Integrating Genetic Data into Electronic Health Records: Medical Geneticists' Perspectives

Objectives Genetic disorders are the main causes of many other diseases. Integrating genetic data into Electronic Health Records (EHRs) can facilitate the management of genetic information and care of patients in clinical practices. The aim of this study was to identify the main requirements for integrating genetic data into the EHR system from the medical geneticists' perspectives. Methods The research was completed in 2018 and consisted of two phases. In the first phase, the main requirements for integrating genetic data into the EHR system were identified by reviewing the literature. In the second phase, a 5-point Likert scale questionnaire was developed based on the literature review and the results derived from the first phase. Then, the Delphi method was applied to reach a consensus about the integration requirements. Results The findings of the first phase showed that data elements, including patients' and healthcare providers' personal data, clinical and genetic data, technical infrastructure, security issues and functional requirements, should be taken into account before data integration. In the second phase, a consensus was reached for most of the items (mean ≥3.75). The items with a mean value of less than 2.5 did not achieve a consensus and were removed from the final list. Conclusions The integration of genetic data into the EHRs can provide a ground for increasing accuracy and precision in the diagnosis and treatment of genetic disorders. Such integration requires adequate investments to identify users' requirements as well as technical and non-technical issues.

[1]  Damian Smedley,et al.  The 100 000 Genomes Project: bringing whole genome sequencing to the NHS , 2018, British Medical Journal.

[2]  Jamie R. Robinson,et al.  Defining Phenotypes from Clinical Data to Drive Genomic Research. , 2018, Annual review of biomedical data science.

[3]  J. B. Gregg,et al.  DEPARTMENT OF HEALTH. , 1910, California state journal of medicine.

[4]  Rachel G Liao,et al.  A federated ecosystem for sharing genomic, clinical data , 2016, Science.

[5]  M. Ullman-Cullere,et al.  Emerging landscape of genomics in the electronic health record for personalized medicine , 2011, Human mutation.

[6]  C. Bennis,et al.  Northeastern University , 2011, IEEE Pulse.

[7]  C. Gaff,et al.  Preparing for genomic medicine: a real world demonstration of health system change , 2017, npj Genomic Medicine.

[8]  Han de Vries,et al.  Are electronic health records ready for genomic medicine? , 2009, Genetics in Medicine.

[9]  Faye L. Bowman,et al.  Healthcare System Priorities for Successful Integration of Genomics: An Australian Focus , 2019, Front. Public Health.

[10]  Christopher G Chute,et al.  Practical considerations for implementing genomic information resources , 2016, Applied Clinical Informatics.

[11]  M. Relling,et al.  Merging Electronic Health Record Data and Genomics for Cardiovascular Research: A Science Advisory From the American Heart Association , 2016, Circulation. Cardiovascular genetics.

[12]  Melissa A. Basford,et al.  The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future , 2013, Genetics in Medicine.

[13]  Sharon F Terry,et al.  The global alliance for genomics & health. , 2014, Genetic testing and molecular biomarkers.

[14]  Kipp W. Johnson,et al.  The next generation of precision medicine: observational studies, electronic health records, biobanks and continuous monitoring. , 2018, Human molecular genetics.

[15]  The 100 000 Genomes Project: bringing whole genome sequencing to the NHS , 2018, British Medical Journal.

[16]  Joshua L. Deignan,et al.  A survey of current practices for genomic sequencing test interpretation and reporting processes in US laboratories , 2016, Genetics in Medicine.

[17]  Jeffrey Braithwaite,et al.  Integrating Genomics into Healthcare: A Global Responsibility. , 2019, American journal of human genetics.

[18]  Christopher G. Chute,et al.  CSER and eMERGE: current and potential state of the display of genetic information in the electronic health record , 2015, J. Am. Medical Informatics Assoc..

[19]  M. Levy,et al.  Integrating cancer genomic data into electronic health records , 2016, Genome Medicine.

[20]  Haleh Ayatollahi,et al.  Health Information Security in Hospitals: the Application of Security Safeguards , 2016, Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH.

[21]  Joshua C. Denny,et al.  Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network , 2017, BMC Medical Genomics.

[22]  G. Hek The research process in nursing , 1994 .

[23]  Eneida A. Mendonça,et al.  Genetic data and electronic health records: a discussion of ethical, logistical and technological considerations , 2013, J. Am. Medical Informatics Assoc..

[24]  Ebony B Madden,et al.  Developing a Common Framework for Evaluating the Implementation of Genomic Medicine Interventions in Clinical Care: The IGNITE Network’s Common Measures Working Group , 2017, Genetics in Medicine.