The Technical and Ethical Complexities of Genomic EHR Integration

Molecular genetics technology has rapidly advanced over the last decade, with significant acceleration as a result of SARS-CoV2. Improved testing platforms, lowered costs and a wider range of options available for patients have outpaced the ability of electronic health records to store and make use of genetic data. This session discusses the complexities surrounding the life cycle of genomic information from the time of reporting to its incorporation into the EHR, to longer-term storage and access control.

Learning objectives

• Identify the technical challenges associated with accurately incorporating genetic results into the EHR for medical decision making.
• Identify the confounders to that integration.
• Describe ethical “best practices” for genomic data use in an EHR (especially for vulnerable populations).
• Consider the potential legal implications of genomic data storage in the EHR and issues around access, information sharing and non-discrimination.

The understanding of how a patient’s unique genetic makeup affects their health has been a rapidly evolving area of medicine since the human genome was fully mapped in 2001, further accelerated with the onset of SARS-CoV2. Recent events, the discovery of CRISPR and precision gene editing technology, the explosion of consumer genetic testing, and the rapid development of mRNA-based vaccines are all signs that we are on the precipice of a revolution in medicine. This revolution will dramatically expand from the specialties currently using genomics (e.g., oncology, immunology, neurology, maternal and fetal medicine, etc.) to include every specialty and area of medicine, including primary care and internal medicine. However, many physicians aren’t practically equipped with the tools or knowledge needed to navigate genomic information; specifically, to order, result and interpret genetic tests, and provide their patients with clear guidance.

Speaker

• Dr. Marsha Fearing

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