The Department of Health and Human Services is asking private- and public-sector health care organizations how information technology can advance the use of genomic testing information to improve and personalize health care.
Responses are due by Jan 2.
HHS is interested in plans that organizations have to use information technology to store or share genetic information, and how this information is used to make evidence-based care decisions.
“Advances in medicine, biomedical science and technology present opportunities for enabling health care practices to be increasingly patient-specific by taking into account individual differences in health states, disease processes, and outcomes from interventions,” said John Agwunobi, assistant secretary for health.
Genomic information can help predict disease risk before any sign of symptoms, giving health care providers the opportunity to prevent or treat a disease, resulting in better outcomes, Agwunobi said.
HHS expects to receive responses from community health delivery systems, HMOs, universities, state and local public health departments, and consumer advocacy organizations.
The request for information follows an intense look at genomic testing data and health care IT during an October meeting of the American Health Information Community, an advisory panel to HHS.
At the meeting, HHS Secretary Michael Leavitt told AHIC that he commissioned the discussion about genomic data testing and health care information technology to consider what must be done to integrate federal efforts into the wider public efforts already under way.
Leavitt said he was impressed with the number of standards and efforts that “have intuitively come together already” in this area.
The Veterans Health Administration also is examining the issue. Joel Kupersmith, chief research and development officer for VHA, said that the VA plans to expand its capacity in genomics to include an internal genomic management committee and a central institutional review board on genomics.
Children with risk factors such as high blood pressure, obesity, diabetes and high cholesterol levels already show signs of fatty build-up in their arteries that could lead to heart attack in adulthood, researchers reported during the American Heart Association’s Scientific Sessions 2006, held this week in Chicago.
“Primary prevention of heart disease must start in childhood,” said Sanaz Piran, internal medicine resident at McMaster University in Hamilton, Ontario, Canada. “We need to start looking at and treating risk factors for heart disease in children.”
Researchers reviewed 26 studies from the United States, the Netherlands, Australia, Finland, Norway and Italy that used noninvasive methods to measure the thickness of the artery walls and blood flow in arteries of children without risk factors, as well as in children with risk factors for cardiovascular disease.
Researchers used ultrasound in three of the studies to examine stiffness in the artery wall. They measured carotid artery intima-media thickness (CIMT), an ultrasound measurement of the thickness of the neck arteries, to determine the level of atherosclerosis. They found that children with risk factors for heart disease and stroke had an average of 8.7 percent more thickening than children without risk factors.
Atherosclerosis is the fatty build-up of plaque in the inner walls of the arteries. It can lead to heart attack or stroke.
Another noninvasive test — brachial or femoral artery flow-mediated dilation (FMD) — showed an average 37 percent decreased blood flow in children with risk factors compared to those without.
FMD measures endothelial dysfunction, which occurs when blood vessels aren’t flexible enough to expand in response to increased blood flow. In FMD, the flow of blood either in the arm or thigh is gauged with ultrasound after a cuff is inflated and deflated. FMD is a validated measure of early atherosclerosis.
“These results indicate structural abnormalities and artery wall dysfunction, both signs of the early stages of atherosclerosis,” Piran said. “Children with risk factors are showing the markers for sub-clinical atherosclerosis.”
The 26 studies included 3,630 children, ages 5 to 18.
The research highlights the need for parents and physicians to target cardiovascular risk factors in children, Piran said.
“Diet and exercise are especially important to curb the escalating problem of childhood obesity,” she said. “Obesity puts children at risk for high blood pressure, diabetes and high cholesterol levels. Children’s diets have changed dramatically, influenced by television commercials and the convenience of fast foods. Children are eating too much fatty and processed foods. Parents need to involve their kids in regular exercise activities and cut down on fatty meals, emphasizing healthy foods such as vegetables.”
Piran also suggested that parents who smoke should not smoke in the presence of their children. And if there is a family history of elevated cholesterol, then children in the family should have their cholesterol levels checked.
“The very things we recommend to adults should be recommended to parents for their children,” she said. “There needs to be a family-oriented approach to cardiovascular prevention and to addressing these risk factors.”
The study was funded by the Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Amy Gillentine covers health care for the Colorado Springs Business Journal.