Like it or not, electronic medical/health records (EMR/EHR) are here to stay. As the healthcare world continues to move away from fee-for-service and toward value-based medicine, there is an increasing need to accumulate historical data regarding patient outcomes in order to individualize patient management, treatment, and develop best practices. But as innovative health systems develop and implement programs to take advantage of the reams of data available to them, it becomes clear that there are crucial elements that must be considered.
Early last week, NPR’s “Your Health” aired a segment titled “Electronic Health Records May Help Customize Medical Treatments.” The piece featured a project developed by the Geisinger Health System in Danville, PA. In conjunction with a genetic test scanning company, Geisinger has begun to add the results of whole exome sequencing to the EMRs of their patients.
While the program has already yielded results in guiding patient management, there are currently also major limitations and concerns. Segment author Richard Harris notes that not only do physicians not “know how to interpret most of the genetic results,” but that often “the test doesn’t provide actionable information for the vast majority of people who get it.” (Source: www.npr.org).
That actionable information is one of the crucial elements we mentioned, as it refers to the clinical utility of a genetic test. While agreement on the exact meaning varies, clinical utility is most often defined as whether or not the test results affect:
- Patient outcomes – What is the prognosis?
- Diagnostic thinking – What is the diagnosis?
- Decision-making guidance – What is the appropriate patient management strategy, treatment, and/or therapy?
- Family impact – Who else in the family is at risk?
- Health system impact – What are the financial and health resource impacts?
The Hayes Genetic Test Evaluation (GTE) program offers GTE Indication, a report that examines the clinical utility of genetic testing for specific indications based on scientific evidence.
The segment goes on to quote Yale University professor of medicine, Dr. Harlan Krumholz. While Dr. Krumholz lauds the efforts of Geisinger, he notes that at present, the data being collected is not “research quality.”
In the conversations being had about data, EHRs and their use in determining patient management, this is yet another crucial point. Without data that is of research quality—in other words, evidence—the collected information is largely a source that identifies trends, but it cannot control for the variables the way evidence from research studies such as a randomized controlled trial can. Unbiased evidence from well-controlled studies, which considers possible confounding factors, provides the necessary scientific foundation and context to EHR data and move healthcare forward by improving patient management and patient outcomes.
Hayes is synonymous with unbiased evidence evaluations. Our solutions, such as the Genetic Test Evaluation program, offer you the research-quality data you need to improve your healthcare delivery and align with your value-based goals.
Download our free white paper, Multigene Panel Testing, to see how the Hayes GTE program can assist you with initiatives like those of the Geisinger Health System.