Project History
In 1998, Duke University’s Director of
the Center for Human Genetics (CHG), Dr. Margaret Pericak-Vance,
met with her former professor and the Chancellor of The
University of North Carolina at Greensboro (UNCG), Dr. Patricia
Sullivan. UNCG had just gained approval for the state of
North Carolina’s first genetic counseling degree program, and Dr.
Pericak-Vance suggested the possibility of a collaboration to
introduce genomic medicine into Greensboro’s Moses Cone Health
System (MCHS). Early discussions involving Drs. Pericak-Vance,
Jeffery Vance, Pascal Goldschmidt from Duke University, and
Mr. Dennis Barry, CEO Emeritus of the MCHS, focused on
the possibility that some form of clinical genetic testing might be
useful for improving the diagnosis for genetically-based disease
risks for patients in the MCHS, which is the major provider for
Greensboro and Guilford County.
In the spring of 2000, Dr. Pericak-Vance and the CHG’s Associate Director, Dr. Jeffery Vance presented a general plan to introduce genomic medicine into community health. In addition to the presence of UNCG’s genetic counseling program, Guilford County possesses other attributes favorable for a demonstration project in genomic medicine: the Moses Cone Health System is the region’s major health care provider, the county has a diverse ethnic and cultural population with extended families living in the area, and a there is a sufficient supply of medical facilities and personnel.
The initiative that has evolved over the last five years is comprehensive - simultaneously addressing scientific, clinical, economic, ethical, legal, and educational issues associated with the introduction of genomic medicine in a community care setting. The overall objective is to develop a model for the practice of genomic medicine that demonstrates a tangible health benefit to patients and is also cost-effective for community health practices. For this reason, the first phase of the initiative is focused on well-defined genetic risks associated with breast/ovarian cancer, colon cancer, and thrombophilia. Moreover, clinical operations are focused on providing the tools to physicians for compiling accurate family histories that assess a patient’s personal risk for disease, preventive interventions that reduce familial-based disease risk, genetic counseling services, and when appropriate, genetic testing for gene variants that increase the risk for disease.
In the spring of 2005, with the assistance of North Carolina’s congressional delegation, notably Reps. David Price, Brad Miller, and Howard Coble, the Guilford Genomic Medicine Initiative (GGMI) began with funding from the Department of Defense (DoD) for three years and $10 million. DoD manages the largest health care system in the country and will be able to incorporate the materials, protocols, and procedures from GGMI into their healthcare operations. GGMI is structured as a partnership between Duke University’s CHG, the MCHS, and UNCG’s Center for Biotechnology, Genomics & Health Research (CBGHR). The CHG is responsible for developing the family history compilation and risk assessment tools, collection, processing and analysis of DNA when appropriate, and assisting in the creation of effective clinical procedures. The MCHS will be responsible for working with selected clinical practices to provide assistance to patients participating in the GGMI and overseeing the administration of the program. The CBGHR at UNCG is responsible for assessing community and professional attitudes about genomic medicine through focus groups and surveys, developing and distributing professional and patient education information, and providing genetic counseling services to participating practices. As this infrastructure is put in place and clinical operations begin, the addition of other genetically based risks for neurological disorders, cardiovascular disease risk, and adverse drug/medication responses will be added.
