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Cloud technologies amplify the value of in-workflow access to genetic and genomic data

Attend any (virtual) conference. Scroll through any professional journal. Review content on social media and blogs like this one. Without a doubt, you’ll notice burgeoning interesting in precision medicine.

Rapid growth of genetic testing, molecular profiling and genomic-based treatment has created a very practical challenge for health systems: How to incorporate precision medicine into clinical workflows. Virtually every service line today – pediatrics, maternal fetal medicine, orthopedics, behavioral health, cardiology, oncology and more – seeks access to this valuable genomic information. Allscripts is lowering barriers for clients upgrading to Sunrise™ 21.1.

With this new version, healthcare providers can leverage 2bPrecise™ Foundations via a tab in the Sunrise EHR. 2bPrecise Foundations delivers in-workflow access to a robust family history tool that helps organizations identify patients who might be at elevated risk for heritable conditions such as cancer, cardiovascular disease, fragile X syndrome, familial hypercholesterolemia, cystic fibrosis and more. Beyond the primary benefit of diagnosing and treating patients sooner, identifying these individuals enables healthcare organizations to refer more patients for genetic counseling and testing, implement timely screening and preventative programs, and initiate early interventions as necessary – all of which can drive revenue and provide a competitive advantage within the service area.

2bPrecise Foundations likewise serves as a gateway to pharmacogenomics, which equips providers with information about potential drug–gene interactions that could interfere with the safety and efficacy of prescribed medications. It can give providers a means to reduce, if not eliminate, trial-and-error prescribing so patients have fewer adverse drug reactions and gain therapeutic benefits more quickly.

This functionality reflects more than five years of commitment to synthesizing genetic and clinical information to make it actionable – and represents value far beyond what is available elsewhere in the industry. In addition to bringing genetic/genomic results directly into the EHR workflow as discrete data, 2bPrecise Foundations enables Sunrise users to lay the foundation for accelerated precision medicine success across their enterprise.

Sunrise clients using 2bPrecise Foundations will benefit from power afforded by Microsoft Azure. While point-of-care integration of genetic and genomic insights have gained acceptance, few organizations have thought beyond a short-term (and, some would say, short-sighted) assessment of what IT strategy is best suited for success. They recognize that genetic/genomic information must be incorporated with medical records via their EHR for use in real-time clinical decisions. But they have failed to explore how best to manage this voluminous new data set. Several considerations must be undertaken:

 

  • EHRs excel at presenting a snapshot in time to inform clinical decision-making. Genetic/genomic data, on the other hand, serves as the patient’s lifelong signature. It can – and should – be referenced and interrogated by providers for decades into the future. How will organizations ensure test results, generated years earlier, can be surfaced when and where needed over time?

 

  • Genetic/genomic science is evolving at a dizzying pace. This means the knowledge sources that render these advances actionable – some which reflect regulatory information – must be kept current for clinicians. Clinical and IT leaders must consider how to accommodate that: if it’s possible leveraging only EHR functionality, or if cloud-based infrastructure augmenting point-of-care access is advisable.

 

  • As a corollary, leaders must also consider their medical liability if they fail to remain up to date. In many cases, for instance, genetic/genomic test reports include “variables of unknown significance” or VUS. While the relevance of the mutation may not be understood at the time of testing, scientists may make an important discovery in the future – either imminently or years in the future. Are healthcare organizations exposed to risk if they have not kept abreast about advances that might transform the significance of a variant finding from “unknown” to “known” if it is stored in the patient record?

 

  • Inclusion of genetic/genomic information potentially compounds alert fatigue. Leaders will need to consider how to orchestrate alerts related to evolving precision-medicine knowledge and insights within the context of existing notifications. Healthcare has not solved the long-recognized alert-fatigue issue yet; how will we handle an additional layer, generated from an entirely new set of data?

2bPrecise Foundations delivers the essentials Sunrise users need to propel their precision medicine strategy along an optimal trajectory: full access at the point of care within a robust EHR, supported by a cloud-based infrastructure that supports agility, responsiveness and scalability.

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