Becker's Hospital Review

70 CIO / HEALTH IT Fairview CEO Bashes Epic, Calls for March on Madison By Julie Spitzer J ames Hereford, the president and CEO of Minneapolis-based Fairview Health Services, called Epic an "impediment to innovation" and told healthcare leaders they should exert more influence over the EHR giant, according to the Minneapolis/St. Paul Business Journal. Epic's headquarters is located about 10 miles outside of Madison, in the nearby city of Ve- rona, Wis. Fairview is a longstanding Epic client, hospital spokeswoman Marie Gentile told Becker's Hospital Review. "I will submit that one of the biggest impedi- ments to innovation in healthcare is Epic, be- cause the way that Epic thinks about their [in- tellectual property] and the IP of others that develop on that platform," Mr. Hereford said at a panel discussion hosted by the Business Journal in early January. "ere are literally billions of dollars in the Silicon Valley chas- ing innovation in healthcare. And yet Epic has architected an organization that has its belief that all good ideas are from Madison, Wisconsin. And on the off chance that one of us think of a good idea, it's still owned by Madison, Wisconsin." Mr. Hereford called on healthcare leaders to play a bigger role with health IT vendors. "ere is an opportunity for us to go to Epic and say, 'Look, you have to open up this plat- form,'" he added. "It's for our benefit in terms of having an innovative platform where all these bright, amazing entrepreneurs can actually have access to what is essentially 80 percent of the U.S. population that is cared for within an Epic environment. I would love for us to get together to see how we march on Madison." Ms. Gentile added that "given Epic's promi- nence as an [EHR] provider, they are unique- ly positioned to support collaboration for innovation in healthcare" but that Fairview welcomes "the opportunity to work with [Epic] for the benefit of our patients." In a statement to the Business Journal and reiterated to Becker's Hospital Review, Epic pointed to its App Orchard as an example of its openness. e App Orchard is an online store that enables soware developers to sell their Epic-compatible apps. "We are proud of our open platform that many health systems and third parties have put to use," Epic spokeswoman Meghan Roh wrote in a statement to the Business Journal. "We are also excited about the hundreds who have joined our developer program, as well as the many whose innovations are now avail- able on the App Orchard." n Gene-Editing Tech CRISPR May Not Work in Humans: 5 Things to Know By Jessica Kim Cohen O ne of the most well-known versions of the gene-ed- iting tool CRISPR may not work in a large propor- tion of the population, according to recent research out of Stanford (Calf.) University. CRISPR, which stands for Clustered Regularly Interspaced Short Palindromic Repeats, is a gene-editing technology that enables scientists to edit an organism's DNA. Many sci- entists consider the CRISPR-Cas9 system — which creates modified RNA segments that bind to the CRISPR-associat- ed protein 9 enzyme — to be one of the most precise and least expensive gene-editing techniques currently in use. However, a research paper released on bioRxiv, an archive of unpublished science papers, raises concerns about a common human immune response that might render CRISPR-based therapies ineffective. Here are five things to know about the research findings. 1. A team of researchers from Stanford University assessed human immune responses to two types of Cas9 proteins used in CRISPR technologies, SaCas9 and SpCas9. They determined 79 percent of donors maintained antibodies against SaCas9 and 65 percent had antibodies against SpCas9, based on blood samples from 22 newborns and 12 adults. The researchers also found T-cells that target Sa- Cas9 in 46 percent of donors. 2. These findings suggest patients with existing immune responses to Cas9 proteins might be immune to CRIS- PR-based therapies. However, Matthew Porteus, MD, PhD, senior author on the research paper, told STAT the findings should not hinder future CRISPR efforts, since much is left to discern regarding a patient's reaction to CRISPR technol- ogies, such as how severe an immune response would be. 3. Dr. Porteus is working to develop a CRISPR-based therapy for sickle cell disease and is one of the scientific founders of Zug, Switzerland-based biotechnology company CRISPR Therapeutics. "Like any new technology, you want to identi- fy potential problems and engineer solutions for them," Dr. Porteus told STAT. "And I think that's where we're at." 4. Samarth Kulkarni, CEO of CRISPR Therapeutics, acknowl- edged the research paper's Jan. 5 release on bioRxiv re- sulted in a drop in the company's stock prices, according to the Boston Globe. However, he brushed aside concerns of CRISPR being ineffective, noting the research paper's findings had been presented at conferences in 2016. He added immune responses to CRISPR technology would likely be limited in regards to patient health. "The data are not new," he told the Boston Globe. "What's new is that someone in the press picked it up and sensa- tionalized it, and all of a sudden everyone else picked it up." 5. Other experts have expressed that the immune re- sponse highlighted in the research paper could be worked around. For example, many clinical trials being discussed involve removing cells from a patient and deploying a CRISPR-based therapy before returning the cells to the participant, according to STAT. In this scenario, there may be too few CRISPR proteins remaining in the patient's cells for their immune system to detect. n

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