5 Questions for Dr. Robert C. Green, Brigham and Women’s Hospital and Harvard Medical School

Dr. Robert Green is director of the Genomes2People Research Program, associate director for Research for Partners Personalized Medicine and associate professor of Medicine at Brigham and Women’s Hospital, a Harvard Medical School teaching hospital in Boston, Massachusetts. We recently sat down with him to discuss his research on personal genomics and where that research is headed in the future.

Intel: How has gene sequencing evolved over the last decade?

Green: Genetic sequencing is tremendously exciting and important for the future of medicine. We have all this technology that allows us to sequence, align, and call these variants so much better than we could before. The real question is, how do you integrate that into the practice of medicine? Our research at Brigham and Women’s Hospital is zeroed in on finding out how we can implement genomic information, particularly sequencing, into the practice of medicine for adults or even for newborns.

Intel: Are patients interested in consumer genetic testing? If so, why?

Green: Patients want to know if they are at increased risk for particular diseases. They want to know if there are drugs they should or shouldn’t take. Some of them want to know if they are carrying recessive carrier traits that would put them at risk for having a child with a recessive disease if their partner is also carrying a copy of a mutation. A lot of people are really curious about the diseases they already have.

Our research helps us understand why people want services like consumer genetic testing. In part, it’s perhaps to predict future illness, but it’s also to explain what they already have or what’s running in their family.

Intel: What kind of impact can genomic sequencing have on patients?

Green: Genome sequencing isn’t going to be relevant to everyone’s disease. It isn’t going to be relevant to everyone’s medication. But it is going to be relevant to people with rare diseases and those on some medications. It’s going to be relevant to a lot of people who have cancer. And it’s highly relevant to people who are planning their family and want to do preconception testing to avoid recessive conditions.

When it comes to individuals who are dealing with sepsis or bad infection, we’re going to not only sequence those patients, but also sequence the microbiomes of the bacteria that are infecting them.

One of the directions for sequencing is to have a file or a database of genomic information a patient can call upon to use when they face a situation where they need a new medication, are going to have a family, or have a mysterious illness. That information will be there. It can be brought up in an electronic health record at the point of care in a decision support manner.

Intel: What’s the biggest hurdle right now?

Green: One of the great challenges for the practice of medicine is to keep up with, educate ourselves about, and use research effectively in our practices.

With initiatives to accelerate the implementation of genomics, like the Intel All in One Day goal, it’s going to be important that clinicians and those who are in training—fellows, residents, medical students—become much more familiar with genomics than they are today.

Intel: What’s your vision for the future of genomic research application?

Green: I think five years from now, about 20 percent of the population is going to walk into their doctor’s office with their own genome, and doctors are going to have to decide how they want to use this information. I can envision that about 10 years from now everyone will use their genome as a daily part of their medical care.