社区卫生系统中的个性化医疗:北岸体验
Sean P David1,2,3,4, Henry M Dunnenberger3, Sarah Choi3
1Department of Family Medicine, NorthShore University HealthSystem, Evanston, IL, United States.
Frontiers in genetics
|December 13, 2023
概括
北岸大学健康系统实施了一项全面的个性化医疗计划,将基因组学纳入初级保健. 该计划成功选了超过225,000名患者,并确定了数千名具有可操作的遗传变异,改善了患者的治疗结果.
科学领域:
- 基因组医学是基因组医学.
- 实施科学 实施科学
- 卫生系统研究 卫生系统研究
背景情况:
- 个性化医疗的实施主要集中在专科护理上,在综合卫生系统中仅有有限的例子.
- 北岸大学健康系统在2014年建立了一个个性化医学中心,以推进这个领域.
- 弥合基因组发现和临床实践之间的差距需要创新的实施策略.
研究的目的:
- 描述综合医疗保健系统内的综合个性化医疗计划的战略和演变.
- 详细介绍基因组学支持的工具和服务在整个医疗保健连续性的实施情况.
- 报告个性化医学的学习健康系统模型对患者的结果和系统层面的影响.
主要方法:
- 开发和部署可扩展的家族史工具 (遗传和健康评估,乳腺健康评估).
- 将药物基因组学,遗传咨询和临床决策支持纳入电子医疗记录.
- 实施一个新的生物信息平台 (FLYPE) 用于基因组学数据管理.
- 在基因组医学和利用实施科学框架方面培训初级保健提供者.
主要成果:
- 在初级保健中对超过225,000名患者进行了遗传性疾病的查.
- 超过35,000名患者完成了临床遗传测试.
- 在4000多名患者中确定了致病变体,具有医疗管理影响.
- 将超过33,000名患者的药物基因组学数据纳入电子健康记录,并提供决策支持.
结论:
- 一个多专业,与领导力一致的战略使得一个全面的,基因组学支持的学习健康系统成为可能.
- 该计划成功地将个性化医疗整合到医疗连续性中,从而产生可衡量的患者结果.
- 实施科学框架对于在大型卫生系统中扩大个性化医疗倡议至关重要.
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