In this episode of The Promise of Personalized Medicine, Perry sits down Eugean Jimanwall, Senior Research Analyst for Medical Policy & Technology Evaluation at Independence Blue Cross’ Medical & Claim Payment Policy Department within Facilitated Health Networks and Medical Affairs.

He is a seasoned expert with more than 15 years of experience in medical policy and health technology assessment. Together, they unpack the evolving world of personalized and precision medicine—what it really means, why the concept isn’t new, and how modern tools like next-generation sequencing and biomarkers are advancing accuracy in care.

Eugene shares insights about:

• Reviewing evidence for medical policy, highlighting both the opportunities and common challenges companies face when validating new tests 
• The importance of clinical utility data to the role of biomarkers in shaping treatment decisions
• The necessity of aligning evidence generation (validity, utility, etc.) with what payors, policy bodies, or HTA organizations require
• Need for clinically meaningful improvements, not just statistical significance. What matters in practice (improved management, symptom relief, survival, quality of life).
• While personalized medicine is about the individual, policy / reimbursement / HTA often think in terms of subpopulations (e.g. groups with a biomarker) or larger cohorts.

This episode offers a candid, expert perspective on what it takes to move from theory to meaningful outcomes.

—-------

Stay connected with our host, Perry Dimas, here on LinkedIn!
📧 Interested in joining our medical director advisory group? Email us at [email protected]
🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down with Dr. Neetu Sharma to explore the evolving world of precision medicine and how it’s transforming patient care. From the role of genetics and biomarkers in tailoring treatment to the importance of lifestyle, environment, and early intervention, Dr. Sharma offers a holistic view of what personalized medicine truly means.

They discuss real-world applications, including chronic kidney disease, and how genetic testing can guide treatment decisions, improve outcomes, and even reduce healthcare costs. Perry and Dr. Sharma also tackle the challenges facing the field—from data privacy and payer adoption to the tension between clinical guidelines and individualized care—and the critical need for patients to take ownership of their health.

Whether you’re a healthcare professional, patient, or simply curious about the future of medicine, this conversation highlights how precision care goes beyond symptom management, empowering both doctors and patients to act upstream and prevent chronic disease before it starts.

—-------

Stay connected with our host, Perry Dimas, here on LinkedIn!
📧 Interested in joining our medical director advisory group? Email us at [email protected]
🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down with Dr. Ryan Nelson, to explore the evolving and sometimes misunderstood world of personalized medicine. 

With years of hands-on experience, Dr. Nelson offers a refreshingly nuanced definition—one that goes beyond genetics to include biomarkers, digital tools, and system-wide collaboration for predictive, preventative, and precisely tailored care.

We dive deep into:

• the challenges and slow adoption of pharmacogenetics in the U.S.
• the ethical and regulatory friction surrounding genetic testing
• why "genetic exceptionalism" may actually hinder progress
• the FDA’s shifting role to real-world cost savings data

Ryan also shares a behind-the-scenes look at MetaCensus, a new distributed platform designed to foster consensus among stakeholders through open-access, federated data—creating space for payers, providers, pharma, and regulators to weigh evidence transparently.

—-------

Stay connected with our host, Perry Dimas, here on LinkedIn!
📧 Interested in joining our medical director advisory group? Email us at [email protected]
🔗 Connect on LinkedIn: linkedin.com/company/accessdx

In this episode of The Promise of Personalized Medicine, Perry sits down with Jonathan Romanowksy, Co-Founder and Chief Business Officer at Inflammatix, Inc. 

With years of experience in the field, Jonathan shares insights into how personalized medicine is expanding beyond oncology and transplantation into new areas such as infectious diseases, neurology, and immunology.

They dive into the challenges and opportunities of bringing innovative diagnostic tools to market, ensuring clinical adoption, and overcoming payer skepticism. The conversation also touches on the critical role of integrated health delivery systems, group purchasing organizations, and the payer community in facilitating the adoption of novel medical technologies. Jonathan provides thought-provoking insights on the need for a more proactive approach from payers, including the implementation of coverage-with-evidence development programs to evaluate and support new innovations.

Key Topics Discussed:

• Sepsis and Acute Infection Management – The critical need for better diagnostic tools and how TriVerity is making an impact
• Clinical Study Rigor – Why broad, well-designed studies are essential for test adoption and payer reimbursement
• Payer Considerations in Precision Medicine – Balancing innovation with cost-effectiveness and scalability
• Early Adoption of Diagnostic Testing – Challenges and strategies for integrating a newly FDA-cleared test into healthcare systems.
• Impact on Patient Care – How the test can help hospitals decide whether to transfer patients, reducing unnecessary transfers and improving outcomes.
• Value-Based Care and Pricing Models – The potential for pricing medical products based on the value they bring rather than traditional reimbursement structures.
• Future of Healthcare Innovation – The need for better collaboration between payers, providers, and innovators to improve patient care and system efficiency.

Tune in as they discuss the challenges of reimbursement models, the potential for value-based pricing, and how the healthcare system can work towards a future where the right patient receives the right care at the right time.

—-------

Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this episode of The Promise of Personalized Medicine, Perry sits down with Sarah Clancey Overton, Director of Revenue Cycle Management at Velsera.

They discuss how genetic profiling is transforming healthcare—enabling targeted treatments, improving prognostic tools, and even opening doors for disease prevention.

The conversation highlights the critical role of diagnostic testing in precision medicine, the increasing collaboration between pharmaceutical companies and labs, and the challenges in payer coverage that impact patient access.

It examines why not all doctors are ordering comprehensive genetic profiling, how diagnostics and therapies can be better aligned, and what changes are needed to ensure patients receive the right treatment at the right time.

Tune in as they discuss the future of medicine—where data-driven insights and tailored treatments have the power to redefine patient care.

—-------

Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this year-end wrap-up episode of The Promise of Personalized Medicine, host, Perry is the guest this week and he’s joined by his producer, Angela! 

They reflect on the significant shifts and trends that defined 2024 in the healthcare and diagnostics industries. Join as they explore FDA regulatory developments, state-level biomarker laws, and innovations shaping personalized medicine.

The fantastic lineup of guests from the past year are celebrated—Beth Davis, Wren Gregory, Dr. Sandra Milligan, Debs Pipphard, Rennie Quarles, Tom Cronin, Mark Hiatt, Tyler O'Malley, and Dr. Sherie Smalley—whose insights enriched the conversation around precision medicine.

In a fun segment, "How Well Do You Know Your Guests?", Perry tests his memory with standout quotes from our guests, sparking discussions about AI advancements, clinical significance, and the evolution of personalized care.

Looking ahead to 2025, the discussion goes towards the industry's trajectory, breakthrough innovations, and the potential impact of policy disruptions on healthcare delivery. Tune in for an engaging and insightful recap of the year that was and a glimpse into what lies ahead.

—----

Stay connected with our host, Perry Dimas, here on LinkedIn! 

In this episode of The Promise of Personalized Medicine, Perry sits down with Dr. Sherie Smalley to explore the nuanced challenges and opportunities in today’s healthcare landscape. Dr. Smalley shares her unique perspective as a physician and medical director, shedding light on the complexities of aligning patient care, financial responsibility, and clinical decision-making.

The conversation dives into the misalignment of incentives within the healthcare system, the critical need for cost transparency, and the importance of equipping both providers and patients with the tools and knowledge to make informed decisions. 

The conversation also dives into:

• why value-based arrangements could be a game changer, fostering collaboration, data sharing, and trust among stakeholders while improving patient outcomes.
• the evolving role of laboratory medicine in supporting clinical decisions
• the potential of genetic testing to revolutionize care
• the systemic fragmentation that often hinders progress. 

This episode is a thought-provoking look at how healthcare professionals, payers, and patients can work together to address systemic challenges and pave the way for better care. 

—---------

Dr. Sherie Smalley is a healthcare consultant and principal at New Dawn Health LLC. Her background experience as a physician executive with 30 years of healthcare experience includes serving as Chief Medical Officer and Senior Medical Director for Medical Policy for health plans providing government and commercial coverage. Her passion is improving health outcomes by promoting patient-centered, high-quality, personalized healthcare. Dr. Smalley also held a volunteer faculty appointment at the University of Hawaii School of Medicine where she taught problem-based learning. Prior to her health plan experience, Dr. Smalley held a role in the California Department of Public Health and practiced anatomic and clinical pathology in Northern California.

Dr. Smalley holds a bachelor’s degree in psychology with a double minor in biology and chemistry from Sonoma State University. She received her medical degree from the University of California, Davis, and completed her residency at Kaiser Permanente’s San Francisco Medical Center. Dr. Smalley is board certified in anatomic and clinical pathology.

Sherie has three children and four grandchildren. She is an avid gardener and enjoys growing orchids.  She has been a member of the Susquehanna Orchid Society and the Honolulu Orchid Society, and currently has almost 100 orchids under her care.

—----

Stay connected with our host, Perry Dimas, here on LinkedIn! 

Today we sit with Tyler O’Malley, an expert in the evolving fields of personalized and precision medicine, to explore how advancements in diagnostics are transforming patient care. Tyler shares his vision for healthcare that shifts away from broad-based disease management toward more individualized treatment, especially in challenging fields like autoimmune diseases. He discusses the role of artificial intelligence in leveraging vast data for actionable insights, which enable doctors to take a proactive approach rather than a reactionary one.

We dive into the current limitations in autoimmune disease management, using lupus as a case study, where outdated diagnostic tools still dominate. Tyler explains the need for more precise diagnostic testing and the challenges of working within a constrained healthcare system with limited specialist availability. We also tackle the complexities of navigating payer dynamics, where reimbursement policies often lag behind clinical innovations.

Finally, Tyler discusses essential strategies for diagnostics companies, emphasizing the importance of early integration of reimbursement planning, setting realistic investor expectations, and fostering strong relationships with payers and physicians alike.

If you’re interested in how the healthcare industry is working to deliver better outcomes through innovation, this episode is for you!

—----

Stay connected with our host, Perry Dimas, here on LinkedIn! 

Imagine going to the doctor and knowing your treatment is designed just for you—tailored to your unique biology, lifestyle, and even your genetic code. That’s the promise of personalized medicine. But with all the advancements in precision healthcare, are we truly getting more personalized care, or are we just layering new technologies onto old practices? Today, we're diving deep into this tension between cutting-edge innovation and traditional healthcare, exploring what it really means to treat the individual patient in this modern medical world.

Today’s guest is Dr. Mark Hiatt, a seasoned radiologist. Rooted in the timeless principles of the Hippocratic Oath, Dr. Mark shares his insights on delivering individualized patient care amidst the advancements in genomic medicine and precision diagnostics. He discusses historical influences like the Flexner Report, and examines how modern healthcare can move beyond reactive, highly specialized care to embrace a more preventive and personalized approach.

Other topics discussed:

• the challenges posed by health plans, including the frustrations of prior authorizations and the tension between cost management and patient-centered outcomes
• innovative solutions such as shifting to an educational approach in prior authorizations and aligning incentives through value-based care models
• broader issues like the role of employers in health insurance, the financial burdens of medical costs on individuals, and the urgent need for a healthcare system that empowers patients to take control of their own health journeys

—----

Stay connected with our host, Perry Dimas, here on LinkedIn! 

The fight for reimbursement often feels like navigating a maze. From lengthy appeals to prior authorizations, labs and healthcare providers must balance innovation with complex payer policies. But what if this process could be less adversarial, more collaborative, and streamlined with the help of cutting-edge technology?

Our guest today is Tom Cronin, Senior Vice President, Revenue Cycle Strategy & Analytics at Quadax. Quadax is the leading and trusted healthcare partner delivering revenue cycle optimization solutions driven by the needs of our clients, powered by business analytics, and supported by superior service to improve reimbursement of care.

Tom acknowledges that while appeals can be a necessary tactic to challenge denied coverage, they are costly and time-consuming. He contrasts older adversarial approaches with today’s more collaborative methods, where payers increasingly appreciate the economic value of tests in the long-term healthcare of patients. He explains how medical policies and prior authorizations play a critical role in determining coverage, while also discussing the evolving trend of health plans requesting medical records electronically to streamline the process.

The conversation also covers technological advancements that could alleviate administrative burdens, such as AI and natural language processing to assist in reviewing medical records. While these technologies are promising, both share that health plans and labs still need human oversight in making final coverage decisions.

—----

For more information about Quadax, please visit https://www.quadax.com/

Stay connected with our host, Perry Dimas, here on LinkedIn!