Kristine began her career with a diagnostic lab that was one of the first in the U.S. to provide pharmacogenetic testing to reduce adverse drug events. She quickly found that providers struggled to interpret the results if specific guidance on medications was not included, so they began to include such in the reports. Unfortunately, when a static report was issued it did not account for co-medication and quickly advancing evidence. It became clear a more dynamic solution was needed.

 

The lab then offered a web-based solution to aid clinicians with interpretation of the DNA test results, allowing updates to the medication list, and offering curated access to the evidence, nearly in real-time. But when presenting it to doctors, she kept hearing, “That's nice. Put in my clinical workflow, or I'm not going to use it.” Hearing this over and over made a lasting impact on her.

 

By 2016, it had become clear that a lab-agnostic pharmacogenomic repository was needed, and doctors and pharmacists needed a tool that could flag when a patient should be tested and also provide real-time information regarding how to optimize drugs and doses based on genetics and all other factors impacting drug response. From her experience, Kristine knew that tool would also have to be integrated into the doctor’s workflow. This is why she spun the web-based technology out of the lab and founded YouScript, now integrated in the clinical workflow in Epic. Cerner, and AllScripts.

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Today, Kristine believes that genomic testing is closer to becoming routine, because 1) The cost of pharmacogenomic testing and genomic testing has come down dramatically; and 2) We are seeing expanded coverage in pharmacogenetics 3) we have the tools to provide real-time, clinical decision support making it easy for providers to appropriately act on genomic information.
 

However, Kristine points out that information silos at health systems, labs and managed care companies need to be broken down to serve patients well. That’s because a cancer patient may be facing additional health challenges such as depression, pain, or comorbidities like heart disease. Genetic information needs to be incorporated anywhere it can improve patient care, not just in one silo.

 

Kristine reiterates the importance of technology tools that manage patient information being integrated into a doctor’s workflow to ensure that insights are applied everywhere across the care spectrum and throughout a patient’s life. Ultimately, Kristine says, if you put the right infrastructure in place, you're able to avoid excess costs associated with running the same tests again and again while also making sure that the patient's care is optimized at every point based on critical, personal information.

 

We learned a lot about the path forward for precision medicine from our discussion with Kristine.

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We hope you'll tune in to the full episode above.

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Download the full transcript of the episode here (pdf).

 

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