The Promise of Personalized Medicine

Why is personalized medicine still so difficult for patients to navigate in practice?In this episode, Perry is joined by patient advocate and Multiple Myeloma Research Foundation co-founder Kathy Giusti for a candid conversation that brings the patient's journey into sharp focus. Drawing from her experience as both a multiple myeloma and breast cancer survivor, Kathy shares what personalized medicine looks like from the patient side—complex, fast-moving, and often overwhelming without the right support systems in place.In this episode, you’ll hear about:Why personalized medicine goes far beyond a diagnosis—and requires deeper understanding through genomic sequencing, biomarker testing, and immune profilingThe challenges patients face at diagnosis, including limited time with physicians and information overloadHow patients can better prepare for doctor visits and advocate for the testing and care they needThe critical (and often underutilized) role of patient advocacy groups and navigatorsWhy caregivers play such an important role in decision-making and supportThe gaps in care coordination—and how fragmented systems create friction for patientsWhy diagnostic innovation isn’t always visible to patients—and how that impacts awareness and accessThe importance of collaboration across providers, researchers, payers, and innovatorsHow Kathy built the Multiple Myeloma Research Foundation into a “doer” organization driving real change in research and careThe need for continuous testing and monitoring throughout the entire patient journey—not just at diagnosisHow shared decision-making is reshaping the relationship between patients and providersThe conversation closes with a forward-looking perspective on the future of personalized medicine—where prevention, earlier intervention, and more integrated care models could dramatically improve outcomes and reduce the burden on patients.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

What does personalized medicine really mean—and why does it still feel so out of reach for patients?In this episode, Perry is joined by patient advocate and lived experience expert Christine Von Raesfeld for a powerful conversation that brings the patient voice to the forefront of personalized medicine. Drawing from over 50 years of navigating complex health conditions, Christine challenges the industry’s assumptions and shares what personalized care actually looks like from the inside—fragmented, evolving, and full of unanswered questions.In this episode, you’ll hear about: How personalized and precision medicine are often misunderstood—and why clearer definitions matterWhy the current healthcare system still feels disconnected and siloed for patientsThe importance of patients becoming active participants in their own careHow pharmacogenomics and multi-omic data can help (but aren’t widely accessible)The limitations of a reactive, symptom-based healthcare modelWhy data access and ownership remain major barriers to progressThe tension between privacy and progress in advancing researchHow current clinical trial designs often exclude the patients who need them mostThe need for more holistic, longitudinal, and real-world data in researchHow Christine is contributing her own data to research and helping pioneer a patient-led model of careThe role of education, storytelling, and younger generations in shaping the future of healthcareThe conversation closes with a hopeful look at what’s ahead—where greater collaboration, better data sharing, and a reimagined relationship between patients and providers could finally make personalized medicine a reality.To learn more about Christine's work, visit her Linkedin! —-------Stay connected with our host, Perry Dimas, here on LinkedIn!  📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

Our DNA holds the keys to understanding our health and well-being.Our guest today is Jill Davies, CEO at Genome Medical. She emphasizes the crucial role of genetic counselors in deciphering complex genetic information for individuals, offering tailored guidance on healthcare decisions. Jill introduces the concept of genetic counseling assistants, streamlining the process and allowing genetic counselors to focus on the most critical aspects of patient care.The conversation also dives into:Sources of patient referralsBarriers to personalized medicine, including limited access to genetic counselors and concerns about payor coverage Advancements in testing methodologiesJill Davies is a leader in the field of genomic healthcare. With over 20 years of experience in the genomics field, Jill has broad expertise across clinical services, telehealth, strategic planning, business development and leadership. She has a special interest in the role of genomics in primary care and preventive medicine as well as the use of technology to enable access to genomic information and services.—----Stay connected with our host, Perry Dimas, here on LinkedIn! If you’re a Medical Director looking to advise laboratory innovators, please DM Perry on LinkedIn!  

What does personalized medicine really mean—and why does it remain so difficult to implement at scale?In this episode, Perry is joined by longtime colleague and molecular pathology expert Dr. Frederico Monzon for an in-depth conversation on the realities behind personalized medicine. Drawing from his experience across academia, clinical practice, and industry, Frederico reframes personalized medicine as not only identifying the right treatment—but also avoiding therapies that offer no benefit and may cause harm.In this episode, you’ll hear about:How personalized medicine has long existed in pathology, even before the term became a buzzwordWhy avoiding ineffective treatments is just as critical as finding the right oneThe ongoing challenge of access to diagnostic testing and actionable informationWhy many patients still aren’t tested—even when guidelines and coverage existThe role of clinical guidelines as guardrails, not rigid rulesTensions and opportunities between laboratories, insurers, and lab benefit managersHow unmet clinical need drives meaningful innovation in diagnosticsWhy collaboration across industry, academia, and payers is essentialWhat excites Frederico most about the future: multimodal medicine combining genomics, pathology, imaging, clinical data, and AIThe conversation closes with a forward-looking discussion on how breaking down data silos—and using AI responsibly—could help healthcare teams deliver more precise, cost-effective care tailored to each individual patient.—-------Stay connected with our host, Perry Dimas, here on LinkedIn!  📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

Using genomics or other biomarkers to improve health care is the essence of Personalized Medicine according to today’s guest, Dr. Bruce Quinn. Moving forward with novel diagnostic testing could prove challenging for a variety of reasons, one of them being a disruption to the overall healthcare industry. If one test could replace multiple, costly tests, then the ROI for certain payors goes down. Join us as we also discuss: The other challenges facing new testsWhere test identifiers are headingThe indirect interest of insurance salesDr. Quinn is the Principal at Bruce Quinn Associates LLC and is an expert in Medicare policy for innovative technology.  His initial career was as a full-time medical school faculty member.  Armed with an MBA in 2001, he shifted to a career in strategy consulting.  He served as a regional Medicare Part B medical director 2004-2008.   He has worked for a global consulting firm, Accenture, as well as for two DC-based health policy firms.   Since 2016, he has been an independent consulting primarily focused on genomics and digital technologies.  His services include product planning and reimbursement pathways for innovators, as well as due diligence investigations for investors.   His website on health policy and new technology, “Discoveries in Health Policy,” has had over a million views, holds 2000 articles, and has hundreds of subscribers from industry, academia, and government.  Dr. Quinn is based in Los Angeles.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this episode of The Promise of Personalized Medicine, Perry sits down with Aditya Pai, a genetic counselor by training and a leader at Genialis, where he works at the intersection of biology-driven analytics, AI, and oncology drug development.Aditya brings a practitioner’s and innovator’s perspective to what personalized medicine truly means today—moving beyond one-size-fits-all care and even beyond single-gene mutations, toward a more holistic understanding of disease biology. Together, they explore how RNA-based insights, pathway-level analysis, and machine learning are reshaping how cancers are understood, treated, and studied across the drug development lifecycle.Aditya shares insights about:Why personalized medicine is not new—but how advances in AI, transcriptomics, and systems biology are making it more actionable than everHow biology-driven, pathway-level approaches outperform single-mutation thinking in complex diseases like cancerThe role of AI and machine learning in building “foundation models” for cancer that help explain response, resistance, and relapseUsing therapeutic intelligence to improve drug discovery, clinical trial design, patient stratification, and combination therapy decisionsHow diagnostics are increasingly guiding therapeutics, and why elevating the value of diagnostic insights is critical to accelerating adoptionThe continued importance of clinical guidelines—and how they can coexist with truly individualized careReal-world examples where understanding underlying biology unlocked better outcomes, even when mutations alone fell shortThis episode offers a thoughtful, forward-looking look at how personalized medicine is evolving—from clinical care to population-level insights—and what it will take to translate cutting-edge science into meaningful, ethical, and accessible outcomes for patients.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, host Perry Dimas recaps highlights from the recent Diagnostics Conference in Napa—a gathering that brought together leaders and innovators shaping the future of precision medicine.Perry shares key takeaways from the event, including thought-provoking discussions on data aggregation for faster industry adoption, insights from MetaCensus on collaborative progress, and a critical legal update from Debbie Parish of Parish Law. He also reflects on Bobbi Buell’s presentation, which explored what the diagnostics industry can learn from pharma’s success in driving education, adoption, and payer alignment.The episode also spotlights an attendee favorite: the Medical Director Workshop, where participants had the rare opportunity to meet with multiple advisors in small groups to refine their company messaging and payer strategies.If you’re interested in attending DX Con 2026, please visit our website to register now! —-------Stay connected with our host, Perry Dimas, here on LinkedIn! 📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down Eugean Jimanwall, Senior Research Analyst for Medical Policy & Technology Evaluation at Independence Blue Cross’ Medical & Claim Payment Policy Department within Facilitated Health Networks and Medical Affairs.He is a seasoned expert with more than 15 years of experience in medical policy and health technology assessment. Together, they unpack the evolving world of personalized and precision medicine—what it really means, why the concept isn’t new, and how modern tools like next-generation sequencing and biomarkers are advancing accuracy in care.Eugene shares insights about:Reviewing evidence for medical policy, highlighting both the opportunities and common challenges companies face when validating new tests The importance of clinical utility data to the role of biomarkers in shaping treatment decisionsThe necessity of aligning evidence generation (validity, utility, etc.) with what payors, policy bodies, or HTA organizations requireNeed for clinically meaningful improvements, not just statistical significance. What matters in practice (improved management, symptom relief, survival, quality of life).While personalized medicine is about the individual, policy / reimbursement / HTA often think in terms of subpopulations (e.g. groups with a biomarker) or larger cohorts.This episode offers a candid, expert perspective on what it takes to move from theory to meaningful outcomes.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down with Dr. Neetu Sharma to explore the evolving world of precision medicine and how it’s transforming patient care. From the role of genetics and biomarkers in tailoring treatment to the importance of lifestyle, environment, and early intervention, Dr. Sharma offers a holistic view of what personalized medicine truly means.They discuss real-world applications, including chronic kidney disease, and how genetic testing can guide treatment decisions, improve outcomes, and even reduce healthcare costs. Perry and Dr. Sharma also tackle the challenges facing the field—from data privacy and payer adoption to the tension between clinical guidelines and individualized care—and the critical need for patients to take ownership of their health.Whether you’re a healthcare professional, patient, or simply curious about the future of medicine, this conversation highlights how precision care goes beyond symptom management, empowering both doctors and patients to act upstream and prevent chronic disease before it starts.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down with Dr. Ryan Nelson, to explore the evolving and sometimes misunderstood world of personalized medicine. With years of hands-on experience, Dr. Nelson offers a refreshingly nuanced definition—one that goes beyond genetics to include biomarkers, digital tools, and system-wide collaboration for predictive, preventative, and precisely tailored care.We dive deep into:the challenges and slow adoption of pharmacogenetics in the U.S.the ethical and regulatory friction surrounding genetic testingwhy "genetic exceptionalism" may actually hinder progressthe FDA’s shifting role to real-world cost savings dataRyan also shares a behind-the-scenes look at MetaCensus, a new distributed platform designed to foster consensus among stakeholders through open-access, federated data—creating space for payers, providers, pharma, and regulators to weigh evidence transparently.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 📧 Interested in joining our medical director advisory group? Email us at [email protected] 🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down with Jonathan Romanowksy, Co-Founder and Chief Business Officer at Inflammatix, Inc. With years of experience in the field, Jonathan shares insights into how personalized medicine is expanding beyond oncology and transplantation into new areas such as infectious diseases, neurology, and immunology.They dive into the challenges and opportunities of bringing innovative diagnostic tools to market, ensuring clinical adoption, and overcoming payer skepticism. The conversation also touches on the critical role of integrated health delivery systems, group purchasing organizations, and the payer community in facilitating the adoption of novel medical technologies. Jonathan provides thought-provoking insights on the need for a more proactive approach from payers, including the implementation of coverage-with-evidence development programs to evaluate and support new innovations.Key Topics Discussed:Sepsis and Acute Infection Management – The critical need for better diagnostic tools and how TriVerity is making an impactClinical Study Rigor – Why broad, well-designed studies are essential for test adoption and payer reimbursementPayer Considerations in Precision Medicine – Balancing innovation with cost-effectiveness and scalabilityEarly Adoption of Diagnostic Testing – Challenges and strategies for integrating a newly FDA-cleared test into healthcare systems.Impact on Patient Care – How the test can help hospitals decide whether to transfer patients, reducing unnecessary transfers and improving outcomes.Value-Based Care and Pricing Models – The potential for pricing medical products based on the value they bring rather than traditional reimbursement structures.Future of Healthcare Innovation – The need for better collaboration between payers, providers, and innovators to improve patient care and system efficiency.Tune in as they discuss the challenges of reimbursement models, the potential for value-based pricing, and how the healthcare system can work towards a future where the right patient receives the right care at the right time.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this episode of The Promise of Personalized Medicine, Perry sits down with Sarah Clancey Overton, Director of Revenue Cycle Management at Velsera.They discuss how genetic profiling is transforming healthcare—enabling targeted treatments, improving prognostic tools, and even opening doors for disease prevention.The conversation highlights the critical role of diagnostic testing in precision medicine, the increasing collaboration between pharmaceutical companies and labs, and the challenges in payer coverage that impact patient access.It examines why not all doctors are ordering comprehensive genetic profiling, how diagnostics and therapies can be better aligned, and what changes are needed to ensure patients receive the right treatment at the right time.Tune in as they discuss the future of medicine—where data-driven insights and tailored treatments have the power to redefine patient care.—-------Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this year-end wrap-up episode of The Promise of Personalized Medicine, host, Perry is the guest this week and he’s joined by his producer, Angela! They reflect on the significant shifts and trends that defined 2024 in the healthcare and diagnostics industries. Join as they explore FDA regulatory developments, state-level biomarker laws, and innovations shaping personalized medicine.The fantastic lineup of guests from the past year are celebrated—Beth Davis, Wren Gregory, Dr. Sandra Milligan, Debs Pipphard, Rennie Quarles, Tom Cronin, Mark Hiatt, Tyler O'Malley, and Dr. Sherie Smalley—whose insights enriched the conversation around precision medicine.In a fun segment, "How Well Do You Know Your Guests?", Perry tests his memory with standout quotes from our guests, sparking discussions about AI advancements, clinical significance, and the evolution of personalized care.Looking ahead to 2025, the discussion goes towards the industry's trajectory, breakthrough innovations, and the potential impact of policy disruptions on healthcare delivery. Tune in for an engaging and insightful recap of the year that was and a glimpse into what lies ahead.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this episode of The Promise of Personalized Medicine, Perry sits down with Dr. Sherie Smalley to explore the nuanced challenges and opportunities in today’s healthcare landscape. Dr. Smalley shares her unique perspective as a physician and medical director, shedding light on the complexities of aligning patient care, financial responsibility, and clinical decision-making.The conversation dives into the misalignment of incentives within the healthcare system, the critical need for cost transparency, and the importance of equipping both providers and patients with the tools and knowledge to make informed decisions. The conversation also dives into:why value-based arrangements could be a game changer, fostering collaboration, data sharing, and trust among stakeholders while improving patient outcomes.the evolving role of laboratory medicine in supporting clinical decisionsthe potential of genetic testing to revolutionize carethe systemic fragmentation that often hinders progress. This episode is a thought-provoking look at how healthcare professionals, payers, and patients can work together to address systemic challenges and pave the way for better care. —---------Dr. Sherie Smalley is a healthcare consultant and principal at New Dawn Health LLC. Her background experience as a physician executive with 30 years of healthcare experience includes serving as Chief Medical Officer and Senior Medical Director for Medical Policy for health plans providing government and commercial coverage. Her passion is improving health outcomes by promoting patient-centered, high-quality, personalized healthcare. Dr. Smalley also held a volunteer faculty appointment at the University of Hawaii School of Medicine where she taught problem-based learning. Prior to her health plan experience, Dr. Smalley held a role in the California Department of Public Health and practiced anatomic and clinical pathology in Northern California. Dr. Smalley holds a bachelor’s degree in psychology with a double minor in biology and chemistry from Sonoma State University. She received her medical degree from the University of California, Davis, and completed her residency at Kaiser Permanente’s San Francisco Medical Center. Dr. Smalley is board certified in anatomic and clinical pathology. Sherie has three children and four grandchildren. She is an avid gardener and enjoys growing orchids.  She has been a member of the Susquehanna Orchid Society and the Honolulu Orchid Society, and currently has almost 100 orchids under her care.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Today we sit with Tyler O’Malley, an expert in the evolving fields of personalized and precision medicine, to explore how advancements in diagnostics are transforming patient care. Tyler shares his vision for healthcare that shifts away from broad-based disease management toward more individualized treatment, especially in challenging fields like autoimmune diseases. He discusses the role of artificial intelligence in leveraging vast data for actionable insights, which enable doctors to take a proactive approach rather than a reactionary one.We dive into the current limitations in autoimmune disease management, using lupus as a case study, where outdated diagnostic tools still dominate. Tyler explains the need for more precise diagnostic testing and the challenges of working within a constrained healthcare system with limited specialist availability. We also tackle the complexities of navigating payer dynamics, where reimbursement policies often lag behind clinical innovations.Finally, Tyler discusses essential strategies for diagnostics companies, emphasizing the importance of early integration of reimbursement planning, setting realistic investor expectations, and fostering strong relationships with payers and physicians alike.If you’re interested in how the healthcare industry is working to deliver better outcomes through innovation, this episode is for you!—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Imagine going to the doctor and knowing your treatment is designed just for you—tailored to your unique biology, lifestyle, and even your genetic code. That’s the promise of personalized medicine. But with all the advancements in precision healthcare, are we truly getting more personalized care, or are we just layering new technologies onto old practices? Today, we're diving deep into this tension between cutting-edge innovation and traditional healthcare, exploring what it really means to treat the individual patient in this modern medical world.Today’s guest is Dr. Mark Hiatt, a seasoned radiologist. Rooted in the timeless principles of the Hippocratic Oath, Dr. Mark shares his insights on delivering individualized patient care amidst the advancements in genomic medicine and precision diagnostics. He discusses historical influences like the Flexner Report, and examines how modern healthcare can move beyond reactive, highly specialized care to embrace a more preventive and personalized approach.Other topics discussed:the challenges posed by health plans, including the frustrations of prior authorizations and the tension between cost management and patient-centered outcomesinnovative solutions such as shifting to an educational approach in prior authorizations and aligning incentives through value-based care modelsbroader issues like the role of employers in health insurance, the financial burdens of medical costs on individuals, and the urgent need for a healthcare system that empowers patients to take control of their own health journeys—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

The fight for reimbursement often feels like navigating a maze. From lengthy appeals to prior authorizations, labs and healthcare providers must balance innovation with complex payer policies. But what if this process could be less adversarial, more collaborative, and streamlined with the help of cutting-edge technology?Our guest today is Tom Cronin, Senior Vice President, Revenue Cycle Strategy & Analytics at Quadax. Quadax is the leading and trusted healthcare partner delivering revenue cycle optimization solutions driven by the needs of our clients, powered by business analytics, and supported by superior service to improve reimbursement of care.Tom acknowledges that while appeals can be a necessary tactic to challenge denied coverage, they are costly and time-consuming. He contrasts older adversarial approaches with today’s more collaborative methods, where payers increasingly appreciate the economic value of tests in the long-term healthcare of patients. He explains how medical policies and prior authorizations play a critical role in determining coverage, while also discussing the evolving trend of health plans requesting medical records electronically to streamline the process.The conversation also covers technological advancements that could alleviate administrative burdens, such as AI and natural language processing to assist in reviewing medical records. While these technologies are promising, both share that health plans and labs still need human oversight in making final coverage decisions.—----For more information about Quadax, please visit https://www.quadax.com/Stay connected with our host, Perry Dimas, here on LinkedIn! 

In personalized medicine, where data, technology, and patient care converge, success depends on embracing change and collaboration. As our guest puts it, 'At the end of the day, it's all about patient care. So if we have to make some changes in order to make a positive change for them, let's do that.'Today’s guest is Rennie Quarles, Sr. Director Biopharma Commercialization. She shares insights on the balance between maintaining exclusivity and fostering open access to new treatments, emphasizing the importance of broadening availability for maximum patient benefit as therapies transition to the commercial space.We discuss the evolution in business philosophy around these collaborations, highlighting the multifaceted relationships that companies build with pharmaceutical clients.Other topics:exciting future developments in personalized medicine, such as leveraging data, AI, and machine learning to improve clinical trials and patient carethe growing approval of biomarkers, not just in oncology but across other fields like neurology, reflecting the industry's potential to impact multiple disease statesthe role of patient advocacy groups and the ongoing, incremental advances that drive the field forward.Join us as we explore the challenges, opportunities, and future directions of personalized medicine, always with a focus on what matters most: improving patient outcomes.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Picture this: You walk into a doctor's office, and instead of a one-size-fits-all prescription, you're handed a treatment plan designed specifically for your genetic makeup. This isn't science fiction; it's the groundbreaking promise of personalized medicine, where cutting-edge technology meets the intricacies of human biology to provide precise and effective healthcare solutions.Today’s guest is Deb Phippard, Chief Scientific Officer at Precision for Medicine. They delve into the fundamental concept of personalized medicine, emphasizing the importance of delivering the right drug to the right patient at the right time. Deb shares her perspective on the advancements in the field, particularly highlighting the significant impact of checkpoint inhibitors like Keytruda on cancer treatment.The conversation explores the challenges of the traditional trial-and-error approach in medicine, the crucial role of companion diagnostics, and the transformative potential of AI in integrating complex data for personalized treatment plans. Deb and Perry also discuss the regulatory landscape, comparing the hurdles faced in the U.S. and Europe, and the implications for clinical trials and patient care.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Personalized medicine still has so much potential. With the need for greater adoption and further advancement becoming more apparent, this conversation is necessary.Today's guest is Dr. Sandy Milligan, the President of Research & Development, Laboratory Operations, IT and HR at Aspira Women’s Health. Dr. Milligan explains the nuances of personalized medicine, defining it as an individualized approach to healthcare that leverages precise diagnostics based on omics data analytics. We explore the challenges and opportunities in adopting personalized medicine, particularly in the United States, and discuss the financial, regulatory, and clinical hurdles that need to be overcome.Dr. Milligan shares insightful examples from the fields of hypertension and oncology, highlighting how personalized medicine can revolutionize treatment plans and improve patient outcomes. We also delve into the critical role of biomarkers in developing innovative therapies and diagnostics, especially for complex diseases like endometriosis and various cancers.Tune in to learn about the current state and future potential of personalized medicine from one of the leading experts in the field!—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Clinical research plays a critical role in advancing medical treatments.Today's guest is Dr. Wren Gregory, the Director of Laboratory Operations and Clinical Research at Precision Genetics. Join us as Dr. Wren describes her responsibilities in overseeing lab documentation, compliance, and team mentorship, ensuring smooth operations at Precision Genetics’ facilities in Greenville and Charleston. She also discusses the critical role of clinical champions in advancing precision medicine, particularly in pharmacogenomics, and the challenges of translating robust evidence into actionable clinical utility.We dive into the complexities of personalized medicine and the importance of user interface in clinical tools, emphasizing the need for real-world input from clinicians to create effective, user-friendly diagnostic tools. Dr. Wren provides insights into the intricacies of working with payers, the importance of economic data in demonstrating value, and the necessity of building relationships with reimbursement champions to navigate the administrative hurdles in healthcare.Tune in to learn about the art of managing change in healthcare, the significance of clinical and reimbursement champions, and how Precision Genetics is contributing to the evolution of precision medicine.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Progress and transformation–are two words we definitely want to be associated with our US Healthcare. Today’s guest, Beth Davis, addresses the significant strides made in digital healthcare and smart technologies, ranging from wearable devices to implantable devices that monitor vital signs and manage chronic conditions like diabetes. She emphasizes the positive impact on test turnaround time, treatment plans, and patient care management facilitated by advancements in biomarkers, diagnostic platforms, and gene sequencing.The conversation also explores challenges that persist, particularly in the regulatory pathway and the complexities of securing funding for emerging technologies. The lengthy and uncertain timeline for test coverage and reimbursement is a factor, shedding light on the financial burden faced by companies bringing new technologies to market.Other topics discussed include:Common mistakes made by companies when launching novel diagnostic tests in the U.S. &  the importance of a well-thought-out reimbursement and market access strategy from the concept phaseThe evolving relationship between the healthcare industry and health plans, and the collaborative efforts and direct dialogue between manufacturers and payers that are neededJoin us for this eye-opening discussion, and if you’re a laboratory professional helping bring forward diagnostic tests, AND have interest in being a guest on this show, please DM Perry on Linkedin. —----Stay connected with our host, Perry Dimas, here on LinkedIn! 

The tables are turned on our regular host, Perry Dimas, and this week–he becomes the guest! Our Producer, Angela, takes the hosting seat and asks Perry all those questions you’ve been wanting to know. Questions like: What are YOUR thoughts on Personalized Medicine?What has made Season 2 special, so far?What is the newest piece of information that you believe would help laboratories as they’re developing their tests in 2024?There’s also an insightful game entitled: “How Well Do You Know Your Guests?”Some thoughts about the future round out this 2023 Wrap Up episode. Enjoy!—----Stay connected with our host, Perry Dimas, here on LinkedIn! If you’re a laboratory innovator who is interested in guest speaking on the podcast, please DM Perry on LinkedIn! 

Our DNA holds the keys to understanding our health and well-being.Our guest today is Jill Davies, CEO at Genome Medical. She emphasizes the crucial role of genetic counselors in deciphering complex genetic information for individuals, offering tailored guidance on healthcare decisions. Jill introduces the concept of genetic counseling assistants, streamlining the process and allowing genetic counselors to focus on the most critical aspects of patient care.The conversation also dives into:Sources of patient referralsBarriers to personalized medicine, including limited access to genetic counselors and concerns about payor coverage Advancements in testing methodologiesJill Davies is a leader in the field of genomic healthcare. With over 20 years of experience in the genomics field, Jill has broad expertise across clinical services, telehealth, strategic planning, business development and leadership. She has a special interest in the role of genomics in primary care and preventive medicine as well as the use of technology to enable access to genomic information and services.—----Stay connected with our host, Perry Dimas, here on LinkedIn! If you’re a Medical Director looking to advise laboratory innovators, please DM Perry on LinkedIn!  

Coding in the world of medical tests and personalized medicine may not be the most scintillating topic, but it's a critical puzzle piece that can make or break the seamless delivery of healthcare services. Our guest today is Dr. James Almas, the National Medical Director for Clinical Effectiveness at Labcorp, who provides an in-depth exploration of the complexities of medical coding in the context of personalized medicine. He shares deep insights into the intricacies of medical coding, especially in the context of genetic testing. The discussion highlights a need for a unified and effective solution in an ever-evolving landscape of genetic testing. The conversation also dives into:How coding impacts reimbursement and clinical utility The background of how coding systems for genetic tests have evolvedThe introduction of Z codes by Moldex & Dex as alternatives to traditional coding systems and the challenges they present in terms of HIPAA compliance.Dr. Almas is the National Medical Director for Clinical Effectiveness at Labcorp.  Prior to that he served as the Medical Director at MolDX (Palmetto) and has served as a medical officer at CMS (Coverage Group).  He is a board certified pathologist with years of service as a pathologist.  He served as the CAP’s advisor to the AMA’s CPT Editorial Panel.—----Stay connected with our host, Perry Dimas, here on LinkedIn! If you’re a Medical Director looking to advise laboratory innovators, please DM Perry on LinkedIn!  

The goal of personalized medicine is to pinpoint the most effective treatments and reduce the morbidity and toxicity associated with unnecessary therapies. One of the major challenges in the field is securing reimbursement for personalized medicine services. While Medicare often leads the way in adopting new approaches, other payers vary in their criteria, making it a complex landscape to navigate.Our guest today is Matt Mega, the Senior Vice President of Market Access at Natera. He emphasizes the importance of identifying patients who will truly benefit from specific treatments, sparing others from unnecessary risks and costs. The conversation also dives into:The nuances of working with payors & the need for robust dataThe importance of listening to payors needs The need for sustained investment The evolving landscape of reimbursement policies—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

While the healthcare industry innovates at an often unprecedented rate, payors grapple with the complexities of implementation and sustainability. From the payors vantage point, there is both excitement and trepidation surrounding personalized medicine’s rapid evolution. Today’s guest, Suzanne Belinson emphasizes the critical role of diagnostics companies in helping healthcare systems manage this transformation effectively. Suzanne is the Vice President of Commercial Markets at Tempus, Inc. Tempus is a technology company focused on bringing the power of data and artificial intelligence to healthcare. Her role focuses on commercial growth for Tempus through the development and execution of partnerships with managed care organizations. The conversation also dives into:Demonstrating the value of diagnostic testingHow innovation can impact member retentionThe urgency to create sustainable platforms & payment models —----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Using genomics or other biomarkers to improve health care is the essence of Personalized Medicine according to today’s guest, Dr. Bruce Quinn. Moving forward with novel diagnostic testing could prove challenging for a variety of reasons, one of them being a disruption to the overall healthcare industry. If one test could replace multiple, costly tests, then the ROI for certain payors goes down. Join us as we also discuss: The other challenges facing new testsWhere test identifiers are headingThe indirect interest of insurance salesDr. Quinn is the Principal at Bruce Quinn Associates LLC and is an expert in Medicare policy for innovative technology.  His initial career was as a full-time medical school faculty member.  Armed with an MBA in 2001, he shifted to a career in strategy consulting.  He served as a regional Medicare Part B medical director 2004-2008.   He has worked for a global consulting firm, Accenture, as well as for two DC-based health policy firms.   Since 2016, he has been an independent consulting primarily focused on genomics and digital technologies.  His services include product planning and reimbursement pathways for innovators, as well as due diligence investigations for investors.   His website on health policy and new technology, “Discoveries in Health Policy,” has had over a million views, holds 2000 articles, and has hundreds of subscribers from industry, academia, and government.  Dr. Quinn is based in Los Angeles.—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Having a baseline understanding of each of our individual health needs should be a no-brainer. Yet, America is still mainly practicing a responsive-based medical model vs. a proactive approach.  Today’s guest, Donna Edmonds, says: “We should learn how to manage health, and focus on wellness and prevention.” She is the CEO of BRAINBox Solutions Inc. and is passionate about working with the leadership clinicians in the field to improve patient access and the quality and management of patient care while reducing overall health costs.Join us as we also discuss: Physicians needing more time to think while on the jobHow to benefit from personalized medicineThe importance of access to baseline testing —----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Why aren't Americans benefiting from customized treatment plans utilizing their specific genome types and targeting the unique needs of the problem? Advanced tests are out there but not enough patients are even getting tested, let alone, having the option of the correct tests!Matt Brane helps break down some of the main reasons preventing these kinds of tests from reaching the average American patient. He is currently the Vice President of Managed Care at Guardant Health and has dedicated his career to helping people receive the treatment they deserve. His diverse background spans 20 years of professional development with expertise in market access and reimbursement strategy, sales and operations management, managed care/managed care management, business development, sales, and marketing in the Genomics, Oncology, Molecular Diagnostics, Medical Equipment, Specialty Pharmacy/Infusion, Physician and Hospital market. Join us as we further discuss: Misaligned Incentives between the payors and physiciansNavigating the option of reimbursementHow health plans can help adopt personalized medicine—----Stay connected with our host, Perry Dimas, here on LinkedIn! 

Who owns the fiduciary responsibility between insurance and physicians? Could the answer include both? This episode includes a fantastic conversation about the perspective of larger economics within these roles. Today’s guest is Dr. Kenneth Schaecher, the Interim Chief Medical Officer at the University of Utah Health Plan. Not only does he break down current ideas of improvement, but also the history behind the relationship of the payer and physicians. Join us as we further discuss: The dynamics of under-utilization and over-utilization of patient testing How monitoring testing affects all of us economically Why values-based fees are the current and future wave of costs —------------Stay connected with our host, Perry Dimas, here on LinkedIn! 

There are guidelines that will naturally protect with the patient, employer and payor. It is also beneficial as an employer to establish a helpful relationship with their payor in order to meet the specific needs of their employees. Dr. Phillip Smith, Regional Medical Director at Oscar Health, takes a deep dive into the benefits of this type of care. Join us as we discuss: Clinical Utility and the benefits of testing of having time with testsNuances of medical policiesPrior Authorizations and how they protect patients, employers, and payors------------------------Stay connected with our host, Perry Dimas, here on LinkedIn! 

What will it take for there to be price transparency for preventative medicine? The No Surprise Bill is a start! There is also the need for consumers to understand their options and for physicians to stay current on the latest technology. This is easier said than done. Today's guest is Dr. Linda Britton, Senior Medical Director, Southeast Region at United Healthcare. Join us as we discuss: Women’s healthcare & the development of personalized medicine Member satisfaction & the need for prior authorization Consumer-driven change in the future surrounding price transparency —------------Stay connected with our host, Perry Dimas, here on LinkedIn! 

Ultimately, we want the world to be a better place. Precision Medicine can help with this long-term goal and the labs that are looking to study, test, and prove this kind of work could have incredible opportunities to show up prepared. Continuing our interview with Dr. Carmen Alfonso, who is the Senior Medical Director of Blue Cross Blue Shield Advantage of Arizona, we dive deeper into how these tests could gain positive medical coverage within health plans.We also discuss:Price transparency within the medical community, currentlyPrior Authorizations and Evidence-Based Medicine—------------Stay connected with our host, Perry Dimas, here on LinkedIn! 

Clearly defining the cost structures so that Doctors, Insurance Companies, and patients feel empowered to use personalized medicine to their advantage is what today’s guest believes is one of the best next steps we can take in healthcare. In this Part 1 of 2 interviews, we are joined by Dr. Carmen Alfonso, who is the Senior Medical Director of Blue Cross Blue Shield Advantage of Arizona and has incredible insights into genomic mapping and how genetic testing would ultimately serve patients long term. Join us as we discuss:Genomic mapping and how directed therapies are the point of personalized medicineWhy current healthcare costs are more expensive How taking a longitudinal view of health is disruptive—------------Stay connected with our host, Perry Dimas, here on LinkedIn! 

With the explosion of popularity with personalized medicine in the last decade, the need for clearly defined clinical utility is ever growing. It’s not enough to have the proof that a test works–but what treatment can Doctors and patients then take with those results? This question is explored with today's guest, Dr. Charles Stemple, former Humana Medical Director. His insights on clinical utility and the need for intention within the tests are impeccable. Join us as we discuss:The need for clearly defined tests and how they will change the treatments for patientsThe importance of a SWOT analysis on developing testsDeveloping the intention for the tests in the marketplaceThe economic impact of the tests —------------Stay connected with our host, Perry Dimas, here on LinkedIn! 

Within novel diagnostics tests, needing clinical utility evidence cannot be understated. And the more evidence accumulated over years, the better. But why? Today’s guest is Dr. Virginia Calega, the President of VCC Healthcare Solutions, and she makes a highly compelling argument that, if payors are going to accept a new novel diagnostic test, and disrupt what they already have, it has to be backed by substantial evidence. Join us as we also discuss: The contrary belief of expensive tests CAN be approved by payorsThe need to clearly define the novel test for the patient’s clinical journeyThe ultimate savings cost built into the newer tests-----------------------------------------------Stay connected with our host, Perry Dimas, here on LinkedIn!