Prepped for Radical Change
Dr. Grace Terrell’s record redesigning health care models landed her in a position to use human genomics to radically transform health care.
When Grace Terrell, M.D., first visited Huntsville’s HudsonAlpha Institute for Biotechnology in 2011, she was instantly sold on its mission and the work being done there. Five years later, when HudsonAlpha Founder Jim Hudson called to ask Terrell to head up Envision Genomics, a HudsonAlpha company, she couldn’t wait to get to Alabama. Terrell took the reins as CEO of Envision Genomics in April 2017 and hasn’t looked back since.
“When I received a call from Jim Hudson asking me to come to Huntsville and be part of a company on the cutting edge of the effort to apply human genomics to radically change clinical health care, I didn’t hesitate,” Terrell says. “Alabama has built upon the infrastructure present here from the aerospace industry to create an entirely new ecosystem of engineers, biotechnologists, software developers and research scientists focused on genomics. The Cummings Research Park is truly a treasure. You can feel the energy in the community of Huntsville. It’s awesome.”
A Lifetime of Preparation
Terrell grew up on a farm in the Piedmont Triad area of North Carolina, near a town called Siler City, “one of the real small towns mentioned on the old Andy Griffith Show from the 1960s,” she says. With a grandfather who was actually the local sheriff, the show rang true to life for her family.
Her Mayberry-like upbringing gave Terrell a firm foundation from which to launch a long career in transformative health care — and the Southern roots to feel at home in Huntsville, where cutting-edge research sometimes happens with a view of cotton fields still thriving outside the windows.
Terrell earned her medical degree at Duke University and completed a residency at North Carolina Baptist Hospital and has been practicing medicine as a general internist for more than 20 years. She also holds a master’s degree in medical management from Carnegie Mellon University.
In 1995, as a North Carolina physician in private practice, Terrell helped found Cornerstone Health Care, a multi-specialty group of 42 physicians. The group was nationally recognized for its work in redesigning care models for patients with complex medical problems such as cancer, congestive heart failure, diabetes, chronic obstructive lung disease and frailty. Terrell served as Cornerstone’s CEO for 16 years while it grew to 275 physicians.
When other physician groups became increasingly interested in making a similar shift toward value-based medicine, the company launched Cornerstone Health Enablement Strategic Solutions (CHESS) in 1995. Terrell also served as CEO for the new company.
“CHESS was focused on integrating these new models of care with payment models and integrated information systems that allowed us to lower the cost of care by 20 percent while greatly improving the outcomes for these complex patients with respect to quality and medical impact,” Terrell says.
In addition to her clinical work, Terrell has been involved with health care information system technology policy at the national level. She serves as one of the commissioners of the Physician Focused Technical Advisory Committee, looking at innovations in care model and payment model design. “What I’ve learned about myself through the years is that I like building companies that do good while doing well,” she says. “I believe there are solutions for many of the problems imbedded in our current dysfunctional health care system that can be built by first focusing on the unmet needs of complex patients and then designing solutions that more effectively meet those needs.”
When she first visited HudsonAlpha in 2011, Terrell was one of eight individuals invited to the campus as part of an Oliver Wyman Health Innovation initiative. The group was focused on mapping out the future of health care over the next 20 years in game-changing ways. The experience impressed her.
“Although my work at the time was focused on redesigning models of care in the more traditional aspects of the health care delivery system, I marveled at the work being done at HudsonAlpha,” Terrell says. “It was focused on applying the technologies of human genomics to radically transform health care from a system focused on reactive medicine to one redesigned around the science of prevention.”
Hudson kept Terrell on his radar, and when Envision Genomics needed a leader, she came to mind. “Dr. Terrell’s experience in improving population health, redesigning patient care models and clinical integration are a great fit for the Envision Genomics model,” says Hudson, who serves as chairman of the board for Envision. “Envision Genomics is dedicated to transforming disease care to true health care through genomics. Dr. Terrell’s expertise will help get us there.”
Founded in 2015, Envision Genomics focuses on whole-genome sequencing in clinical testing for rare diseases, undiagnosed disorders and hereditary cancers, with the goal of reducing multiple point-of-care tests. It is one of about 27 companies associated with HudsonAlpha.
When patients have their genome sequenced in a test as simple as drawing blood, doctors can survey their entire DNA to provide more complete, accurate diagnoses and treatment options. Each genome sequence examines 6 billion base pairs of a person’s genome. Envision aims to help make genome sequencing available to physicians across the country.
“Envision Genomics will deliver solutions for patients who have the most wicked health care problems: those with rare, undiagnosed and misdiagnosed diseases,” Terrell says.
“One in 10 Americans fits in that category, but the current health care delivery system is poorly equipped to meet their needs. Now, with the insights that can be provided from whole genome sequencing technologies, the diagnostic odyssey these patients and their families face can be eliminated and new models of care can be developed to improve their care. Insights from the sequencing technologies will exponentially accelerate therapies for these patients and will ultimately do the same for more common diseases we all face.”
Currently, the Smith Family Clinic for Genomic Medicine, located on the HudsonAlpha campus, sees patients with undiagnosed and misdiagnosed diseases and uses genomic testing for diagnostics. In addition, the Insight Genome project at HudsonAlpha offers genome sequencing for healthy patients who want that information to help them guide healthcare and medication decisions.
Envision works closely with both the Smith Family Clinic and Insight Genome, but the company’s main focus is on scaling the technology used in Huntsville to be used in hospitals across the country. For starters, the company is working to develop partnerships with children’s hospitals across the country to offer genome sequencing for children with rare or undiagnosed conditions. With the capabilities of HudsonAlpha, Envision has the capacity to sequence 15,000 clinical genomes per year.
“What’s happening here in Huntsville is world-class, state-of-the-art work that’s going to change medicine,” Terrell says.
Nancy Mann Jackson and Dennis Keim are freelance contributors to Business Alabama. Both are based in Huntsville.