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5 Representing Genomic Information in the EHR Ecosystem
Pages 47-52

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From page 47...
... • Four use cases focused on pharmacogenomics will be the initial starting point for implementing the standards framework designed by the action collaborative. The goal of the effort is to pilot a project and demonstrate how genomic information can effectively flow through a health information technology system.
From page 48...
... STANDARDS AND SCALE Today, individual hospitals are using genomics to improve the care of patients, but these individual efforts generally do not scale, said John David Larkin Nolen, a senior director and the general manager of the Laboratory Business Unit for Cerner Corporation. A learning health care system that works on a small scale may not be efficient or effective in a larger facility if the current state of the system is that it cannot handle the rapid growth of genomic knowledge, Nolen said.
From page 49...
... USE CASES The goal of the action collaborative is to "accelerate the rate at which we develop clinical genomic and information technology support and deploy it," said Sandy Aronson, executive director of information technology for Partners HealthCare Personalized Medicine. By continually evaluating the stakeholder groups represented (government agencies, health care providers, laboratories, information system vendors, standards bodies, patient representatives)
From page 50...
... The funding for generating the genetic data and delivering it through an interface that is interoperable generally flows through providers and laboratories. These entities in turn depend on government agencies to establish a reimbursement framework or to pay for generating and Funding/reimbursement environment that makes this possible Data Providers Labs Interoperability and functionality EHR Vendors Proof of what is Cooperation/ possible/helpful Interfaces Government LIS Vendors Agencies Supporting Vendors Input Standards and Ontologies Standards & Ontology Organizations FIGURE 5-1 Interdependencies in the health care system complicate the establishment of inter-institutional project management structures.
From page 51...
... As an example of how the rule would be used in practice, Aronson described the fourth case study, the post-test alert. In this case, a drug has been ordered for a patient on the basis of a genetic test, and the clinical decision support identifies whether that order is inconsistent with a pharmacogenomics result and alerts the clinician if a problem is detected.
From page 52...
... Reference laboratories, academic hospitals, community hospitals, and other institutions have all been eager to participate in the action collaborative regardless of reimbursement by payers because they realize that there is value in the form of cost savings and in providing better care for their patients. As Aronson said, "The goal of this work should be to make the incorporation of these genetic tests easier and more efficient."


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