Genomic Information for Clinicians in the Electronic Health Record: Lessons Learned From the Clinical Genome Resource Project and the Electronic Medical Records and Genomics Network

Marc S Williams; Casey Overby Taylor; Nephi A Walton; Scott R Goehringer; Samuel Aronson; Robert R Freimuth; Luke V Rasmussen; Eric S Hall; Cynthia A Prows; Wendy K Chung; Alexander Fedotov; Jordan Nestor; Chunhua Weng; Robb K Rowley; Georgia L Wiesner; Gail P Jarvik; Guilherme Del Fiol

doi:10.3389/fgene.2019.01059

Genomic Information for Clinicians in the Electronic Health Record: Lessons Learned From the Clinical Genome Resource Project and the Electronic Medical Records and Genomics Network

Front Genet. 2019 Oct 29:10:1059. doi: 10.3389/fgene.2019.01059. eCollection 2019.

Authors

Marc S Williams¹, Casey Overby Taylor^{1

2}, Nephi A Walton¹, Scott R Goehringer¹, Samuel Aronson³, Robert R Freimuth⁴, Luke V Rasmussen⁵, Eric S Hall⁶, Cynthia A Prows⁷, Wendy K Chung⁸, Alexander Fedotov⁹, Jordan Nestor¹⁰, Chunhua Weng¹¹, Robb K Rowley¹², Georgia L Wiesner¹³, Gail P Jarvik¹⁴, Guilherme Del Fiol¹⁵

Affiliations

¹ Genomic Medicine Institute, Geisinger, Danville, PA, United States.
² Department of Medicine, Johns Hopkins University, Baltimore, MD, United States.
³ Partners HealthCare, Boston, MA, United States.
⁴ Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States.
⁵ Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
⁶ Department of Pediatrics, University of Cincinnati College of Medicine, and Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
⁷ Divisions of Human Genetics and Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
⁸ Departments of Pediatrics and Medicine, Columbia University, New York, NY, United States.
⁹ Irving Institute for Clinical and Translational Research, Columbia University, New York, NY, United States.
¹⁰ Department of Medicine, Division of Nephrology, Columbia University, New York, NY, United States.
¹¹ Department of Biomedical Informatics, Columbia University, New York, NY, United States.
¹² National Human Genome Research Institute, Bethesda, MD, United States.
¹³ Division of Genetic Medicine, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.
¹⁴ Departments of Medicine (Medical Genetics) and Genome Sciences, University of Washington, Seattle, WA, United States.
¹⁵ Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States.

Abstract

Genomic knowledge is being translated into clinical care. To fully realize the value, it is critical to place credible information in the hands of clinicians in time to support clinical decision making. The electronic health record is an essential component of clinician workflow. Utilizing the electronic health record to present information to support the use of genomic medicine in clinical care to improve outcomes represents a tremendous opportunity. However, there are numerous barriers that prevent the effective use of the electronic health record for this purpose. The electronic health record working groups of the Electronic Medical Records and Genomics (eMERGE) Network and the Clinical Genome Resource (ClinGen) project, along with other groups, have been defining these barriers, to allow the development of solutions that can be tested using implementation pilots. In this paper, we present "lessons learned" from these efforts to inform future efforts leading to the development of effective and sustainable solutions that will support the realization of genomic medicine.

Keywords: clinical decision support; education; electronic health record; genomics; implementation; infobutton; interoperability; knowledge synthesis.

Abstract

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