From AI scribes to genomics: How one GP is driving innovation in primary care
Dr Janice Tan is determined to ensure they are shaped by the people who use them to ensure the best outcomes for primary care providers and their patients.
On 4 September, the Sydney GP will share what genomics looks like from both ends of the postcode divide at the annual Creative Careers in Medicine (CCIM) conference.
Dr Janice Tan stands at the forefront of health innovation in primary care.
Alongside caring for her patients in south-western Sydney, the GP leads clinical innovation at Bupa, where she is overseeing the roll out of AI scribes across Bupa’s primary care health centres.
Janice is also supervising one of Australia’s first digital health and innovation extended skills registrar posts, based at Bupa, providing valuable insights into how AI tools are created, implemented and evaluated.
Janice credits general practice as the reason she has been able to have a diverse career.
“It’s flexible in a way most of medicine isn’t, so you can carve off a day a week to try something and see whether it sticks. That’s how I ended up in health tech at all,” she said.
“The other thing is that the skills carry over much further than people expect. Running a multidisciplinary team around one complicated patient is the same job as building a product: you’ve got clinicians, engineers, lawyers, governance and design people who all see the problem differently, and someone has to get them moving in the same direction.”
Popularity on the rise
Janice said genomics and longevity medicine had become much more accessible in Australia – with implications for both patients and primary care providers.
She added that while this technology provides valuable information for generalists, it doesn’t mean they need to become geneticists.
“What it does mean is knowing when a test is worth doing, what a result means for this particular person, and what happens next,” she said.
“Both sides of the desk walk in better informed than they used to, and the care that comes out of it is more personalised.”
The postcode divide
According to Janice, where a patient lives determines whether genomics is a service or a purchase.
Clinical genetics sits in metropolitan tertiary centres with long public waitlists, and most of what falls outside the Medicare Benefits Schedule – pharmacogenomics, polygenic risk scores, and nearly all of what gets sold as longevity medicine – is paid for out of pocket.
“Where I work in south-western Sydney, that’s often where the conversation ends,” said Janice.
“Family history is harder to take when relatives are overseas or the story got lost somewhere in a migration, and you’re already running late.
“A few suburbs away, people are buying whole-body MRIs and biological age panels.”
Janice said early-career doctors could help bridge the postcode divide by putting their hand up for opportunities, such as genomics education offered by PRECISE through Medcast.
“The other thing costs nothing: take the family history properly – don’t ever skimp on this! It’s still one of the highest-yield genomic tools we have,” she said.
Unlocking genomics’ full potential
In Janice’s view, good implementation is when the technology is just one small part of the project plan.
“The rest is the actual work – who explains the test, what happens when an unexpected result lands at 4pm on a Friday, who gets paid for the follow-up, what you offer the patient who can’t fund any of it,” she said.
Janice believes the key to unlocking the full potential of genomics is building workforce capability in the primary care sector.
“Genomics education needs to live inside vocational training and mainstream CPD, not as an optional webinar attended by the GPs who were already interested,” she said.
“Capability is what stops this becoming a service that only reaches the people who went looking for it.”
