Directed ‘HIT,’ the center of the precision medicine bullseye

The Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing titled “Continuing America’s Leadership: Realizing the Promise of Precision Medicine for Patients.” The hearing discussed the reality that, with innovative approaches, physicians may no longer need to make treatment recommendations based upon outcomes for an average patient. Instead, precision medicine could be utilized to account for individual differences in patients’ genes, environments, and lifestyles in order to enhance the quality and effectiveness of health care. The hearing covered ways that health information technology (HIT) could be advanced to make precision medicine the norm in order to achieve goals like those set out in President Obama’s Precision Medicine Initiative.


Dr. Karen DeSalvo the National Coordinator of the HHS Office of the National Coordinator for Health for Health Information Technology (ONC) testified before the Senate committee that “health information technology is the foundation required to bring precision medicine to operational life.” To achieve broad utilization of precision medicine, DeSalvo testified that the nation needs to continue to move forward with plans like the ONC’s interoperability roadmap. To develop the HIT infrastructure, the ONC believes three goals need to be met: (1) develop consistent use of applicable standards for application programming interfaces, health care terminology, implementation, and security; (2) foster an environment of trust and security around individual’s data; and (3) incentivize interoperability.


Jeffrey Shuren, Director, Center for Devices and Radiological Health (CDRH) at the FDA, testified that technology will also play a key role in precision medicine through technological medical advancements like Next-Generation Sequencing (NGS). According to Shuren, “An NGS test is capable of detecting the billions of bases in the human genome, and in doing so identify the approximately 3 million genetic variants an individual may have.” As a result, a single use of an NGS test could help diagnose and even predict patient’s risks for countless conditions. Francis S. Collins, the Director of the National Institutes of Health (NIH) added that technology can increase biomedical understanding through “widespread adoption of electronic health records, the recent revolution in mobile health technologies, and the emergence of computational tools for analyzing large biomedical data sets.”


Senator Lamar Alexander (R-Tenn) criticized what he called the “failed promise” of the EHR incentive program as a barrier to the advancement of precision medicine. Alexander said that the $28 billion drive to increase EHR utilization has not been worth the effort due to complaints of disrupted workflow. Alexander did say that interoperability should remain a goal. Senator Patty Murray (D-Wash) commented that Republicans and Democrats need to work together and invest in “priorities like the President’s precision medicine initiative.” Murray added that while it is important to promote precision medicine, the protection of privacy needs to remain a top concern in light of “serious security breaches impacting families’ personal health information.”