Informatics for a Precision Learning Healthcare System

Healthcare delivery is increasingly influenced by two emerging concepts: Precision medicine and the learning healthcare system. Geisinger has implemented a large clinical research program that is combining rich, longitudinal electronic health record data with genomic sequence data for the purposes of both discovery and clinical care. The latter requires extensive interaction with clinical and laboratory information systems. Implementation has identified essential elements in the workflow dependent on informatics solutions. While there are some existing systems and emerging standards that can be employed, for the most part implementation has depended on the development of novel solutions, work-arounds, and substantial manual effort. This chapter details the implementation of genomic medicine in an integrated learning healthcare system with a focus on the informatics requirements, challenges, and gaps that impact such an implementation.

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