [04:46]
A
Yeah, absolutely. And I love that you mentioned that complementary piece because that's so important I think, because again, it's just, it's an added piece to this which then in turn supports other initiatives and other pieces of the puzzle, so to speak.
- [04:59]
B
Yeah.
- [05:00]
A
If we're looking at this from a strategic perspective, then how can precision medicine in turn support some of those strategic priorities with again that collaboration in mind for health system, Whether that's improving care quality, driving down costs or strengthening payer relationship ships? What examples come to mind for you there?
- [05:19]
B
Yeah, it's a great question and I like to think a little bit back to the People often talk about this thing called the quadruple aim. It's how do I improve my patient experience, how do I improve the health of my population community, how do I reduce costs at the same time? And really how do I make my providers happier as well? How do I make sure they have a great experience? I actually think precision medicine has the potential to be check marks in all those major categories. I think when you think about the typical financial models of health systems, the first one is typically obviously fee for service. If I can find a patient who's been hiding in plain sight, manage them much earlier and make me as an organization a key part of their care trajectory, it's going to drive better financials across the board for various service lines. Whether or not that's catching patients early for cancer or catching them early for cardiovascular conditions, or helping them manage both the diagnosis and the prognosis and therapeutic treatment of those conditions. I think we think about the fee for service side of the house as being much more about how does improve patient management, how do I capture those patients better? We find physician health is a key component of all those different parts of it. The total cost of care side, particularly if you're in a value based arrangement, is really about then how do I leverage these data to drive both significant improvements in adverse event management or reductions, how do I reduce catastrophic care? And then how do I think about the testing chassis or the access points being less of a chemistry event but more of a testing a data event and all those things actually trend the cost curve pretty significantly downwards, which we were really excited about.
- [07:00]
A
Yeah, so it's really a holistic view at all of it together in terms of that collaborative piece and then seeing the holistic view of things, not just isolated pieces, which I think is very interesting. Now that we have sort of established, you know, what we can do, what's needed, etc. The infrastructure needs to be there. Right. Systems need to be able to do this on a regular basis. They need to be able to scale this. What do you think what partnerships, what cultural shifts, etc. Are important for health systems to embrace, to really operationalize some of this, to be able to operationalize genomics and then really scale it and see that full value?
- [07:38]
B
Yeah, this is a great question as well, because I think what you often see in physician health, and it's probably not dissimilar to what you see in a variety of novel technology areas in healthcare, is that you've got a smattering of point solutions everywhere in your organization. Right. So you have a testing solution, then you have this software management solution, then you have this laboratory solution, then you have this other thing and every one of those has a kind of very narrow case P and L, a very narrow case ROI around it. I think what we're finding in our organizations is there's a tremendous amount of value generation in precision health across the board. But it's hard to capture if you have 50 different point solutions. Just the integrations are just making it impossible. A lot of our thinking has been what is the right organizing principle to enable an enterprise to really adopt it at scale and be successful at that? We really partner with major healthcare systems across the country almost on a full stack basis. So how do we think about this as an enterprise value solution versus just a, hey, I solved a very narrow problem in just mental health primary care. That's how we think about the instrumentation. And that workflow is capability, automation. And then the education that goes along with it is a key part of ensuring that both the patients and providers can be successful in this world.
- [09:06]
A
So it's a combination of being able to have the enterprise piece that you've mentioned, but then also talking about change management.
- [09:14]
B
Totally. I mean, it is inevitably a change management component of it because you're asking the systems to adopt new data and new technology at a very rapid rate. And frankly, in healthcare we had to get used to that. That's happening every day now. If you look at not just precision health and genomics, but you look at things like AI, this continuous medical education, this continuous assistance with new novel digital tools is going to be part of the practice. And so I think we're part of our larger stream around how do we digitize the entire experience and make it just better for everyone.
- [09:48]
A
Yeah, certainly a lot to come. Still, I feel like if we meet again in three months, there's new things that we can talk about.
- [09:54]
B
Yeah, I'm hoping one day no one wants to talk to me anymore because it's so boring. Because that's routine, right? Right. If we're successful, it will become routine. And, you know, you won't have me on the podcast anymore.
- [10:05]
A
I'd still have you any day, Dr. Lu. I'd still have you any day. Is there. Is there anything else that we didn't touch on that you think would be important for folks to understand when we talk about this?
- [10:16]
B
I mean, I think there's. There's been a little bit of sense in the space historically that it's like only the, you know, the academic systems can do this. Right. Or it's only these mega national systems can really adopt these programs. And I think that's just not true anymore. I think we've gotten to a point now where the benefits from an enterprise perspective are available to almost all leading health systems across the country. And the implementation cycle and the success in these programs is also, I would say, becoming more of a playbook, more of a routine that you can deploy in many different settings and places. It's not to say there's not work to be done now, but I do think the question of, like, oh, is it another five years till this field really takes off? I think my view is we can stop saying that now. I think we're really on the trajectory.
- [11:02]
A
Yeah, absolutely. Which is great to know. We still have you on, Dr. Lucey. We'll still need you. We'll still need you.
- [11:09]
B
I need to come up with new ideas.
- [11:11]
A
Exactly. Exactly. Well, thank you so much for your time and insights today. This was a fantastic conversation. Thanks for being here.
- [11:17]
B
Of course. Thanks for having me.
- [11:19]
A
Absolutely. You also want to thank our podcast sponsor, Helix. You can tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com.