Practical applications for genomics-making data available to all providers at the point of care

Healthcare is on the brink of repeating a mistake that has plagued us since the advent of electronic clinical information systems:

Locking new sets of critical patient information into data silos.

The danger lies in how we handle patient-specific genomic data, which promises to revolutionize how healthcare approaches diagnostic testing, disease prevention, and treatment.

The current buzz around precision medicine is more than just noise. The science of genomics is advancing rapidly. Consumers are highly aware and demanding relevant testing. Provider organizations recognize the impact it can have on identifying at-risk patients, keeping them healthier and alive longer, and preventing avoidable treatment errors or adverse effects.

But we can realize the promise of precision medicine only if we ensure that critical information is available across the entire enterprise, in a vocabulary meaningful to providers, integrated with clinical decision-making tools.

As we begin to normalize the role of genomics in patient care, it might be tempting to take a piecemeal approach:

• Implement precision oncology software to identify best protocols or clinical trials for faster therapeutic value.
• Conduct routine germline tests on newborns in the pediatrics department to document variants indicating lifelong risk for specific diseases or conditions.
• Adopt pharmacological testing within the behavioral health service to deliver faster, more comfortable relief.

But this would be shortsighted.

Data resulting from genomic testing most likely impacts care of patients across all areas of practice in your organization. Consider this scenario: A 48-year-old weekend warrior is scheduled for orthopedic surgery. A pharmacogenomic panel is ordered to optimize medications that may be prescribed during surgery and post-operatively. Test results indicated the patient is slow metabolizer of Coumadin and requires a lower dose than typical to avoid complications—which in turn will reduce his length of stay and speed recovery.

Five years later, the patient is seen by a cardiologist for a clotting condition. Without visibility into the patient’s genomic results generated by the orthopedist, the cardiologist may treat the patient inappropriately or trigger an adverse effect.

So how should healthcare organizations ensure they avoid these dangers? Begin with the end in mind. Consider not only the immediate need for a specific precision medicine solution, but look a few years into the future. Select a solution that:

• Can scale across your enterprise, enabling the benefits of precision medicine to be leveraged by all areas of practice no matter what your “starting point” is;
• Consumes data from all molecular labs (in-house or outsourced) and integrates it into any EHR;
• Demonstrates the ability for full clinical integration, so data is rendered meaningful and actionable for improved clinical decision making; and
• Is future-proofed with a robust data model to accommodate new scientific and therapeutic discoveries.

There can be no doubt that the era of precision medicine has arrived. Forward-looking healthcare leaders are laying out their informatics strategy now to ensure that they avoid the pitfalls of creating data silos and can fully leverage the value of genomics.