Division of General Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
J Am Med Inform Assoc. 2020 Jan 1;27(1):154-158. doi: 10.1093/jamia/ocz177.
Pharmacogenomics (PGx) clinical decision support integrated into the electronic health record (EHR) has the potential to provide relevant knowledge to clinicians to enable individualized care. However, past experience implementing PGx clinical decision support into multiple EHR platforms has identified important clinical, procedural, and technical challenges. Commercial EHRs have been widely criticized for the lack of readiness to implement precision medicine. Herein, we share our experiences and lessons learned implementing new EHR functionality charting PGx phenotypes in a unique repository, genomic indicators, instead of using the problem or allergy list. The Gen-Ind has additional features including a brief description of the clinical impact, a hyperlink to the original laboratory report, and links to additional educational resources. The automatic generation of genomic indicators from interfaced PGx test results facilitates implementation and long-term maintenance of PGx data in the EHR and can be used as criteria for synchronous and asynchronous CDS.
药物基因组学（PGx）临床决策支持整合到电子健康记录（EHR）中，有可能为临床医生提供相关知识，从而实现个体化护理。然而，过去在将 PGx 临床决策支持整合到多个 EHR 平台方面的经验表明，存在重要的临床、程序和技术挑战。商业 EHR 因缺乏准备实施精准医学而受到广泛批评。在此，我们分享了在独特的存储库中实施新的 EHR 功能图表 PGx 表型的经验和教训，而不是使用问题或过敏列表。Gen-Ind 具有其他功能，包括对临床影响的简要描述、到原始实验室报告的超链接以及到其他教育资源的链接。从接口 PGx 测试结果自动生成基因组指标有助于在 EHR 中实现 PGx 数据的实施和长期维护，并且可以用作同步和异步 CDS 的标准。
