Cerner targets genomics as area of growth
Kansas City Business Journal - October 20, 2006
by Rob Roberts
Staff Writer
Cerner Corp. became a $1 billion company by positioning itself at the nascent intersection of two highly complex fields: health care and information technology.

Now, the North Kansas City-based health care IT leader is bolstering its position on another challenging frontier: genomic medicine.

On Oct. 9, Cerner announced a new partnership allowing it to sell Phoenix-based Visual Technologies LLC's genomics research software, Visual Data Explorer, to clients in the clinical arena.

The software, the third offering in Cerner's genomics portfolio, transforms the complex data sets produced by genetic analysis into graphic content that is easier to visualize and manipulate.

In the past, Visual Technologies CEO Brad Edwards said, Visual Data Explorer has been targeted to academic and other basic research centers, where the 1990s mapping of the human DNA sequence accelerated research into the functions and characteristics of the 30,000 genes contained in nearly every human cell.

More than 99 percent of human DNA sequences are the same across the population. Mark Hoffman, Cerner's director of genomics strategy, said the variations can have significant effects on how patients respond to disease, viruses, drugs and other environmental factors.

That discovery led to the emergence of "personalized medicine" -- the use of drug and other therapies tailored to patients with particular genetic makeups -- and a new marketplace for Cerner.

"They see the continuing overlap of what's going on in the genomics research and pharmaceutical development labs and what's going on in clinical treatment settings," Edwards said. "I'm not aware of any other (health care IT vendors) who have made the kind of initiatives to bridge that gap that Cerner has."

Hoffman, who joined Cerner as a software developer in 1997, approached David McCallie, director of Cerner's medical informatics group, three years later with his suggestion that Cerner enter the medical genomics arena.

Two years later, Hoffman began work on Cerner's first genomics offering, Millennium Helix, which allows genetic data to be incorporated into patients' electronic medical records.

Since then, the software has been sold to 15 institutions, the most recent being the Virginia Commonwealth University Medical Center.

That number pales in comparison with Cerner's 1,500 worldwide clients. Hoffman, however, said he sees lots of upside because of the benefits genetic analysis promises in areas ranging from reduction of genetically related adverse drug reactions to molecular diagnosis of infectious diseases.

"Using culturing methods, it used to take six to eight weeks to determine whether or not someone had tuberculosis," Hoffman said. "Using a molecular test for the tuberculosis gene, a lab can now detect TB in less than a day."

Another easy-to-grasp example involves the fact that a genetic mutation present in 7 percent of the population renders those with the mutation unable to benefit from codeine, Hoffman said.

Unfortunately, he said, genetic testing, which begins with a blood draw or cheek swab, is not being ordered in many clinical settings.

"But I think every physician in the next five to 10 years is going to be challenged by patients who want their genetic information to be utilized as one part of making medical decisions," Hoffman said.

That will mean increased demand for software that embeds alerts for genetic testing into routine physician order entries, thus eliminating the need for doctors to review mountains of literature to keep up with genomic medical advances, Hoffman said.

The increased capture of genetic data during the delivery of patient care also will create demand for programs like Visual Data Explorer from in-hospital and contract laboratories that serve clinical clients, he said.

Dr. Gary Pettett, past president of the Metropolitan Medical Society of Greater Kansas City, said genomic medicine "is certainly on the frontier."

But he said he thinks its widespread use will be slowed by pharmaceutical companies, "who are not going to tailor medications to specific genomic features of the population unless there's enough demand to make it worth their while."

For every big pharma player that is slow to relinquish the one-size-fits-all blockbuster approach, however, there may be a biotech company eager to embrace personalized medicine, also known as pharmacogenomics.

San Francisco-based Genentech, considered the founder of the biotechnology industry, received Food and Drug Administration approval in 1998 for Herceptin, a breast cancer drug proven effective in women whose tumors contain high levels of a protein produced by the HER2 gene.

Although those women represent only 25 percent of breast cancer patients, U.S. sales of Herceptin hit $747 million in 2005.

 

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