A survey of informatics approaches to whole-exome and whole-genome clinical reporting in the electronic health record : Genetics in Medicine : Nature Publishing Group

A survey of informatics approaches to whole-exome and whole-genome clinical reporting in the electronic health record : Genetics in Medicine : Nature Publishing Group

A survey of informatics approaches to whole-exome and whole-genome clinical reporting in the electronic health record

• Peter Tarczy-Hornoch MD,
• Laura Amendola MS,
• Samuel J. Aronson MA, ALM,
• Levi Garraway MD, PhD,
• Stacy Gray MD, AM,
• Robert W. Grundmeier MD,
• Lucia A Hindorff PhD, MPH,
• Gail Jarvik MD, PhD,
• Dean Karavite MS,
• Matthew Lebo PhD,
• Sharon E. Plon MD, PhD,
• Eliezer Van Allen MD,
• Karen E. Weck MD,
• Peter S. White PhD
• & Yaping Yang PhD

• Affiliations
• Corresponding author

Genetics in Medicine

(2013)

doi:10.1038/gim.2013.120

Published online

26 September 2013

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Abstract

• Abstract•
• References•
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Purpose:

Genome-scale clinical sequencing is being adopted more broadly in medical practice. The National Institutes of Health developed the Clinical Sequencing Exploratory Research (CSER) program to guide implementation and dissemination of best practices for the integration of sequencing into clinical care. This study describes and compares the state of the art of incorporating whole-exome and whole-genome sequencing results into the electronic health record, including approaches to decision support across the six current CSER sites.

Methods:

The CSER Medical Record Working Group collaboratively developed and completed an in-depth survey to assess the communication of genome-scale data into the electronic health record. We summarized commonalities and divergent approaches.

Results:

Despite common sequencing platform (Illumina) adoptions, there is a great diversity of approaches to annotation tools and workflow, as well as to report generation. At all sites, reports are human-readable structured documents available as passive decision support in the electronic health record. Active decision support is in early implementation at two sites.

Conclusion:

The parallel efforts across CSER sites in the creation of systems for report generation and integration of reports into the electronic health record, as well as the lack of standardized approaches to interfacing with variant databases to create active clinical decision support, create opportunities for cross-site and vendor collaborations.

Genet Med advance online publication 26 September 2013

Keywords:

clinical decision support; clinical sequencing; decision support rules; electronic health record; electronic medical record; next-generation sequencing