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Published on: December 9, 2015
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Implementation of Integrated Clinical Pharmacogenomics Testing at an Academic Medical Center
Claire E Knezevic1, James M Stevenson2,3, Jonathan Merran2
1Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
The Journal of Applied Laboratory Medicine
|December 10, 2024
Summary
Implementing an in-house pharmacogenomics pipeline improved clinical care by reducing turnaround times and integrating results into electronic health records for better decision support.
Area of Science:
- Clinical Genomics
- Pharmacogenomics Implementation
- Health Informatics
Background:
- Pharmacogenomics offers benefits like reduced adverse events and cost savings.
- Key barriers to pharmacogenomics implementation include long turnaround times and EHR integration challenges.
- A novel clinical workflow was developed to streamline in-house pharmacogenomics testing and EHR incorporation.
Purpose of the Study:
- To develop and implement an efficient pharmacogenomics testing pipeline.
- To integrate pharmacogenomics results into the electronic health record (EHR) with clinical decision support.
- To evaluate the impact of the implemented workflow on turnaround times and clinical utility.
Main Methods:
- Developed and validated an 11-gene actionable pharmacogenomics panel using QuantStudio 12K Flex.
- Integrated allelic results, diplotypes, and metabolic phenotypes into the EHR via a custom driver and rules engine.
- Incorporated an electronic consultation (eConsult) service and monitored actionable result frequency and turnaround times.
Main Results:
- The panel covered 39 alleles across 11 genes, providing diplotypes and metabolic phenotypes.
- Clinician-facing phenotype summaries (Genomic Indicators) were presented in the EHR.
- Mean turnaround time was 4.6 days; 22.1% of tests had actionable pharmacogenes, with 67% involving eConsults.
Conclusions:
- Successfully operationalized an in-house pharmacogenomics pipeline at an academic medical center.
- Direct EHR integration of pharmacogenomics results enhanced clinical decision support.
- The workflow facilitated the use of pharmacogenomics testing across multiple clinical areas.
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