The New York City-based, Icahn School of Medicine at Mount Sinai and the Institute for Family Health have received a $3.7 million grant from the government for a personalized medicine initiative that will allow providers to test and monitor patients’ genomic information through their electronic health record (EHR).
The providers will use the patients' genomic information at the point-of-care to individualize treatment, testing and monitoring. Linking genomic information with the EHR has become Mount Sinai’s calling card in 2013. In May, it announced 25,000 people signed on to participate in its biobank program, BioMe, where each patient has broadly consented to DNA sequencing, contact from researchers, and longitudinal studies related to data embedded in the electronic medical record (EMR).
Along with monitoring through the EHR, the latest genomic initiative allows providers to use Clipmerge, which is a clinical-decision support engine for delivering guidelines with genetic variants of clinical significance to enhance treatment. Clipmerge was the basis for another pilot announced back in April.
The program, Sinai says, is the first ever genetic testing in a primary care setting to identify genetic risk for kidney disease in patients with hypertension. It’s aimed at Africa American patients, which according to Sinai research have a one-in-eight chance of a gene that makes them greater risk for developing chronic kidney disease or end-stage kidney disease if they have hypertension, or high blood pressure.
"We believe that with genomic information made available to doctors through a patient's electronic health record, we will be able to achieve better and stricter control of blood pressure and targeted use of medications that inhibit the renin angiotensin system, which are recommended in hypertensive patients at risk for kidney disease. More comprehensive tracking will also help ensure that optimal tests will be performed to stop progression of kidney disease,” stated Erwin Bottinger, M.D., Director of the Charles Bronfman Institute of Personalized Medicine at the Icahn School of Medicine at Mount Sinai, and one of two principal investigators of the grant.
The program will begin with a cluster-randomized controlled trial that will be conducted at 12 primary care sites in New York, including practices at Mount Sinai and the Institute for Family Health, which operates an independent network of community health centers in Manhattan and the Bronx.
Mount Sinai is part of a larger trend where more and more providers are linking genomic information to the EHR.