CURATING Health Precise Information for Personalizing Medicine and Better Health Hello, my name is Gordon Jones, I am a Doctor of Health Administration and I have been working across the health care spectrum for the past 25 years – from academic medical centers, to physicians practices and provider organizations, to health information technology companies (even building my own digital health apps), insurance and managed care organizations, and most recently Patient Engagement & Communications for Population Health strategies. For years, I taught Health Care and Society, and Health Care Organizations to the students of the Medical University of South Carolina. Since 2000, I have been working throughout the US and Internationally consulting and learning on best practices in how to provide the best care and excellent customer service to our patients. Now, I wish to focus all my knowledge and interests in my local health community – the Central Savannah River Area in SC and GA! I have spent the past several months vetting out various companies that I believe are the best at the specific service I include in our Curating Health’s offering for your practice and health organization. It would be an honor and a pleasure for me to have a conversation with you about how I may help you serve your patients better, generate new income, and reduce some overhead costs. Its all from the perspective of how we personalize our health services to our specific patients. Throughout the presentation, I will guide you through the offerings we can use to begin our discussions about how we may collaborate. Most Sincerely, 1 Our Patients Want Personalized Medicine & Health Services Right Treatment, Right Time I started thinking about the idea of “Precise Information for Personalizing Medicine and Better Health” after attending the 2013 TEDMED conference in Washington, DC. In late 2014, I began preparing to move my health business practice into this arena of personalized patient communications and health services. It was fortuitous to hear during his State of the Union address for 2015, President Obama announcing a $215 Million initiative of precision medicine to "bring us closer to curing diseases like cancer and diabetes, and to give all of us access to the personalized information we need to keep ourselves and our families healthier. We are in a new era of medicine — one that delivers the right treatment at the right time.“ With genetic testing cheaper than ever and an overabundance of personal health data being captured – everywhere – information like never before is available to doctors; but medicine has been slow to develop treatments that make use of these new processes. As a practitioner, when was the last time you changed your clinical pathway, protocols, and/or care plans to adapt these new resources? Curating Health is in the business of identifying and selecting service providers (i.e. testing labs, pharmacies, digital health systems, payors and health services) to collaborate in adopting the latest (approved & reimbursable) technologies and clinical protocols to deliver on the promise of Precise Information for Personalizing Medicine and providing Better Health. Please review the attached information; yes it is a lot of detail but you will appreciate the education. I have made it convenient for you to get through to the subject you may be most interested by clicking on the item on the contents page. Once you sifted through that subject, you can click on the Hand in the lower right and it will bring you back to the table page to go to the next subject of interest. Please know that this is not everything! We are vetting and curating the best all the time and we will present them to you as we confirm them to be high caliber and of esteem quality solutions. Let us know when you’d like to talk and learn more about how we can help you better care for your patients and manage your practice. We can plan a call or a telehealth visit on our video platform. 3 We help physicians provide reimbursable personalized medicine services for patients that: Are easily and quickly administered; Decrease adverse drug reactions; End “Trial and Error” medication management ID pre-dispositions to 8 cancer types; Lower practice liability; Increase Patient Satisfaction; and Increase practice revenues. 4 These services include (to jump directly to the section, just click on the item below): Pharmacogenetics Testing; DNA sequencing for 8 Cancer Types; Genetic Counseling; FDA Approved & NDA Coded Medication Collection Kits – that are PBM reimbursable to the prescriber; Toxicology Testing Services; Onsite Lab Technician for qualified sites; Automated Care Plan Management & Patient Outreach; Video collaboration platform for telehealth visits. 5 Pharmacogenetic and Genetic testing for Cancer has been FDA Approved and adopted by (click): Johns Hopkins Medicine; Mayo Clinic; St. Jude’s & Boston’s Children’s; Duke University; and Vanderbilt University Medical Centers. 6 Pharmacogenetics – Molecular Testing Labs Molecular Testing Labs™ is a CLIA certified and CAP accredited testing laboratory that specializes in the cutting edge field of Molecular Genetics; MTL’s Pharmacogenetics technology provides the tools to look at the individual Base Pairs of DNA, which are the molecules that dictate how a person metabolizes medications; Based in Vancouver, WA and servicing all states. 7 Some serious facts to consider about Adverse Drug Reactions (ADR) : $300 Billion wasted as ineffective pharma; 2 million hospitalized due to ADR; 106,000 death due to ADR; ADR is the 4th leading cause of death; Testing for safety and efficacy is rapidly becoming the standard of practice. 8 What is Pharmacogenetic Testing (PGT)? Pharmacogenetics is the study of how a person’s genetic makeup affects the metabolism of medications. Pharmacogenetic testing (PGT) detects variations in the genes and their associated enzymes. Cytochrome P450 (CYP) is a superfamily of 57 enzymes, which are responsible for 75% of drug metabolism. These CYP enzymes may deactivate a medication or turn a medication into its active form. Pharmacogenetics testing can mean the difference between a treatment failure and a successful outcome for patients. 9 Our PGT allows for a personalized treatment approach by helping prescribers to: Identify patients carrying a genetic polymorphism that causes increased or decreased CYP450 enzyme activity; Identify individuals with higher risk of adverse drug reactions and overdose; Choose more effective medications at safer dosages; Minimize drug interactions; Avoid time-consuming and ineffective drugs trials; and Optimize pain management. 10 Pharmacogenetics to the Practitioner PGT looks at your patient’s DNA to help you decide if a specific drug may or may not be the right therapy for your patient. The main benefits are to avoid adverse drug reactions and give your patient the right medicine, in the right dosage, right from the start. The test looks at specific enzymes within the cytochrome P450 family. These specific enzymes tested are responsible for the metabolism of approximately 95% of the medications prescribed. 11 What physician specialties are most impacted by the benefits of PGT? Primary Care Pain Doctors/Clinics Internal Medicine Gerontologists Cardiologists All Script Writers: Nephrologists MD (Doctor of Medicine) Endocrinologists DO (Doctor of Osteopathy) Pediatricians PA (Physician Assistant) OBGYN’s NP (Nurse Practitioner) Psychiatrists 12 National Genetics for Cancer Lab - GeneID GeneID is a CLIA and CAP (College of American Pathology) Certified Molecular Laboratory specializing in Next Generation DNA Gene Sequencing using the Ion Torrent Micro Chip Technology by Life Technologies; The microchip contains over 7 million mini Test Tubes which enable the best accuracy, to do many tests at once, and have a very quick turnaround time; Based in Ramsey, NJ and servicing all states except New York. 13 What is Genetic Testing for Cancer Risk? Genetic testing for cancer risk is predictive testing that can help predict the likelihood that an individual will develop cancer in his or her lifetime; Not everyone with a cancer-related gene will develop cancer, but those at risk include: People with Personal history of Breast, Ovarian, Colorectal, Pancreas or Prostate cancer; People with a family member who tested positive for a mutation; People with two or more relatives on the same side of the family with the same or related forms of cancer (one under age 50). 14 What is the PrevenTest™ for Cancer? First-to-Market,* non-invasive risk pre-disposition test for 8 of the most common solid tumor cancers: Colorectal Prostate Breast Pancreas Ovarian Stomach Endometrial Skin *In 2014, the Supreme Court ruled that Myriad Genetics could not patent the BRCA1 and BRCA2 genes, the company announced that by 2015 it would replace its “BRCAnalysis” test with a broader “myRisk” panel analyzing 25 genes associated with hereditary cancers, including breast, colorectal, ovarian, endometrial, pancreatic, prostate, gastric, and melanoma. 15 Identifying hereditary disease saves lives! 10% of cancers are due to factors that are passed from one generation to the next; and Patients CAN and SHOULD take preventive measures to reduce risk of cancer. 16 Why is Testing more Genes better? After the Supreme Court ruling* that Myriad Genetics could not patent the BRCA1 and BRCA2 genes, they announced a broader “myRisk” panel analyzing 25 genes associated with hereditary cancers through blood draw collection; they report: Testing for 25 genes has the ability to identify 51% more patients with higher risk of hereditary breast and ovarian cancer than testing of BRCA1 and BRCA2 genes alone**; and a 61% improvement in detection of hereditary colon cancer***. In comparison, the PrevenTest™ uses a Cheek Swab process and analyzes 31 genes associated with hereditary cancers. **2013 Myriad Funded Study | ***2013 Collaborative Group of the Americas on Inherited Colorectal Cancer (CGA) Study 17 PrevenTest™ Panel of Genes 31 Genes linked to 8 Cancer Types (6 more than competitor): 18 APC CDK4 MSH2 RAD50 ATM CDKN2A MSH6 RAD51C BARD1 CHEK2 MUTYH RAD51D BMPR1A ELAC2 NBN RET BRCA1 EPCAM PALB2 SMAD4 BRCA2 HRAS1 PMS2 STK11 BRIP1 MLH1 PTCH1 TP53 CDH1 MRE11A PTEN What are the Risks to those with Heredity? Risk for Cancer is significantly increased with a Genetic Mutation 19 One Mutation can increase the Likelihood of many other Cancers: Lynch Syndrome: Is a “Cancer Syndrome” defined by a mutation in one of 5 Genes: MLH1 MSH2 MSH6 PMS2 EPCAM Increasing the risk of Colon, Endometrial, Ovarian, Skin and Stomach Cancer 20 Curating this Precise Information allows you and your patient to Take Control! Knowledge is power when it comes to Cancer and the good news is that patients can do something about it! People at a higher risk for cancer may have the option of: More frequent cancer screenings; Avoid specific risk factors; Make lifestyle changes to lessen additional risk; Take preventive medication (chemoprevention); and / or Risk reducing surgeries (Angelina Jolie as an example). 21 What physician specialties are most impacted by the benefits of Genetic Testing for Cancer? General Oncologist (Avg. 40 Tests per Month) OB/GYN’s (Avg.15 Tests per Month) Primary Care (Avg.40 Tests per Month) Breast Surgeons (Avg. 20 Tests per Month) Multi-specialty Groups 22 National Genetic Counseling Services Board-certified Genetic Counseling for Your Patients; Largest independent genetic provider network; Increased convenience and access to genetic counseling via telehealth visit; HIPAA Security compliant data and telehealth; Most specialties and sub-specialties; 75 million (+) lives under contract. 23 Counseling Guidelines & Recommendations: Anyone who elects to take a Genetics Test; Commission on Cancer Standard 2.3 that all risk assessments be accompanied by Genetic Counseling Women whose family history is associated with an increased risk of BRCA1 or BRCA2 gene mutations; Cigna coverage requires pre-testing genetic counseling from an independent board-certified genetic counselor or clinical geneticist; 24 Patient Benefits using InformedDNA: No Travel, Less Time Spanish and ASL Counselors No Wait Time for Appointments Concierge Level of Service Personalized Screening and Management Plan Family Appointments 25 Day, Evening, Weekend Genetic SubSpecialists Center Benefits using InformedDNA: Offer Personalized Healthcare Meet Accreditation Standards Standard of Care; Best Practices Research Opportunities Retain Patient Stewardship Market Differentiator Minimal Costs 26 National PBM Service Partner - VantageRx VantageRx is a national pharmaceutical dispensing company that has online software with direct access to the PBMs enabling our physicians to check patient eligibility and gain pre-authorizations within 38 seconds of submitting the information; No other program has this capability currently; Access to PBMs such as Caremark, Express Scripts, Medicare, Medco, Paid Prescriptions. 27 FDA Approved NDC coded DNA & Toxicology Medicated Collection Kits Using the Advanced Medicated DNA Collection Kit for Pharmacogenetics screening 3 - times a day & an average reimbursement of $400 increases daily revenue by $1,200 with a net profit of $900 which is $18,000 in new monthly revenue; Using the Active Medicated Urine Collection Kit for toxicology screening 3 - times a day & an average reimbursement of $200 increases daily revenue by $600 with a net profit of $375 which is $7,500 in new monthly revenue from toxicology specimen collection; Together, the practice could increase monthly income by $25,500; with average of 120 tests a month, we’ll plact a lab tech onsite. 28 FDA Approved NDC coded DNA & Toxicology Medicated Collection Kits Wet Kits and service is reimbursable to physicians by many payors (PPO/HMO/Workers Comp/Traditional) through the pharmacy benefit DNA Kit Cost = $100 Remit = ~$400 Net = ~$300 29 Placement of an Onsite Service Rep for the medical practice: The average practitioner has ~2,500 patients, it is projected that ~20% of patients are on more than one medication warranting the test; When the practice has ordered 150 tests or more per month, we will place a service lab tech in the practice to manage the process for the practice; This will lower the cost to the practice of administering the program. 30 National Toxicology Lab Partner - ACLS Advanced Clinical Laboratory Solutions (ACLS) is one of the country’s leading specialty laboratories, nationally licensed and state regulated, adheres to guidelines stipulated by the Clinical Laboratory Improvement Act and College of American Pathologists. Comprehensive testing services included: Drug Testing, Biological Monitoring, Medical Surveillance, Therapeutic Drug Monitoring, Forensic Toxicology, Medication Monitoring, and Pharmacogenetic Testing. 31 FDA Approved NDC coded DNA & Toxicology Medicated Collection Kits Wet Kits and service is reimbursable to physicians by many payors (PPO/HMO/Workers Comp/Traditional) through the pharmacy benefit Tox Kit Cost = $ 75 Remit = ~$300 Net = ~$225 32 Placement of an Onsite Service Rep for the medical practice: When the practice has ordered 150 tests or more per month, we will place a service lab tech in the practice to manage the collection process for the practice; This will lower the cost to the practice of administering the program and providing the service to the patient. 33 Gene ID and PGT Care Plans – Vitamin C Vitamin C is mobile and web-based platform that creates simple care plans that enable effective and efficient communication between provider and patient; We use VitaminC to scan the doctor’s EMR to identify and qualify eligible patients and in need of a DNA pharmacogenetics test; then VitaminC automates the outreach to the patient on behalf of the doctor, inviting the patients in to learn more about the benefits of a pharmacogenetics test. 34 Video Collaboration & Telehealth Visits Health Communications HIPAA – Compliant Video Conferencing; Feature-rich video platform to support any telehealth use; Highest quality video, audio, and screen sharing; Easily integrates with healthcare environments; Any mobile and browser platforms; 35 Keep in Touch with DrJ Dr. Gordon Jones [email protected] 706.383.3776 www.LinkedIn.com/in/drgordonjones Curating Health Video Conferencing Center 36
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