Learn how AdventHealth's GRACE program combines genomics, Risk Pathways™, and Volpara® Scorecard™ to bring personalized cancer risk assessment into routine care, helping identify patients who may benefit from more tailored screening, prevention, and follow-up pathways.
The following article was originally published by Healthcare IT News on June 16, 2026, and written by Bill Siwicki, Managing Editor. It is shared here for informational purposes; Lunit is not the author. This article reflects the experience and opinion of the clinician and may not be representative of all users. The manufacturer has not independently verified the efficiency results described.
The health system's GRACE program combines genomics, imaging data and clinical workflows to make personalized risk assessment part of everyday practice.
For decades, cancer screening has been guided largely by age-based recommendations and broad population guidelines. Those approaches remain foundational to preventive care, but advances in genomics, artificial intelligence and precision medicine are creating opportunities for health systems to better understand which patients may face elevated risk long before disease is detected.
At the same time, clinicians are confronting a troubling reality. Adults are developing certain cancers at younger ages than in previous generations, increasing interest in more personalized approaches to screening, surveillance and prevention. The challenge is not simply identifying risk. It is integrating that information into routine clinical workflows in a way that helps care teams take meaningful action.
For AdventHealth, those trends prompted a fundamental rethink of where cancer risk assessment should occur.
Rather than treating risk assessment as a specialty function centered primarily within radiology departments, the health system launched GRACE, a systemwide initiative designed to bring genomics, advanced diagnostics, imaging insights and clinical decision support into everyday care. GRACE stands for Genomics Risk Assessment for Cancer and Early Detection.
The goal is to identify patients at elevated risk earlier, connect them with evidence-based interventions and make personalized risk assessment available consistently across the organization's 57 hospitals.
Leading the effort is Dr. Wes Walker, vice president of genomics and precision health at AdventHealth, who oversees the integration of genomic medicine and precision health capabilities throughout the health system.
"For many patients, cancer screenings can feel like a one-size-fits-all process, without a clear understanding of their individual risk or what it means for their future – something we were seeing play out across AdventHealth," Walker said.
Health system leaders concluded that traditional screening programs often fail to capture important differences between patients. Family history, genetic predispositions and other clinical factors can significantly influence risk, yet those variables frequently exist in separate systems or are not incorporated consistently into routine screening efforts.
"We realized that applying standardized approaches across broad populations didn't always account for a patient's personal history, family history or unique circumstances," Walker said.
The need for a more individualized approach has become increasingly apparent as clinicians see cancer diagnoses occurring in younger populations.
"Adults in the United States are developing cancer at earlier ages than in the past, and that trend doesn't appear to be slowing – making more personalized, proactive approaches increasingly important for patients and their families," he said.
The challenge extended beyond clinical science. AdventHealth needed a model that could operate reliably across dozens of hospitals and care settings while providing patients with a consistent experience regardless of where they entered the system.
"Consistency was the other challenge," Walker said. "To scale something across 57 hospitals and many different locations, high reliability is a must. Ensuring every patient has access to the same level of insight and care, no matter where they enter the system, is a key part of delivering on that promise."
Rather than creating a standalone precision medicine program, AdventHealth sought to embed risk assessment directly into existing care processes.
"The proposal behind GRACE was to create the most advanced and accurate way to understand risk and connect it directly to routine care – so patients can better understand their risk and what it means for their overall health journey," Walker said.
To accomplish that goal, the organization needed a way to combine genomics, clinical risk factors and imaging insights into a single assessment process.
Risk Pathways from vendor Lunit became a key component of that strategy, enabling the health system to incorporate imaging-based information such as breast density alongside other patient-specific factors. But technology alone was not enough. Success depended on making those insights available where clinicians already work.
"But we also knew that for any tool to drive real adoption across our system, it had to integrate with Epic," Walker said. "Epic is the source of truth. That's where everyone across the care team goes, and if you're asking clinicians to go outside of it, broad adoption becomes very difficult."
Walker said the organization also viewed the initiative as a long-term platform. Clinical guidelines continue to evolve, as do AI-driven tools, requiring ongoing updates and future expansion into additional care settings.
The workflow begins during routine breast imaging visits. Patients answer a brief series of questions that are combined with AI-based breast density analysis generated through Volpara Scorecard. Those inputs are processed through Risk Pathways to create a more comprehensive assessment of individual risk.
Importantly, the information does not remain within radiology.
"That information doesn't stay siloed," Walker said. "It's documented in the radiology report and flows into Epic. By making risk visible and accessible within the existing workflow, care teams can more easily act on it – helping ensure patients receive consistent, coordinated care across settings."
Yet AdventHealth leaders designed GRACE around more than technology.
"Part of helping our patients feel whole is making sure their experience is as stress-free as possible," Walker said. "We needed an approach that not only identified risk earlier but also reflected a more whole-person model of care – making sure there was a real person on the other end to help patients understand what it means for them and guide them through what should happen next."
Patients identified as having elevated risk are enrolled in a navigation pathway that connects them directly with nurse navigators. Depending on their circumstances, patients may be referred for genetic counseling, supplemental imaging such as MRI or ultrasound, or more personalized surveillance plans.
"It's not just a message or alert; it's a real person helping them understand their results and what to do next," Walker said.
AdventHealth says the initiative has transformed risk assessment from an intermittent process into a standard component of care.
Today, 99.5% of eligible patients receive a structured risk assessment through the program. The health system reports a 28% increase in the identification of high-risk patients compared with previous workflows.
The organization also reports that 100% of identified high-risk patients are now contacted by a high-risk nurse navigator, helping ensure elevated risk leads to follow-up action rather than remaining a data point in the medical record.
Walker said the downstream impact is becoming increasingly visible, with some patients moving into appropriate care pathways sooner and, in certain cases, cancers being detected at earlier stages.
For AdventHealth, success is measured not by the volume of data generated but by whether patients receive the care they need sooner.
"That is ultimately what GRACE was designed to do – connecting insight to action in a way that reflects a more whole-person approach to care – and it's where we are seeing it make a meaningful difference for the patients we serve," Walker concluded.
