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Solutions for Unexpected Challenges Encountered when Integrating Research Genomics Results into the EHR
Luke V Rasmussen1, Christin Hoell2, Maureen E Smith2
1Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States.
ACI Open
|July 9, 2026
Summary
Returning genetic research results via the electronic health record (EHR) presented communication challenges. Future implementations should include preparatory emails with EHR screenshots to improve participant understanding.
Area of Science:
- Genomics
- Bioinformatics
- Health Informatics
Background:
- Published reports often focus on technical challenges of integrating genetic test results into electronic health records (EHRs).
- Less attention has been given to the sociotechnological and communication barriers encountered during this process.
Purpose of the Study:
- To describe unforeseen issues encountered when returning genetic research results through the EHR.
- To share lessons learned from the electronic Medical Records and Genomics (eMERGE) 3 consortium for future genetic result return implementations.
Main Methods:
- Sequenced 3,000 participants using a 109-gene panel.
- Initially returned genetic results in person or by letter.
- Later implemented direct return of results into the EHR and patient portal.
Main Results:
- Returning results via EHR led to participant confusion and system contact.
- This confusion prompted a temporary halt in the return of research results.
- Identified causes included result delivery delays, impersonal email notifications, limited EHR description space, and mandatory ordering physician information.
Conclusions:
- Proposed solutions include preparatory emails with EHR screenshots to manage participant expectations.
- Aimed to guide other institutions implementing similar genetic result return systems.
- Encouraged EHR developers to enhance system flexibility for research result integration.
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