All of Us and the Promise of Precision Medicine: Achieving Equitable Access for Federally Qualified Health Center Patients.
Carolyn Plunkett NeuhausDanielle M PaciaJohanna T CraneKaren J MaschkeNancy BerlingerPublished in: Journal of personalized medicine (2023)
The United States National Institutes of Health's (NIH) All of Us (AoU) initiative recruits participants from diverse backgrounds to improve the makeup of biobanks, considering nearly all biospecimens used in research come from people of European ancestry. Participants who join AoU consent to provide samples of blood, urine, and/or saliva and to submit their electronic health record to the program. In addition to diversifying precision medicine research studies, AoU will return genetic results back to many participants, which may require further follow-up care (i.e., more frequent cancer screening or mastectomy after a BRCA result). To help achieve its goals, AoU has partnered with Federally Qualified Health Centers (FQHCs), which is a type of community health center whose patient base is comprised largely of people who are uninsured, underinsured, or on Medicaid. Our NIH-funded study convened FQHC providers involved in AoU to better understand precision medicine in community health settings. Drawing from our findings, we present barriers community health patients and their providers face when accessing diagnostics and specialty care after genetic results necessitate medical follow-up care. We also propose several policy and financial recommendations to help overcome the challenges discussed, stemming from a commitment to equitable access to precision medicine advances.
Keyphrases
- healthcare
- quality improvement
- end stage renal disease
- public health
- electronic health record
- mental health
- affordable care act
- ejection fraction
- newly diagnosed
- palliative care
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- squamous cell carcinoma
- risk assessment
- pain management
- patient reported outcomes
- young adults
- genome wide
- climate change
- social media
- human health
- deep learning
- health promotion
- patient reported
- copy number