When technology outpaces policy – Hayley Robinson
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Molecular diagnostics are already having a big impact on healthcare, but advances in the laboratory often outstrip the slower pace of policy development leaving healthcare institutions unable to recoup the costs of genetic testing. This is just one of the many challenges facing Hayley Robinson of Massachusetts General Hospital as part of her work at the Center for Integrated Diagnostics.
What are you working on right now?
I am a clinical laboratory supervisor at the Center for Integrated Diagnostics (CID) at Massachusetts General Hospital in Boston. Our laboratory provides clinical testing to help characterize cancer patients’ tumors; the goal being to detect actionable mutations specifically within the DNA driving the cancer process allowing the patient to seek personalized therapies or access clinical trials. My role is to coordinate the day-to-day workflow, overseeing the technologists responsible for running the testing as well as managing the design and validation of new tests so we can stay at the forefront of our field. Additionally, our lab is one of four sites nationwide participating in the NCI-MATCH, a clinical trial coordinated by the National Cancer Institute. This initiative assigns cancer patients to a personalized treatment based solely on their tumor’s molecular genotype, as opposed to the traditional approach of prescribing drugs solely based on the cancer type or location in the body. It is hoped that there will be improved patient outcomes by selecting drugs based on the specific molecular signature of the disease.
What’s the biggest challenge you face in your work at the moment?
The biggest challenge we currently face is the lack of reimbursement by medical insurance companies. The molecular testing our laboratory provides has outpaced the policies dealing with the alignment of molecular genotyping and clinical utility. While we strive to offer the most comprehensive testing based on cutting-edge discoveries in medical journals, we are increasingly unable to recuperate the costs associated with the testing we provide. Historically, philanthropy was the main mechanism for funding cutting-edge medical science, but this has also become increasingly difficult to attain.
Name one big development that you would like to see in your field over the next 18 months.
I would like to see an increased awareness of clinical laboratory science as a STEM field. Over the past few decades there has been an overall decline in the availability of degree programs, and I feel there would be a higher demand if the field were made more visible to high school and undergraduate students interested in the health sciences.
What are you most proud of in your career?
I am very proud to be a member on the team I currently work with at the MGH. Over the past few years we have worked very hard to develop new genotyping assays across a variety of platforms that allow us to serve our patients in a more comprehensive way. It has been an incredibly rewarding experience to work as a team with people of various backgrounds and expertise; medical pathologists, oncologists, medical technologists, and data scientists. It provides for a very enriching and engaging atmosphere; there is always something new to learn or a different perspective to benefit from.
Which scientists, living, dead, or fictional, would you invite to dinner, and why?
I would love to have a conversation with Rosalind Franklin, Ludwik Fleck and Rudolf Weigl. These individuals made such important contributions to their fields despite facing oppression in various ways. It would be incredible to hear in their own words how they overcame societal and political pressures, while maintaining a focus on their scientific goals and being compassionate human beings in difficult circumstances. And as an avid X-Files fan I would also need to invite Dana Scully for good measure.
What advice do you wish someone had given you at the start of your career?
It’s never too early to seek out a mentor. It can be daunting at various stages of your career in terms of gauging where you are and where you want to go. Connecting with someone who you respect and trust who is a little further along in their career than you can be a great way to explore the path you are on or to explore which path to go down next.
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Why not check out The Short Read archives?
George Church – “Follow your dreams, not the drove”
Amalio Telenti – Defying the “exome-centric” view
Anna Middleton – “It’s ok to be a bit creative and entrepreneurial”
Nan Doyle – “Get clear on what matters to you”
David Smith – The “real keys to scientific success”
Hannes Smárason – The importance of Grit
Eric Topol – “Always question; never accept dogma”
Kristen Sund – “You don’t change culture overnight, it happens in baby steps”
Manuel Corpas – “Don’t rely on the future to make your choices now”
Brendan Gallagher – “Let your work’s ripple effects help sort the future out”
Opinions and views expressed in The Short Read are the interviewee’s and not those of the home institution