Headquarters: Salt Lake City, UT
Type: Not-for-profit, integrated health system
Recognizing the growing use of genomic information to tailor treatment to cancer patients’ individual molecular profiles, Intermountain’s leadership believed that they had a medical duty to rigorously study the clinical utility and cost effectiveness of precision medicine. From its unique position as a leader in evidence-based medicine, Intermountain made an enterprise-wide commitment to formalize the practice of precision oncology and measure clinical outcomes and costs. The Intermountain Precision Genomics service was launched in July 2013 at a single site, with the intent that the program would be rolled out system-wide only if it demonstrated both clinical and cost-effectiveness.
Building a formal precision medicine program presented Intermountain with many problems. Its physicians wanted to use tumor sequencing to identify molecularly targeted therapies for cancer patients, but were ordering inadequate, inappropriate, and duplicative tests from multiple send-out labs. Test results were stored in the EMR as scanned faxes or PDFs and could not be queried to inform clinical decision support tools or for quality improvement. Many physicians were not equipped to make clinical decisions based on genomic data. Even when a clinician did order a targeted drug based on test results, the procurement rate was poor.
Intermountain decided to launch a comprehensive precision oncology program to provide advanced cancer patients with molecularly targeted therapies informed by an in-house tumor sequencing test (the “ICG100”). Syapse provided the IT infrastructure to enable web-based test ordering and results delivery, Molecular Tumor Board case review, interactive clinical decision support, and drug procurement. In addition to streamlining Intermountain’s clinical workflow, the centralized capture of clinical, molecular, treatment, and outcome data in Syapse enabled Intermountain to demonstrate that its systematic application of precision oncology doubled progression-free survival of advanced cancer patients without increasing cost of care.
Case Study: Precision Cancer Care Comes to Intermountain
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