Precise Information for Personalizing Medicine and Better Health

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,
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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.
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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).
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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.
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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.
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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
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PrevenTest™ Panel of Genes
31 Genes linked to 8 Cancer Types (6 more than competitor):
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 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
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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
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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).
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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
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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.
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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;
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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
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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
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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.
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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.
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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
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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.
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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.
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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
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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.
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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.
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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;
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Keep in Touch with DrJ
Dr. Gordon Jones
DrJ@CuratingHealth.com
706.383.3776
www.LinkedIn.com/in/drgordonjones
Curating Health Video Conferencing Center
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