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Disclosures

EHRI Lessons Learned and Future Directions Panel Clinical Decision Support Perspectives Sandy Aronson Partners HealthCare. Disclosures. My employer, Partners HealthCare, receives royalties on the sale of GeneInsight software

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Disclosures

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  1. EHRI Lessons Learned and Future Directions PanelClinical Decision Support PerspectivesSandy AronsonPartners HealthCare

  2. Disclosures • My employer, Partners HealthCare, receives royalties on the sale of GeneInsight software • My group receives funding from Persistent to develop open source SMART on FHIR apps and platform functionality to support this development

  3. Our First Genetics Based Clinical Decision Support Rule

  4. Lesson 1Variant by Variant Coding of Genetic Aware Clinical Decision Support is InfeasibleThe Support Must Be Driven Off of a Knowledge Base

  5. Challenge in Personalized Medicine ConstantFlow of Cases Treating CliniciansConsume Reports Geneticist ConstantlySigns out Cases Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician CaseHistory Leveraged and maintained as each case is signed out Continuously Grows Updating Reports When New Information Emerges on a Variant is Critical … But Unreimbursed Evolving Knowledgebase

  6. Driving Cost Out of Increased Quality Treating ClinicianConsumes Reports GeneInsight Geneticist ConstantlySigns out Cases New Variant Assessments and Knowledge Base Updates Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician Picture of TreatingClinician CaseHistory Reports Continuously Grows Cases / Identified Variants GeneInsight Report Generation Engine Knowledgebase Occurs Automatically on Knowledgebase UpdateNo Case Level Work Required

  7. This screenshot was taken from a demonstration system – the content of this screen should not be used for any clinical purpose

  8. Lesson 2Clinical Decision Support Alters Clinical WorkflowsTight Collaboration Between Clinicians, Laboratorians and IT Professionals is Needed to do this Well

  9. Lesson 3Genetic Aware Clinical Decision Support is Entirely Dependent on Access to Structured Data and Knowledge which is Highly Fractured Across the HealthCare Ecosystem

  10. GeneInsight Generated Reports Structured Patient Variants This screenshot was taken from a demonstration system – the content of this screen should not be used for any clinical purpose Structured Knowledge Knowledge Curated within GeneInsight

  11. GeneInsight Generated Reports Structured Patient Variants Other External Laboratories This screenshot was taken from a demonstration system – the content of this screen should not be used for any clinical purpose Structured Knowledge Knowledge Curated within GeneInsight

  12. GeneInsight Generated Reports Structured Patient Variants Other External Laboratories eMERGE Informed FHIRTransition Standards This screenshot was taken from a demonstration system – the content of this screen should not be used for any clinical purpose Structured Knowledge Knowledge Curated within GeneInsight

  13. Patient Population List of Patients Who May Benefit from IHD Assessment Assistance in Assessing Clinical Risk

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