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Technical, Biological, and Systems Barriers for Molecular Clinical Decision Support
Niklas Krumm1, Brian H Shirts1
1Department of Laboratory Medicine, University of Washington, Box 357110, 1959 Northeast Pacific Street, NW120, Seattle, WA 98195-7110, USA.
Clinics in Laboratory Medicine
|May 1, 2019
Summary
Molecular clinical decision support (CDS) systems offer genomic data advantages but face technical, biological, and systemic hurdles. A hybrid system combining genomics consultants with active CDS may offer a practical solution.
Area of Science:
- Genomic Medicine
- Clinical Informatics
Background:
- Molecular clinical decision support (CDS) systems leverage genomic data for enhanced patient care.
- Implementation challenges include technical, biological, and systemic barriers, hindering widespread adoption.
Purpose of the Study:
- To review technical advancements in genomic CDS over the past decade.
- To identify and assess the impact of underestimated biological and systemic barriers to molecular CDS adoption.
- To propose potential solutions for integrating genomic data into clinical workflows.
Main Methods:
- Literature review of technical progress in genomic CDS.
- Analysis of biological limitations inherent in genomic data interpretation.
- Examination of systemic factors affecting the integration of molecular CDS into healthcare.
- Evaluation of a hybrid consultative CDS model.
Main Results:
- Significant technical progress has been made in genomic CDS systems.
- Biological limitations of genomics and systemic adoption barriers are substantial and often underestimated.
- Current CDS systems face challenges in fully utilizing complex genomic information.
Conclusions:
- While technical aspects of genomic CDS have advanced, biological and systemic issues remain significant obstacles.
- A hybrid consultative CDS model, incorporating genomics expertise, presents a viable interim strategy.
- Further research and development are needed to overcome barriers and optimize molecular CDS.
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