40 Clinical OMICs July/August 2017 www.clinicalomics.com
Precision Medicine
Up to Code
Geisinger's MyCode Genomics Data Brings
Power to Precision Medicine and Research
Malorye Allison Branca, Contributing Editor
W
ith it's 150,000th patient recently enrolled, Geisinger
Health System's MyCode project is helping set the
standard for big health data projects around the world. The
program has a system to easily enroll patients, process both
their genomic and clinical data, return relevant results to
them, and spur research. It's what many biobank develop-
ers are dreaming of.
Genomics databases now abound: there is the Million
Veterans Program, the China Kadoorie Biobank Study, Van-
derbilt's BioVu, U.K.'s 100,000 Genomes Project, and many
more. MyCode is unusual because of it's rapid growth and
the fact that it not only has a robust sequencing database but
also more than 20 years worth of electronic health record
(EHR) data. Most importantly, Geisinger is already using
information gleaned from analysis of this data to guide care
of its patients for almost 30 conditions, including breast and
ovarian cancers, Lynch syndrome cancers, and hereditary
high cholesterol.
"There's an immense amount of information in clinical
records," said Jeremy Rotter, Ph.D., who is helping build a
biobank based at UCLA. "And people are starting to learn
how to efficiently mine that data, including billing records
as well as doctors' and nurses' notes." Rotter is director of
LA BioMed's Institute for Translational Genomics and Pop-
ulation Sciences, Harbor-UCLA Medical Center.
Another development that has helped MyCode and sim-
ilar projects is the rise of cloud computing, which is a tool
Geisinger and most biobanks use. "When you are dealing
with a terabyte of data it costs a lot to store it," explains
Andrew Gruen, communications officer at Seven Bridges,
which provides genomics-related data analysis and man-
agement services to multiple big data projects, including
the Cancer Genomics Cloud, the Million Veteran Program,
and the U.K.'s 100,000 Genomes program. Jeff Reid, Ph.D.,
agrees. He is executive director of Genome Informatics at
the Regeneron Genetics Center (RGC), which outsources
sequencing, analytics, and related services to dozens of orga-
nizations, ranging from small to large, including Geisinger.
"The idea of being able to spin up as much storage as you
need, as you want it is revolutionary," he said. "It's very dif-
ferent from figuring out how many computers you need."
"We were one of the first health systems to install an EHR,
we now have an average of 14 years of data on each patient
in the system," said Andrew Faucett, one of MyCode's
principal investigators, a professor, and director of policy
& education at Geisinger. Normalizing and integrating that
data with the genomic data, he explains, is one of the key
challenges in this field.
Any Geisinger patient can enroll in MyCode, either online
or during a visit to one of the systems' facilities. After they
agree to donate a blood sample and have their EHR data
mined (with privacy protection for research purposes), that
sample undergoes exome sequencing.
In terms of patient health, MyCode focuses on just 76
"actionable" genes related to 27 conditions. Only the results
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