Research project aims to improve care after cancer genetic testing

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Genomic medicine brings new possibilities to prevent disease and decrease health care costs. Preventive genomic medicine can identify people with inherited cancer risk, giving health systems a chance to offer risk management options to improve patients’ longevity and quality of life. Unfortunately, infrastructure to support people with inherited cancer syndromes is limited and people cannot always follow recommended risk management plans.

Sarah Knerr, a UW Department of Health Systems and Population Health (HSPop) assistant professor and investigator for the Health Promotion Research Center (HPRC), received a 5-year, $4.6M award from the National Institutes of Health to investigate methods to improve adherence to risk management after cancer genetic testing. The study will compare the benefits and costs of two population management interventions that health systems can implement after genomic testing, using hereditary cancer as an example.

The project will test a “high-touch” and a “low-touch” approach to patient outreach. The first links patients to pre-existing online educational materials. The second connects patients with a care manager to discuss risk management and provide personalized care reminders. These interventions are easy to scale up and similar to programs health systems currently use to support cancer screening, diabetes management, and other types of care for chronic conditions.

Seniors using a medical app on a tablet to talk with a doctor

Knerr and her colleagues will randomly assign patients from two health systems, Kaiser Permanente of the Northwest and Denver Health, to either the online materials or care manager groups, and will then track which group has more patients who remain current with recommended cancer screenings over a period of two years. The project is a continuation of a longstanding and very successful collaboration between the two health systems.

Denver Health is a network of federally qualified health centers and has a large Spanish-speaking patient population, while Kaiser Permanente of the Northwest primarily serves individuals insured through their employers. “Working in these two systems lets us understand a range of operational issues and patient needs,” Knerr said. “I feel very lucky to be able to continue to partner with Dr. Sonia Okuyama at Denver Health and Dr. Beth Liles at Kaiser Permanente of the Northwest.”

Other outcomes, such as the difficulty of implementing the two interventions, sustainability and cost comparisons will also be collected and considered. Knerr and her colleagues hope that generating meaningful and easy to understand information about different population management approaches will help increase health systems’ interest in investing in these types of programs.

The project will provide clinical champions with data to select and implement population management interventions that address critical gaps in post-testing quality and patient safety. “If we want health systems to be excited about preventive genomic medicine, we need to help them feel confident in their ability to care for high-risk patients,” Knerr said. “Creating tools to help build this confidence is our goal with this project.”

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