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Transform Care December 15, 2015

Precision Medicine: Syapse Founder Jonathan Hirsch on What Targeted Therapies Mean for Healthcare (1/2)

Founder & President, Syapse
Key Takeaway
Precision medicine will disrupt current clinical workflows & resource utilization - @JonathanHirsch @Syapse

Although genomic and molecular data are increasingly viewed as key information to inform diagnoses and therapeutic interventions, they remain complex and cumbersome to incorporate into clinical decisions. Syapse is working to make this process simpler. The software startup's platform has recently been adopted by Swedish Cancer Institute and it has launched a data-sharing initiative with Caris Life Sciences. In part 1 of this 2-part series, Oliver Wyman Associate Terrance Wallace connects with Syapse Founder Jonathan Hirsch to learn more about how his team is streamlining operations and improving clinical outcomes with precision medicine tools:

Terrance Wallace: How is precision medicine changing the healthcare market?

Jonathan Hirsch: Precision medicine represents a disruption to the current clinical workflows and resource utilization of the healthcare ecosystem. It represents a shift in where spending occurs in the ecosystem. That means moving away from reliance on chemotherapy to targeted therapies – moving away from exclusively using pathology and imaging to diagnose and monitor disease to using laboratory-based sequencing tests. From a health system standpoint, precision medicine is a disruptive shift in spending, staffing, and utilization. From a clinical perspective, precision medicine shifts diagnosis and treatment planning from one-size-fits-all to a data-driven personalization of care, leveraging both genomic and clinical knowledge at scale. That represents a major shift in how physicians think, in how the healthcare system operates, and in the tools that both need to run their complex clinical services. Many healthcare systems are unprepared for this transformation. Health systems have been preoccupied for the past few years putting in place clinical documentation and billing systems, such as electronic medical records, and have not paid sufficient attention to clinical data, workflow, and decision support systems.

TW: What role is Syapse playing in this transformation?

JH: Precision medicine is producing clinical benefits, both in terms of patient outcomes and operational efficiency, but at small scale. Our role at Syapse is to scale precision medicine at both academic and community health systems through our software platform. There are four key components to our work:

  1. Integration of all relevant clinical and molecular data on patients
  2. Decision support at point-of-care to help the physician understand what the best testing and treatment options are for a patient at any given point in time in the patient’s care journey
  3. Clinical workflow to implement those decisions and rigorously track outcomes, such as procuring a specialty drug, assessing eligibility for a clinical trial, and documenting progression of disease
  4. Quality improvement and learning health capabilities at population-scale so physicians can more rapidly assess which treatments are working and apply that knowledge to future patients

TW: How does your role differ from that of genomic labs?

JH: Our role is not to be the laboratory testing company. There are dozens, if not hundreds, of genomic and molecular testing labs providing clinical testing at high level of scale, reliability, and cost effectiveness. Many of them are send-out labs, both commercial and non-profit, and health systems are increasingly rolling out testing in their own internal pathology labs. Genomic testing is rapidly becoming commoditized, and many would argue that it already is. Our role is to take the information generated by these tests, combine it with all of the other clinical data, and assist the clinicians in utilizing that at point of care.

TW: How is Syapse adding value to the ecosystem – and what does a win look like?

JH: Our key value add is the real-world clinical implementation of precision medicine in the health system. Right now, we’re the only software and services organization that has successfully implemented clinical precision medicine programs across multiple health systems that use different EMRs and testing labs. Again, this isn’t research; it is real-world clinical implementation. We add value to the healthcare providers, individual patients, and the health system through demonstrable improvement in outcomes, streamlined clinical workflows, efficiency gains in complex processes such as specialty drug procurement, and many other ways. Above and beyond that direct impact on a health system, there’s broader value that we bring to the precision medicine ecosystem by helping to build the clinical utility evidence for precision medicine through multi-institution data aggregation and sharing. Our software can enable multiple health systems to share data about their patients, including clinical history, genomic profiles, treatments, and outcomes. This aggregated data can be used by health system collaborators to develop evidence-based standards of care.

TW: How could other stakeholders use this aggregated data?

JH: Other stakeholders, such as payers, pharmaceutical developers, and diagnostics companies, directly benefit from this. Payers are consistently asking for clinical utility and cost effectiveness data, but biopharma and diagnostic companies have trouble generating this information. Payers are asking for proof that a tumor genomic profile resulting in use of a $10K per month specialty drug is really benefitting the patient above and beyond standard of care. Is the patient really living longer, is that resulting survival gain accompanied by a high quality of life, or is the payer just throwing a lot of money at achieving a small incremental survival benefit?

TW: Do you currently work across those other stakeholder groups or is your business model purpose built to only serve the provider market at this time?

JH: Today our customer is only the healthcare provider – whether that’s an academic medical center, a community health system, integrated delivery network, or a network of cancer centers. Testing labs are also an important aspect of the ecosystem. Our partner program for testing labs enables electronic ordering and reporting, including return of structured test results to the physician in their Syapse-powered clinical workflow. We’re at the beginning phases of working with payers on evidence development programs, in conjunction with our health system partners. You’ll see more news about this in the next few months.

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