Perspectives from various regions on pharmacogenomics EHR development and implementation

Abstract

There are few documented instructions to implementation, yet the design of electronic health records is vital to the effective introduction of 
novel genomic services.
In this study, we followed the four-year development process of a locally produced electronic health record that serves a major 
pharmacogenomics program at a tertiary-level academic medical facility.
Electronic health record (EHR) procedures for ordering a pharmacogenomics panel in anticipation of clinical need (preemptive genotyping) or 
in response to a particular therapeutic indication were developed and implemented by program personnel. As a result, panel-based genotyping 
results were kept separate from the EHR until clinically actionable evidence of drug-gene interactions was found. A
The drug-response phenotype prediction service supplied a summary of drug-gene interactions, prompted inpatient and outpatient clinical 
decision support, updated laboratory records, and produced gene results inside online personal health records.
Conclusion: Generalizability of a locally constructed electronic health record that incorporates pharmacogenomics into its design. Scalability 
of the model to larger collections of genomic data is examined, as is the difficulty of putting genomic data in a way that is both understandable 
and therapeutically useful.