Genetics Aware Clinical Decision Support

Abstract More extensive electronic clinical decision support (CDS) will be required to support the adoption of genetic information in healthcare. This support is needed to help clinicians track and interpret genetic results that may remain relevant throughout a patient’s lifetime, apply evolving genetic knowledge, obtain just-in-time reference information on demand, effectively use pharmacogenomics to guide drug ordering and generally manage the increasing amounts information these tests are generating. Passive, active, and asynchronous CDS strategies are required to achieve these objectives. Multiple challenges must be overcome to improve genetic CDS. Genetic results must be transferred to electronic health records (EHRs) in a format that can be used by CDS, rules and displays must be developed, and the clinician workflow must be carefully considered as support is introduced (Table 14.1). Progress will depend on cross-industry collaborations surrounding standards and best practices, the augmentation of the EHR using infobuttons and pretest, posttest, and knowledge alerts.