Hello, and welcome to Healthcare Insider, a podcast series from the Modern Healthcare Content Studio. I'm your host, Maria Castellucci, Deputy Editor of the Content Studio. Today, we're talking about how One Health System is reimagining cancer detection and prevention by offering all patients a cancer risk assessment to help identify patients earlier and guide personalized care. Joining me today are two leaders from AdventHealth to discuss what they call GRACE, Genomics Risk Assessment for Cancer and Early Detection Program. Dr. Wesley Walker is Vice President of Genomics and Precision Health at AdventHealth, where he leads system-wide efforts to integrate genomic medicine and advanced diagnostics into clinical care. And Dr. Clark Rogers is medical director of GRACE, where he leads the clinical strategy behind integrating genomics, risk assessment, and early detection pathways into routine care. Thank you both so much for joining the podcast. Thanks so much, Maria. It's great to be here. Thank you. It's a pleasure to be with you. Before we dive in, I'd like to thank Lunit for sponsoring today's episode. Lunit is a global leader in AI-powered cancer detection and diagnostics. Their clinically validated solutions enable earlier identification and smarter clinical decision-making. Lunit partners with health systems worldwide, like Avent Health, to improve outcomes through personalized screening and precision oncology. Thanks, Lunit, for your support. Dr. Walker, to start us off, can you set the scene for us? What problems was Avent Health trying to solve when you launched the GRACE program and what trends were you seeing that made this feel urgent? Yes. Unfortunately, adults in the United States are actually developing cancer at earlier ages than they have in the past. And this trend, unfortunately, does not appear to be abating. Because of that and because of the importance of early detection, we wanted to create a system and a program that was the most advanced and accurate in terms of risk assessment. And kind of more importantly, we wanted to make sure that we tied that to a screening protocol or to routine clinical care, because we know if we're going to scale something across the entire system to many different locations, we need to have consistency and high reliability. So we created the GRACE program. And as you mentioned, it's an acronym, Genomics and Risk Assessment for Cancer Early Detection. And the goal of the program is really to identify those who are at high risk for developing cancer And if they are high risk navigating them into high risk clinical pathways that are based on strong evidence and really the gold standard clinical guidelines And so that what we've done. Dr. Rogers, can you walk us through what this looks like in practice? What happens from the moment a patient checks in for an appointment to the point where risk is identified and follow-up begins? Thank you. So we've always felt it was important to be able to stratify patients based on their risk for cancer, in this case, particularly breast cancer. And this is something that's very important to us as an organization and also to the patients and for their own health. So to make this smooth and seamless for patients on the day that a woman is scheduled for her diagnostic mammogram or for her screening mammogram for any breast imaging, she presents just like she normally would for her imaging and the technologist will go through a series of brief questions with her to help as we use a computer algorithm. We input these questions and the patient's answers into the computer algorithm and they're able to determine the patient's risk for breast cancer. So from the patient's standpoint, it's not any different than she's always done. She comes in for her screening mammogram, goes through the questions, and then with the answers to the questions plus her breast density, which is calculated using AI, we're able to determine her risk for breast cancer. So the risk for breast cancer across the standard population is about one out of eight women will develop breast cancer throughout her life. And we are able to determine if a woman has an even higher risk of developing breast cancer through this system. And if she is more likely to develop breast cancer, we're able to help her be aware of that and let her know that there are other options that she can use for additional screening, such as breast MRI, and also that she can have a discussion with genetics and with some counselors that might give her some other ways that she can lower her risk for breast cancer. So it's really, you know, in answer to your question, though, it's really just part of her normal imaging routine. She'll come in to get her images and just answer a few questions as part of her day. Abbott Health often talks about whole person care. How does that philosophy shape the design of the GRACE program? Dr. Walker? Sure, sure. Thank you. From a care design standpoint, we wanted to ground the program in kind of our fundamental philosophy, which is whole person care. And what that means is that when we're viewing medical care, we're not just focusing on a test or a diagnosis. We're focusing on the whole person, mind, body, and spirit. And so when we designed the program there are many aspects that contribute to that whole person philosophy but I just mentioned a couple First we absolutely want to individualize the care for every person because every person is unique. They have a unique family history, medical history, personal history, and unique circumstances. So we really want to personalize that care to their situation. And then secondly, we don't just want to give the result of a test. these are these results can be at times stress inducing they can be accompanied by anxiety so we want to make sure there is a real person on the other end of that that can support kind of any of the high risk patients that we identify and that comes in the form of a nurse navigator so it's not just an email it's not just a call it's actually a live person that's dedicated to making sure that that high-risk individual understands kind of what they have and then what the recommended steps are, and that nurse navigator can really kind of function as a partner throughout that clinical care process. That makes a lot of sense. Diving in a little deeper into that idea, Dr. Rogers, how does AdventHealth ensure those patients continue receiving appropriate monitoring and follow-up care? So Dr. Walker mentioned this, but I think it is very important to understand that at Advent Health, we're not just going to leave the patient without some follow-up. So any patient that is determined to be high risk by this algorithm that we already talked about in these questions that we give the patients and their breast density is put into our navigation system. And as Dr. Walker mentioned, we have a team of nurse navigators whose job it is to contact these patients and basically help them navigate what comes next, which can include meeting with a geneticist, a genetic counselor. It also can include if the patient chooses to have some additional screening, such as breast MRI or potentially whole breast ultrasound, depending on what the patient would like and after she speaks with her doctor and some genetic counselors. So we make sure that the patient is aware of her results by talking to nurse navigators. An additional thing that we have done is if the patient is high risk, we make sure that it's also documented in her report so that her primary care provider is aware as well. So we use nurse navigators and we also document it in the radiology report that of the study that she came to get that day that she went through the questions. Dr. Walker, to close us out, for health systems that want to build something similar, what lessons have you learned from launching and scaling this program? And how should organizations think about choosing the right technology partners to support these programs I think that the technology partner is key I mean you have to kind of first of all design the program and the technology supports the workflow but the technology absolutely has to work and be dependable and highly reliable And so I think there were a couple things that we looked at when we were looking at potential partners. We needed a kind of a proven and mature platform. We did not want to be a alpha or beta site for this program. We simply have too much volume for that. We also needed a program and a platform that could scale and that has been proven to scale because there are some platforms that work for smaller health systems, but we have 57 hospitals. And so we need something that absolutely can do the volume that's needed when we want to implement this organization wide. I'd say the next thing is we absolutely needed somebody who could successfully integrate with Epic. As Dr. Rogers talked about in the previous question, having all that information in one place in the Epic electronic medical record is incredibly important because that's kind of the source of truth. That's where everybody goes across the entire healthcare team to kind of view, and you want everyone on the same page. If you're asking people to go outside of Epic to third-party systems, it's often very difficult to get broad adoption. And then finally, I would say, you know, you want an organization that has a compelling roadmap. I mean, we certainly want to implement kind of best practice today, but we also know that guidelines and technology is going to change. Lunen has been kind of great across the field on that. They're very interested in helping us expand this program to other care venues and other ambulatory areas. And they're very involved in kind of evaluating and developing the risk models of the future. And so, you know, we're very pleased to have worked with them and to be working with them and to have them as a strategic partner. And I'd say, you know, we look forward to working with them for many years to come. Thanks so much for sharing, Dr. Walker. I think that's a great place to leave off. Thanks to both of you, you and Dr. Rogers, for joining us and sharing how AdventHealth's grace program is approaching cancer risk assessment and early detection. Thank you so much, Maria. It's been a pleasure. Thank you. Yeah, it's been great. Thanks for your time. And thanks to our sponsor, Lunet, for supporting today's episode. For more information about them, please visit their website, lunet.io. This has been an episode of Healthcare Insider. For more episodes, visit modernhealthcare.com or subscribe on your favorite podcast platform. I'm your host, Maria Castellucci. Thanks for listening.
