Utility in Concierge Care

Use of Whole Genome Sequencing in Concierge Medicine
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Concierge Medicine Today issued a statement of support, noting, “Genetic technology has reached the point where the cost of conducting comprehensive genetic testing [ie. Whole Genome Sequencing] for hundreds of preventable diseases at a single time is now affordable,” said Catherine Sykes, CEO and Publisher of the national trade publication. “After years of thoughtful consideration, careful research and review, countless hours of dialogue with various physicians and technology companies, we encourage Concierge Medicine Physicians to make personal genomic data information available to patients so that they can start to understand their makeup, learn more about their individual genome and predictors, and begin to use these insights to improve their lives.”

Genetics usually refers to the study of individual genes and their role in disease or inheritance. Genomics refers to an individual’s entire genomic make-up. Genomics looks at the genetic sequence of genes, and their structure and function as well as the interactions between genes. An easy way to think about genetic testing is to compare it to a book, because genetics is truly our Instruction Manual of Life and genetic testing is simply a way to proofread each person’s Instruction Manual for potential typos, according to Sequencing.com.

The accuracy of whole genome sequencing is quickly improving and the cost is quickly dropping. Within the next couple of years, this technology will most likely be widely used by Concierge Physicians in the daily clinical care of their patients.

The Concierge Medicine Physician can, should [and currently is] acting as the informed fiduciary, shepherding the patient treatment process so as to make informed decisions with actionable data, together, with their patients. Advanced DNA research and whole genome sequencing have powerful applications, says trade publication, Concierge Medicine Today. Companies see Concierge Physicians as the ideal delivery model, allowing people to learn more about their DNA and make informed, data-driven decisions under the direction and support of their involved [Concierge] physician, to live a healthier life.

“The genetic revolution has already begun, and it is having far-reaching effects on healthcare right now,” said Brandon Colby, MD and author of Outsmart Your Genes. “Our knowledge of how to use this information is increasing at an exponential rate. What this means is that we can now start to integrate genetics into our everyday lives. With comprehensive genetic testing, we launch an innovative strategy against disease, attacking it before it even manifests. Genetic testing, therefore, provides a new counter-offensive in our war against Alzheimer’s, cancer, heart disease, and many other diseases that have plagued our civilization for centuries. This is the most exciting, and potentially groundbreaking, medical development of this century.”

“The data, however, should be owned by the patient. Their Physician can help direct them on how to apply the information contained in WGS to maximize its benefits,” states Michael Tetreault, Editor of Concierge Medicine Today. “Patients need the ability to securely store, use, and understand genetic data.”

Concierge Medicine Today advises this should be accomplished through physician involvement and technology that integrates genetic data into software applications [apps]. Software apps are now available that analyze genetic data and transform the data into actionable information that can have a real impact on health.

Colby notes, whole genome sequencing allows him to “cast a wide net” by generating a tremendous amount of genetic data. He then uses apps at Sequencing.com that analyze the data and provide straightforward reports focused on relevant, actionable findings. He also noted that there are five questions you [patients and physicians] need to ask in order to assess the quality of the outcomes data: (1)  The credibility of the laboratory doing the testing; (2)  What types of diseases are included in the test; (3)  How thoroughly does the test actually evaluate risk for each of the diseases; (4)  Whether the information is provided in a way that makes it actionable; and (5)  Will the results be delivered in a format that is straightforward and easy to understand?

At the Louisville Innovation Summit (October 2015), former White House CTO, Aneesh Chopra outlined his vision for a future of healthcare managed by “information fiduciaries.”

“We are essentially undergoing the most entrepreneurial period in healthcare history,” Aneesh Chopra told the crowd at the Louisville Innovation Summit. In his keynote speech, From Innovation to Integration: Understanding the interdependence on people and data, Chopra presented his vision of the future of healthcare. That future, Chopra explained, is dependent on the careful management and integration of data into patient care. Chopra envisions a future where “each and every one of is given a valet key to their data.” The valet key, Chopra said, is not unlike how Netflix determines your user preferences. These valet keys can be distributed to patients. “They can be handed to an entity that the patient trusts to organize and manage their healthcare.

The third piece of the future of healthcare, Chopra said, is about managing options. He envisions a system where patients will have advisors, acting in their interests, to help them figure out their best plan. “I see the rise of an entirely new job description that doesn’t exist in health care,” Chopra said. With all the choice we have, we will need what he calls an “information fiduciary”—a person to entrust our data with, who can offer help making smarter decisions. “Which plan should I choose? Which primary care doctor?” asked Chopra. “What’s missing today from our delivery system is this muscle of being able to interpret and organize and advise individuals. We need someone to connect the dots.” [1]

Within a couple of years, Concierge Medicine Today understands genome sequencing will most likely be widely used by [Concierge] physicians in the daily clinical care of their patients. Currently available in academic medical centers, this advanced healthcare decision support tool provides the ability to predict and prevent disease and, if disease manifests, personalized therapies tailored to each patient. Due to decreasing costs and better understanding about how this information can be made actionable, this technology is now accessible to Concierge physicians.

“If I were to ask you to describe how you picture your life in ten years, chances are you could paint a fairly clear picture,” says Tetreault. “DNA data with the continuous interaction and direction of a [Concierge] physician ushers in a healthcare utopia. In this way, it simplifies decision making using data, not practice.”

“Anything that moves us toward the realization of better outcomes using data and evidence-based medicine gets a green light by Concierge Medicine Today” says Publisher, Catherine Sykes. “Whole Genome Sequencing used by Concierge Doctors empowers them to move purposefully in a predetermined direction on behalf of their patients. Our observation is that physicians and patients without clear vision are easily distracted. They have a tendency to drift from one ailment, prescription, problem or activity, to another. Without Concierge Physicians at the helm, there is no relational, financial, or data-driven compass that will appropriately impact a person’s life. Consequently, Physician surveys are finding that they are often making insurance-based decisions almost entirely on a patient’s insurance plan coverage (56%), decisions which can rob patients of their health, lifestyle and dreams.”

“What would happen if a physician were to begin speaking to a patient’s future potential rather than their past performance?” adds Colby. “Where the practice of medicine may fall short, a story is often found in our DNA that will provide clarity. Instead of waiting for sickness to occur, the clarity provided by a patient’s DNA can empower a Concierge physician to create a personalized plan for optimizing each patient’s health and longevity.”

Sykes concluded by saying, “Concierge Medicine Today believes that having your whole genome sequenced provides access to information that can empower people to improve their long term health and wellness. We support the use of Whole Genome Sequencing within Concierge Medicine programs and believe knowing more about your DNA will allow you to take steps towards living a healthier life.”

[1] http://www.techrepublic.com/article/chopra-health-care-is-about-to-get-a-lot-more-entrepreneurial-data-will-improve-personalized-health/