Supports Penn Medicine plan to replace decaying Wyeth building

Radnor township has evolved considerably over the last decade with the development of new and outstanding schools, greenspaces, living and corporate buildings. As we consider future planning, the township should continue to partner with organizations committed to bringing valuable services to our community while maintaining Radnor’s unique quality of life. Penn Medicine has promised that with a planned new healthcare facility on King of Prussia Road. So how can we fix the issue unless we frankly acknowledge what drives it — the perception of race? Indeed, rather than discarding the idea of race, some medical schools now include “unconscious bias” training, classes in which students are essentially asked to contemplate their own often unintentional racism.I write this letter both as an employee of Penn Medicine and a longtime township resident.

In part one of our Allscripts CEO Paul Black on Thursday, he explained how the acquisition this year of McKesson's health IT business has vastly increased the company's scale nationwide, and how he plans to capitalize on that to position the company for a new era in healthcare focusing on innovation on an array of fronts and having some "fun" helping its clients solve an array of challenges.

In part two, Black looks toward 2018 and beyond, discussing how Allscripts aims to continue making inroads with precision medicine, artificial intelligence and more.

Penn purchased the long-vacant Wyeth building two years ago and has designed a plan to build an environmentally friendly, world class healthcare facility which expands on many of the medical services currently offered in our community. Contrary to some misinformation being circulated, both Penn and Radnor officials have determined that the project will result in less traffic compared to alternate uses already permitted on the site. This is a problem because what’s “normal” probably varies according to ancestry. Dr. Wu hopes to devise a version of the test that accounts for variations in blood count according to ancestry. But instead of using self-reported race as a way to specify this variation, he is trying to determine patients’ backgrounds directly with genetic testing — looking at what proportion of a person’s DNA comes from East Asia, say, or Europe. Penn Medicine is already a longstanding, responsible community partner with decades of contributions to our tax base (despite their non-profit status) and support of local programs such as the Radnor Run. Penn Medicine understands what it means to be a good neighbor.

I think it is here today, but not necessarily at volume. But the fact that there are some 50,000 orderable procedures that you can order through LabCorp or other lab houses, the fact that those genetic tests are out there not necessarily for a full genetic sequence, but also could include a two-panel test for a very specific condition you might have. To the extent that those are already out there, I would say it's already mainstream today.

But to the question of when it will be best community practice, I think that will be specialty type by specialty type. Clearly ASCO is pushing that for oncology and there's a lot of efficacy for getting genotyped for breast cancer and for other types of cancer. So the importance of getting the chemotherapy right based on the way your body is going to metabolize it is extraordinarily important, because you want to make sure you're on the right regimen. Different specialties will bring this to the forefront at different rates. But there is so much being published about it, so many studies being run, so many countries doing serious work based on certain segments of the population to understand why they are sick and how to best treat that in genomic sequencing in some form or another that's all playing a very major role today.

I think Precise is very well positioned in that it's EMR agnostic, in that it surveils the database to actually look for people who should be sequenced, based on family medical history, based on current diagnosis, based on current medication regimen. It will actually say, This person might benefit from, and other people like them have benefited from, a genomic test. That then leads to the question of will insurance companies, will CMS become players in this. And I think the answer to that is yes and in many cases they already have. On the macroeconomics, the health economists will say these tests will pay for themselves, because of the efficacy, because you minimize the delay, minimize the effect of having people on the wrong medication, so you have the same or smaller spend.

Penn Medicine has provided years of great medical care close to where we live, and the plan submitted for approval by the Radnor Township Board of Commissioners replaces the decaying Wyeth building with a new facility tailored to Radnor’s special environment. If you support this proposal, contact your commissioner in advance. The truth is that there is sometimes more variation within what we call races than there is between them.

But not all African-Americans carry the variants. That is important because, in an attempt to account for the higher risk of kidney problems among African-Americans, kidney donor registries include information about race. And kidneys from “black” donors might be discarded on the assumption that they are more prone to failure. But by looking directly at whether patients and donors carried this gene variant — in particular, two copies of it — scientists at the University of Alabama at Birmingham recently found they could theoretically improve transplant outcomes. Kidneys donated from black donors that might otherwise have been discarded could, with genotyping, go to patients who needed them.

We have talked about a new EMR that would be AI-based, machine learning based. That is something we have been working on. And that solution is predicated on the machine doing a lot more work for the physician with regard to how you practice, practice patterns, condition of payment, the medical history you have on a person and what sort of questions should be asked the patient is in the room what kind of things have you asked of this patient that you either have or have not yet documented.

And so that component of a true assistant something that truly adds value to the experience for the physician as well as the patient, is work that has been underway for the past three-plus years inside the company. We also have a substantial amount of data that we collect and have in a database of some 40 million different lives. That we have, in a deidentified way, a set of capabilities to look for patterns in that data that we might historically not have seen without the advent of an AI data crawler or capabilities where the data are being correlated in different ways that a PhD scientist may not have had a thesis around, historically.