On March 26, 2009, El Camino Hospital launched the Genomic Medicine Institute (GMI). Our history of innovation and our Silicon Valley location put us in a position to help bring the emerging field of genomics out of the research lab and into the hands of our physicians. The GMI works under the leadership and direction of our Physician Advisory Board. The GMI’s mission is comprised of four distinct initiatives: physician education, community outreach and education, clinical trials, and risk assessment programs.
The primary goal of the GMI is to provide El Camino’s medical staff with information and resources about clinically useful genomic tests. The DNA Direct Physician Portal was developed to provide you and your patients with well-documented, practical information about a number of genetic tests in common use today. The tests included on this portal are those recommended by our content partner, DNA Direct, and approved by our Physician Advisory Board. Some controversy remains concerning the clinical utility of a number of these tests, and we provide ample documentation of all the studies on which these tests are based.
The physician portal includes tools to help you incorporate genomics into your medical practice: links to laboratory websites, algorithms that help you determine if a test is right for your patient, sample letters of medical necessity for pre-authorization purposes, and educational reports that translate results into plain English for your patients.
Because of the speed with which the genomics industry has evolved, physicians who completed training more than a few years ago may have had only minimal exposure to genomics. The GMI has sponsored several grand rounds and webinars, including Genomics 101 and specialty programs in cancer and cardiology.
Most importantly, the GMI has contracted with DNA Direct to provide board-certified genetic counselors who can consult with both you and your patients. You are always welcome to call the counselors with any questions you may have about genetic testing or family history evaluation. Our counselors are also available to work with your patients, both pre- and post-test. There are referral forms available on the Physician portal that you can e-mail or fax to DNA Direct. Or, simply call the GMI at 650-962-4577 and we will connect you or your patient with a genetic counselor at DNA Direct.
Community Outreach and Education
In collaboration with DNA Direct, the GMI has launched the online Family Medical History Tool. The tool offers patients an easy way to store, organize, share, and update family health history. The GMI also has a small office located on the first floor of the Melchor Pavilion, Suite 107, right next to the coffee shop. Patients are welcome to stop by and pick up one of our pamphlets or even work on their family medical history at one of two computer workstations maintained for that purpose. In addition, a DNA Direct genetic counselor will offer your patients on-site consultations, by appointment. Physicians are also welcome to drop by for both formal and informal consultations or advice on ordering genetic tests.
Although the GMI was never intended to be a research institute, working with our doctors in a real-world, community setting is an undeniable draw for industry innovators. Among the trials currently underway are:
- The REACT lung cancer trial - using a genetic test along with low-dose screening CT to predict the risk of lung cancer in current or former smokers
- Plavix® sensitivity test efficacy pilot - identifying patients who may not metabolize Plavix properly
- Tailored Advanced Cancer Therapy (TACT) national trial - genetic sequencing of tumors in patients with refractory cancers to identify possible novel treatments
If you would like more information about any of these trials or how your patients might participate, please call the GMI at 650-962-4577.
Risk Assessment Programs
The GMI is currently working with both the El Camino Cancer Center and the Woman’s Hospital to develop a series of risk assessment programs designed to identify mutation carriers for hereditary syndromes before disease occurs. The first such program will be implemented in the mammography suite at El Camino Hospital, using a well-validated risk assessment tool developed by Kevin Hughes, MD, Associate Professor of Surgery at Harvard and Co-Director of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital. The risk assessment will be loaded onto a tablet computer, and patients will be asked to complete it when they come in for their screening mammogram. If family history indicates a high risk for the BRCA mutation, the patient and her referring physician will be notified and offered genetic counseling. Should the counselor confirm the risk, the patient may then opt for BRCA testing. Please note that Doctor Hughes’ risk assessment program is “freeware,” and you can provide the same service in your office. The GMI is limited in the assistance we can provide you to install the application.
The GMI plans to develop additional risk assessment programs - the most likely next candidate being hereditary nonpolyposis colorectal cancer (Lynch syndrome). If you would like to see us develop a particular risk assessment program, please contact the GMI at 650-962-4577 or talk with any of the doctors on the Physician Advisory Board.