Patient-Centered Precision Health In A Learning Health Care System: Geisinger's Genomic Medicine Experience

被引:73
|
作者
Williams, Marc S. [1 ]
Buchanan, Adam H. [1 ]
Davis, F. Daniel [2 ]
Faucett, W. Andrew [1 ]
Hallquist, Miranda L. G. [1 ]
Leader, Joseph B. [3 ]
Martin, Christa L. [4 ]
McCormick, Cara Z. [1 ]
Meyer, Michelle N. [5 ]
Murray, Michael F. [1 ,6 ]
Rahm, Alanna K. [1 ]
Schwartz, Marci L. B. [1 ]
Sturm, Amy C. [1 ]
Wagner, Jennifer K. [7 ]
Williams, Janet L. [1 ,8 ]
Willard, Huntington F. [9 ]
Ledbetter, David H. [10 ]
机构
[1] Geisinger, Genom Med Inst, Danville, PA 17822 USA
[2] Geisinger, Ctr Bioeth & Healthcare Policy, Danville, PA USA
[3] Geisinger, Phen Analyt & Clin Data Core, Danville, PA USA
[4] Geisinger, Autism & Dev Med Inst, Danville, PA USA
[5] Geisinger, Ctr Translat Bioeth & Hlth Care Policy, Res Eth, Danville, PA USA
[6] Yale Sch Med, New Haven, CT USA
[7] Geisinger, Bioeth Res, Ctr Translat Bioeth & Hlth Care Policy, Danville, PA USA
[8] Geisinger, Res Genet Counselors, Genom Med Inst, Danville, PA USA
[9] Geisinger, Natl Precis Hlth Inst, Danville, PA USA
[10] Geisinger, Danville, PA USA
关键词
IMPLEMENTATION; BIOBANK; MODEL;
D O I
10.1377/hlthaff.2017.1557
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Health care delivery is increasingly influenced by the emerging concepts of precision health and the learning health care system. Although not synonymous with precision health, genomics is a key enabler of individualized care. Delivering patient-centered, genomics-informed care based on individual-level data in the current national landscape of health care delivery is a daunting challenge. Problems to overcome include data generation, analysis, storage, and transfer; knowledge management and representation for patients and providers at the point of care; process management; and outcomes definition, collection, and analysis. Development, testing, and implementation of a genomics-informed program requires multidisciplinary collaboration and building the concepts of precision health into a multilevel implementation framework. Using the principles of a learning health care system provides a promising solution. This article describes the implementation of population-based genomic medicine in an integrated learning health care system-a working example of a precision health program.
引用
收藏
页码:757 / 764
页数:8
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