Geisinger reshaping genomic medicine as DNA sequencing to become part of routine clinical care

On Sunday, I was honored to speak at HLTH, the Future of Healthcare event in Las Vegas. This gathering attracts thousands of innovators and big thinkers from all across healthcare and business to discuss what the future needs to be. It was the ideal setting to make a major announcement about Geisinger’s next step in applying genetics to everyday preventive care for our patients. 

We think it’s time to transition our successful population health genomics program beyond the realm of research and into routine clinical care for our patients. Geisinger patients will be the first to have the sequencing of their exomes as part of the standard care they receive from their primary care physician. 

At a typical check-up or wellness visit, your primary care physician asks about your family’s health history, including what conditions your mom, dad, sisters, brothers or other family members may have had. That background helps your doctor take a better guess at what diseases, like heart disease or cancer, you may be at higher risk of developing. Your doctor will recommend screenings based on your health status, age and known history such as an annual mammogram, blood profile or colonoscopy. 

At Geisinger, we’ve decided to be more precise on what specific conditions our patients may face in the future. By proactively looking at their genetic code as part of their routine care, we can lower their risk, treat at early stages or help them avoid certain conditions before they even take hold. 

Geisinger has long been considered a leader in precision health thanks to the success of our MyCode Community Health Initiative. MyCode was launched in 2007, and in 2014, in collaboration with Regeneron Pharmaceuticals, we greatly increased our rate of sequencing participants’ DNA. Over the years, we’ve asked people in our community, “Would you allow us to look at your DNA?” The response has been overwhelmingly positive. More than 200,000 people have already said yes, giving us the potential to create one of the world’s largest databases of sequenced exomes.  

For research purposes, this treasure trove of genetic information, combined with 20 years of clinical data from our electronic health record, is unmatched. That’s a great start. But now we’re moving into the clinical realm, to proactively improve and save even more lives. 

Whenever a medically actionable result comes back, we share that with the patient. It’s similar to precision medicine, but that is really for someone who is already sick and getting care. I think what we’re doing is actually anticipatory medicine. 

Right now, more than 30 gene mutations are known to indicate a predisposition to specific cancers, heart disease and other conditions. We can use those today to take action. That knowledge empowers you. It puts you in charge of your own health. We are already seeing life-threatening diseases managed and prevented before they happen. By integrating genetic sequencing into our routine practices, we expect to see even greater results. 

This early knowledge has a cascade effect through families. If one member has a result, then others get tested. It can change the course of entire families. With this precision, you don’t waste anxiety on guesswork. You can know if you’ve inherited the gene responsible for mom’s colon cancer or dad’s congestive heart failure, or if you have not, and know what you need to do. 

To help patients understand their results and make decisions on what steps to take, we have one of the largest teams of genetic counselors in the country. Already in the first phase of this initiative, more than 500 patients have received actionable results. Each one can meet with a genetic counselor as well as their doctor to develop a plan. 

Anticipatory medicine has the potential to revolutionize how we prevent illness and improve lives. We are providing this groundbreaking care today in Pennsylvania and southern New Jersey and we’ll share what we discover with others. Our vision is a future where diseases are avoided and our family members, friends and neighbors can live longer, healthier lives.

As I shared at HLTH, healthcare is focused on the wrong part of the problem. As providers and leaders, we focus our energy on quality care at affordable prices after someone has an illness or injury. While that is crucial, we could do much more to change lives and improve health by focusing on zip codes and genetic codes long before a health issue arises. We know that where you live and work determines much of your health status. We also know that each person’s genetic code, their DNA, reveals what their future health may hold. At Geisinger, we aren’t waiting. We’ve dived into discovering what our genes are telling us, and we’re applying that knowledge today to save lives.