#Aim2Innovate. Share session insights and questions socially. Genomics, Precision Medicine and the EHR 6/17/2015

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1 Genomics, Precision Medicine and the EHR Making Genomics part of everyday practice Andrew Ury, M.D. CEO and founder, ActX, Inc. June 17, 2015 DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS. Share session insights and questions socially #Aim2Innovate 1

2 Disclosure of Conflicts of Interest 1. Chairman and CEO of ActX, Inc. Agenda Human Genetics an fulfilled promise for patient care Genomics and Precision Medicine Current EHR use of genomics and the challenges Example use cases: pharmacogenomics, risks ActX as an example of Genomics Clinical Decision Support ActX approach Conclusion Questions 2

3 Learning Objectives Describe the potential of genomics and precision medicine Recognize the challenges of implementing genomics and precision medicine in an EHR Identify possible solutions Categorize what is practical to do today Human Genetics an unfulfilled promise for patient care 2003 entire human genome sequenced An explosion in medical knowledge occurs But very few changes in clinical practice for most physicians A last mile, translational barrier prevents Genomics knowledge from reaching most physicians 3

4 Why Genomics? 2003 (~$2B ) 2005 Test costs have dropped 100,000-fold in 10 years! Why Genomics? An explosion in knowledge has paved the way 4

5 Precision Medicine 20-75% Average response rates to medications 2M Americans hospitalized yearly from adverse drug reactions 82K Cancers in US per year are hereditary Precision Medicine Applying genomic and molecular data to better target health care treatments and disposition to a particular disease or condition. Current EHR use of genomics Very limited use of existing EHR clinical decision support rules PDF reports are the principal method 5

6 Importance of workflow and point of care solutions Tailoring therapy to the patient is the future of medicine Point of care decision support (the EHR) makes physician adoption feasible Solutions that are not integrated into normal workflow will not be widely adopted What a good solution needs Be present at the point of care Fit into normal workflow Present credible, evidence based information in a useful way 6

7 Example Use cases Drug-Genomic interaction checking during the prescription Serious, actionable risks Demonstration 7

8 ActX approach Focus on Actionable Genomics --- where there is sufficient evidence that the doctor and patient can do something Evidence based on the original literature, usable information Web Service in a secure cloud handling knowledge curation, genomic data storage, processing to support real time clinical decision support ActX approach (cont.) Full EHR integration in multiple EHRs Allscripts Greenway Epic Many more Integration means full workflow integration Turnkey - includes inexpensive DNA sequencing / genotyping 8

9 What ActX enables Every prescription is checked against the patient s genetics as it is written Physicians are automatically alerted for actionable genetic risks such as the need for early cancer screening Genomic profile provided as a summary of the patient s genomics ActX Team of clinicians, geneticists, genetic counselors, pharm D s and software developers Advised by leading academics Large institutions are adopting ActX genomic decision support 9

10 What we are finding Drug-genomic interactions Risks 10

11 Conclusion Precision medicine is coming and will be clinically useful Storing and analyzing genomic data is challenging Workflow integration at the point of care is what will make widespread adoption possible Questions? 11

12 Thank you Andrew Ury M.D. CEO and Founder, 12

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