In a recent conversation with ACCC, Kevan Simms, MBA, PMP, Assistant Vice President of Precision Medicine at Ochsner Health, shared how his organization is building a scalable stewardship model that not only improves current oncology care but also prepares for the future.
As precision medicine continues to transform oncology, health systems face a growing challenge: how to translate rapid scientific advances into consistent, coordinated care. From genomic testing and targeted therapies to germline and pharmacogenomics and genetic/cellular therapies, the expanding landscape offers new opportunities—but also introduces variability, operational strain, and gaps in access.
Leading organizations are addressing this complexity through precision medicine stewardship, a structured, system-level approach that standardizes genomic testing, integrates workflows, and helps ensure patients receive the right intervention at the right time.
In a recent conversation with ACCC, Kevan Simms, MBA, PMP, Assistant Vice President of Precision Medicine at Ochsner Health, shared how his organization is building a scalable stewardship model that not only improves current oncology care but also prepares for the future.
One of the most immediate challenges in precision medicine is the variability across practices. In the absence of standardized processes and clearly defined workflows, testing decisions are often left to individual providers. This lack of consistency can lead to fragmented care, including inconsistencies in what and when tests are ordered and delays in treatment decision-making.
At Ochsner, this process begins with selecting preferred laboratory partners and embedding those choices into their electronic health record (EHR). By standardizing vendors and workflows, the organization reduces variation and makes the “right way” the easiest way for clinicians to practice. This approach supports sustainable and efficient scalability. Instead of managing multiple disconnected workflows creating multiple disconnected processes, teams can focus on optimizing a single, integrated precision medicine pathway.
A key component of stewardship at Ochsner is the creation of a Care Variation Committee that evaluates new tests and determines whether they should be adopted across the system. This governance structure ensures that decisions are evidence-based and aligned with system priorities—while also minimizing confusion among providers.
“If a new genetic test is being requested, it goes through the Care Variation Committee to vet and understand it, allowing greater scrutiny and selection of tests which serve the same function…It has been very beneficial to the system,” Simms explained.
By centralizing decision-making, organizations can reduce unnecessary testing, avoid duplication, and provide clinicians with clear guidance in a rapidly evolving field where many may lack formal genetics training.
Beyond governance, operational execution is where precision medicine stewardship delivers its greatest impact. At Ochsner, significant effort has gone into designing workflows that not only standardize testing but also remove friction from the care process, making it faster, easier, and more consistent for clinicians and patients alike.
A central component of this approach is the implementation of reflex testing protocols, enabled by a dedicated molecular navigation function. Rather than relying on individual providers to initiate testing after a patient’s first oncology visit, Ochsner has shifted this step upstream by embedding decision-making directly into the diagnostic process. This proactive model helps standardize care, reduce delays, and ensure patients are identified for the appropriate testing earlier.
At the point of pathologic diagnosis, pathologists use a standardized testing grid developed collaboratively with oncology teams to guide biomarker and genomic testing decisions. This grid is organized by cancer type and stage and is regularly updated—often quarterly or as new evidence emerges—to reflect evolving clinical guidelines. By clearly defining the appropriate test through these criteria, this reduces variability, supports timeliness, and promotes consistency in practice.
Once a diagnosis is established, the process moves quickly. Serving in a central coordination role, the molecular navigator reviews cases in near real time and initiates the orders in the EHR, within 24 hours. This tightly coordinated process significantly reduces turnaround time compared to traditional models, where testing typically does not begin until after a patient’s oncology consult.
Equally important, the molecular navigator serves as a single point of coordination across pathology, oncology, laboratory partners, and patients. This role ensures continuity, reduces administrative burden on clinicians, and helps patients navigate what can otherwise be a complex and fragmented process.
The result is a workflow that is not only faster, but more reliable and scalable. By embedding precision medicine into standardized, proactive processes, organizations can ensure that testing happens consistently—and that critical molecular insights are available earlier, when they can most meaningfully inform treatment decisions.
Embedding precision medicine into the EHR is another cornerstone of effective stewardship. At Ochsner, discrete genomic data flows directly into clinical systems, enabling decision support and proactive care management.
“We have discrete results that drive clinical decision support…We can alert providers or identify patients that may benefit from an alternate approach, giving them the care needed based on their genetics,” Simms shared.
Without this level of integration, genomic data risks becoming siloed, limiting its clinical utility and making it harder to track outcomes.
Rather than attempting to build internal testing infrastructure, Ochsner has prioritized partnerships with external vendors, a strategy Simms strongly recommends for organizations starting out.
“You shouldn't start with trying to internalize testing…We ended up abandoning it because it was so distracting and didn't allow us to focus on improving clinical outcomes.”
These partnerships not only reduce operational and administrative burden but also expand patient access to genomic testing. Many vendors offer robust financial assistance programs, helping ensure patients receive testing even when coverage is limited.
By leveraging these external partnerships, this model allows stewardship programs to focus on clinical integration, systemwide alignment, and patient access, rather than laboratory economics.
While oncology remains the primary focus, precision medicine stewardship is rapidly expanding into new areas. At Ochsner, programs are extending into:
Simms underscored that stewardship spans the entire cancer journey. This continuity is where stewardship delivers some of its greatest value—ensuring patients are identified early, treated appropriately, and monitored effectively over time.
As precision medicine becomes more deeply embedded in clinical care, organizations that fail to adopt stewardship models risk falling behind.
Simms offers a simple but powerful perspective:
“We like to say that that precision medicine is focused at the moment—but in the near future precision medicine is just going to be medicine. Genetic testing will be more routine, and less scary, allowing for broader adoption across all specialties. Our role is to help to organize, facilitate making the full continuum of ordering, resulting, and providing clinical decision support easier to both patient and provider.”
In other words, the question is no longer whether to invest—but how quickly and how effectively organizations can build the infrastructure to support it.
To support this transition, ACCC will soon release a new Precision Medicine Stewardship Implementation Guide, designed to help health systems move from concept to execution.
The guide will include:
These tools will provide a practical roadmap for organizations at any stage—whether launching a new program or strengthening an existing one.
Precision medicine is transforming oncology—but without coordination, its potential remains fragmented. Precision medicine stewardship offers a path forward that aligns clinical innovation with operational excellence, reduces variability, improves access, and ultimately enhances patient outcomes.
For organizations looking to lead in the next era of cancer care, the message is clear: The future of precision medicine depends on stewardship, and the time to start is now.
Learn more about the Precision Medicine Stewardship program on the ACCC website.
