Skip to main content
Erschienen in: Journal of Medical Systems 2/2017

01.02.2017 | Systems-Level Quality Improvement

Incorporating Pharmacogenomics into Health Information Technology, Electronic Health Record and Decision Support System: An Overview

verfasst von: Abdullah Alanazi

Erschienen in: Journal of Medical Systems | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

As the adoption of information technology in healthcare is rising, the potentiality of moving Pharmacogenomics from benchside to bedside is aggravated. This paper reviews the current status of Pharmacogenomics (PGx) information and the attempts for incorporating them into the Electronic Health Record (EHR) system through Decision Support Systems (DSSs). Rigorous review strategies of PGx information and providing context-relevant recommendations in form of action plan- dose adjustment, lab tests rather than just information- would be ideal for making clinical recommendations out of PGx information. Lastly, realistic projections of what pharmacogenomics can provide is another important aspect in incorporating Pharmacogenomics into health information technology.
Literatur
1.
Zurück zum Zitat Wilkinson, G. R., Drug metabolism and variability among patients in drug response. N. Engl. J. Med. 352(21):2211–2221, 2005.CrossRefPubMed Wilkinson, G. R., Drug metabolism and variability among patients in drug response. N. Engl. J. Med. 352(21):2211–2221, 2005.CrossRefPubMed
2.
Zurück zum Zitat Roden, D. M., and George, A. L., Jr., The genetic basis of variability in drug responses. Nat. Rev. Drug Discov. 1(1):37–44, 2002.CrossRefPubMed Roden, D. M., and George, A. L., Jr., The genetic basis of variability in drug responses. Nat. Rev. Drug Discov. 1(1):37–44, 2002.CrossRefPubMed
3.
Zurück zum Zitat Exner, D. V., Dries, D. L., Domanski, M. J., and Cohn, J. N., Lesser response to angiotensin-converting–enzyme inhibitor therapy in black as compared with white patients with left ventricular dysfunction. N. Engl. J. Med. 344(18):1351–1357, 2001.CrossRefPubMed Exner, D. V., Dries, D. L., Domanski, M. J., and Cohn, J. N., Lesser response to angiotensin-converting–enzyme inhibitor therapy in black as compared with white patients with left ventricular dysfunction. N. Engl. J. Med. 344(18):1351–1357, 2001.CrossRefPubMed
4.
Zurück zum Zitat Taylor, A. L., Ziesche, S., Yancy, C., Carson, P., D’Agostino, R., Jr., Ferdinand, K., Worcel, M., et al., Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N. Engl. J. Med. 351(20):2049–2057, 2004.CrossRefPubMed Taylor, A. L., Ziesche, S., Yancy, C., Carson, P., D’Agostino, R., Jr., Ferdinand, K., Worcel, M., et al., Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N. Engl. J. Med. 351(20):2049–2057, 2004.CrossRefPubMed
5.
Zurück zum Zitat Ma, Q., and Lu, A. Y. H., Pharmacogenetics, pharmacogenomics, and individualized medicine. Pharmacol. Rev. 63(2):437–459, 2011.CrossRefPubMed Ma, Q., and Lu, A. Y. H., Pharmacogenetics, pharmacogenomics, and individualized medicine. Pharmacol. Rev. 63(2):437–459, 2011.CrossRefPubMed
8.
Zurück zum Zitat Ma, J. D., Lee, K. C., and Kuo, G. M., Clinical application of pharmacogenomics. J. Pharm. Pract. 25(4):417–427, 2012.CrossRefPubMed Ma, J. D., Lee, K. C., and Kuo, G. M., Clinical application of pharmacogenomics. J. Pharm. Pract. 25(4):417–427, 2012.CrossRefPubMed
9.
Zurück zum Zitat Shi, M. M., Bleavins, M. R., and Felix, A., Pharmacogenetic application in drug development and clinical trials. Drug Metab. Dispos. 29(4):591–595, 2001.PubMed Shi, M. M., Bleavins, M. R., and Felix, A., Pharmacogenetic application in drug development and clinical trials. Drug Metab. Dispos. 29(4):591–595, 2001.PubMed
10.
Zurück zum Zitat Roper, N., Storer, B., Bona, R., and Fang, M., Validation and comparison of pharmacogenetics-based warfarin dosing algorithms for application of pharmacogenetic testing. J. Mol. Diagn. 12(3):283–291, 2010.CrossRefPubMedPubMedCentral Roper, N., Storer, B., Bona, R., and Fang, M., Validation and comparison of pharmacogenetics-based warfarin dosing algorithms for application of pharmacogenetic testing. J. Mol. Diagn. 12(3):283–291, 2010.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Wang, M., Lang, X., Cui, S., Fei, K., Zou, L., Cao, J., Wang, Y., et al., Clinical application of pharmacogenetic-based warfarin-dosing algorithm in patients of Han nationality after rheumatic valve replacement: A randomized and controlled trial. Int. J. Med. Sci. 9(6):472, 2012.CrossRefPubMedPubMedCentral Wang, M., Lang, X., Cui, S., Fei, K., Zou, L., Cao, J., Wang, Y., et al., Clinical application of pharmacogenetic-based warfarin-dosing algorithm in patients of Han nationality after rheumatic valve replacement: A randomized and controlled trial. Int. J. Med. Sci. 9(6):472, 2012.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Feldman, E. A., The Genetic Information Nondiscrimination Act (GINA): Public policy and medical practice in the age of personalized medicine. J. Gen. Intern. Med. 27(6):743–746, 2012.CrossRefPubMedPubMedCentral Feldman, E. A., The Genetic Information Nondiscrimination Act (GINA): Public policy and medical practice in the age of personalized medicine. J. Gen. Intern. Med. 27(6):743–746, 2012.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Whirl-Carrillo, M., McDonagh, E. M., Hebert, J. M., Gong, L., Sangkuhl, K., Thorn, C. F., Klein, T. E., et al., Pharmacogenomics knowledge for personalized medicine. Clin. Pharmacol. Ther. 92(4):414, 2012.CrossRefPubMedPubMedCentral Whirl-Carrillo, M., McDonagh, E. M., Hebert, J. M., Gong, L., Sangkuhl, K., Thorn, C. F., Klein, T. E., et al., Pharmacogenomics knowledge for personalized medicine. Clin. Pharmacol. Ther. 92(4):414, 2012.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Hernandez-Boussard, T., Whirl-Carrillo, M., Hebert, J. M., Gong, L., Owen, R., Gong, M., … and Woon, M., The pharmacogenetics and pharmacogenomics knowledge base: accentuating the knowledge. Nucleic Acids Res. 36(suppl 1)D913–D918, 2008. Hernandez-Boussard, T., Whirl-Carrillo, M., Hebert, J. M., Gong, L., Owen, R., Gong, M., … and Woon, M., The pharmacogenetics and pharmacogenomics knowledge base: accentuating the knowledge. Nucleic Acids Res. 36(suppl 1)D913–D918, 2008.
15.
Zurück zum Zitat O’Donnell, P. H., Bush, A., Spitz, J., Danahey, K., Saner, D., Das, S., Ratain, M. J., et al., The 1200 patients project: Creating a new medical model system for clinical implementation of pharmacogenomics. Clin. Pharmacol. Ther. 92(4):446–449, 2012.CrossRefPubMedPubMedCentral O’Donnell, P. H., Bush, A., Spitz, J., Danahey, K., Saner, D., Das, S., Ratain, M. J., et al., The 1200 patients project: Creating a new medical model system for clinical implementation of pharmacogenomics. Clin. Pharmacol. Ther. 92(4):446–449, 2012.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Johnson, J. A., Cavallari, L. H., Beitelshees, A. L., Lewis, J. P., Shuldiner, A. R., and Roden, D. M., Pharmacogenomics: Application to the management of cardiovascular disease. Clin. Pharmacol. Ther. 90(4):519–531, 2011.CrossRefPubMedPubMedCentral Johnson, J. A., Cavallari, L. H., Beitelshees, A. L., Lewis, J. P., Shuldiner, A. R., and Roden, D. M., Pharmacogenomics: Application to the management of cardiovascular disease. Clin. Pharmacol. Ther. 90(4):519–531, 2011.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Gottesman, O., Kuivaniemi, H., Tromp, G., Faucett, W. A., Li, R., Manolio, T. A., Brilliant, M., et al., The electronic medical records and genomics (eMERGE) network: Past, present, and future. Gen. Med. 15(10):761–771, 2013. Gottesman, O., Kuivaniemi, H., Tromp, G., Faucett, W. A., Li, R., Manolio, T. A., Brilliant, M., et al., The electronic medical records and genomics (eMERGE) network: Past, present, and future. Gen. Med. 15(10):761–771, 2013.
18.
Zurück zum Zitat Schildcrout, J. S., Denny, J. C., Bowton, E., Gregg, W., Pulley, J. M., Basford, M. A., Ritchie, M. D., et al., Optimizing drug outcomes through pharmacogenetics: A case for preemptive genotyping. Clin. Pharmacol. Ther. 92(2):235–242, 2012.CrossRefPubMedPubMedCentral Schildcrout, J. S., Denny, J. C., Bowton, E., Gregg, W., Pulley, J. M., Basford, M. A., Ritchie, M. D., et al., Optimizing drug outcomes through pharmacogenetics: A case for preemptive genotyping. Clin. Pharmacol. Ther. 92(2):235–242, 2012.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Pulley, J. M., Denny, J. C., Peterson, J. F., Bernard, G. R., Vnencak‐Jones, C. L., Ramirez, A. H., Crawford, D. C., et al., Operational implementation of prospective genotyping for personalized medicine: The design of the Vanderbilt PREDICT project. Clin. Pharmacol. Ther. 92(1):87–95, 2012.CrossRefPubMedPubMedCentral Pulley, J. M., Denny, J. C., Peterson, J. F., Bernard, G. R., Vnencak‐Jones, C. L., Ramirez, A. H., Crawford, D. C., et al., Operational implementation of prospective genotyping for personalized medicine: The design of the Vanderbilt PREDICT project. Clin. Pharmacol. Ther. 92(1):87–95, 2012.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Goldspiel, B. R., Flegel, W. A., DiPatrizio, G., Sissung, T., Adams, S. D., Penzak, S. R., Figg, W. D., et al., Integrating pharmacogenetic information and clinical decision support into the electronic health record. J. Am. Med. Inform. Assoc. 21(3):522–528, 2014.CrossRefPubMed Goldspiel, B. R., Flegel, W. A., DiPatrizio, G., Sissung, T., Adams, S. D., Penzak, S. R., Figg, W. D., et al., Integrating pharmacogenetic information and clinical decision support into the electronic health record. J. Am. Med. Inform. Assoc. 21(3):522–528, 2014.CrossRefPubMed
21.
Zurück zum Zitat Overby, C., Tarczy-Hornoch, P., Hoath, J. I., Kalet, I. J., and Veenstra, D. L., Feasibility of incorporating genomic knowledge into electronic medical records for pharmacogenomic clinical decision support. BMC Bioinf. 11(Suppl 9), 2010. doi:10.1186/1471-2105-11-s9-s10 Overby, C., Tarczy-Hornoch, P., Hoath, J. I., Kalet, I. J., and Veenstra, D. L., Feasibility of incorporating genomic knowledge into electronic medical records for pharmacogenomic clinical decision support. BMC Bioinf. 11(Suppl 9), 2010. doi:10.​1186/​1471-2105-11-s9-s10
22.
Zurück zum Zitat Shabo, A., Meaningful use of pharmacogenomics in health records: Semantics should be made explicit. Pharmacogenomics 11(1):81–87, 2010.CrossRef Shabo, A., Meaningful use of pharmacogenomics in health records: Semantics should be made explicit. Pharmacogenomics 11(1):81–87, 2010.CrossRef
23.
24.
Zurück zum Zitat Peterson, J. F., Bowton, E., Field, J. R., Beller, M., Mitchell, J., Schildcrout, J., Pulley, J. M., et al., Electronic health record design and implementation for pharmacogenomics: A local perspective. Genet. Med. 15(10):833–841, 2013.CrossRefPubMedPubMedCentral Peterson, J. F., Bowton, E., Field, J. R., Beller, M., Mitchell, J., Schildcrout, J., Pulley, J. M., et al., Electronic health record design and implementation for pharmacogenomics: A local perspective. Genet. Med. 15(10):833–841, 2013.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Shirts, B. H., Salama, J. S., Aronson, S. J., Chung, W. K., Gray, S. W., Hindorff, L. A., Van Allen, E. M., et.al., CSER and eMERGE: current and potential state of the display of genetic information in the electronic health record. J. Am. Med. Inform. Assoc. ocv065. Shirts, B. H., Salama, J. S., Aronson, S. J., Chung, W. K., Gray, S. W., Hindorff, L. A., Van Allen, E. M., et.al., CSER and eMERGE: current and potential state of the display of genetic information in the electronic health record. J. Am. Med. Inform. Assoc. ocv065.
26.
Zurück zum Zitat Bell, G. C., Crews, K. R., Wilkinson, M. R., Haidar, C. E., Hicks, J. K., Baker, D. K., … Hoffman, J. M., Development and use of active clinical decision support for preemptive pharmacogenomics. J. Am. Med. Inform. Assoc. 21(E1), 2014. doi:10.1136/amiajnl-2013-001993 Bell, G. C., Crews, K. R., Wilkinson, M. R., Haidar, C. E., Hicks, J. K., Baker, D. K., … Hoffman, J. M., Development and use of active clinical decision support for preemptive pharmacogenomics. J. Am. Med. Inform. Assoc. 21(E1), 2014. doi:10.​1136/​amiajnl-2013-001993
27.
Zurück zum Zitat Sauver, J. L., Bielinski, S. J., Olson, J. E., Bell, E. J., Gree, M. E., Jacobson, D. J., and Vitek, C. R., Integrating pharmacogenomics into clinical practice: Promise vs reality. Am. J. Med. 129(10):193–199, 2016.CrossRef Sauver, J. L., Bielinski, S. J., Olson, J. E., Bell, E. J., Gree, M. E., Jacobson, D. J., and Vitek, C. R., Integrating pharmacogenomics into clinical practice: Promise vs reality. Am. J. Med. 129(10):193–199, 2016.CrossRef
28.
Zurück zum Zitat Masys, D. R., Jarvik, G. P., Abernethy, N. F., Anderson, N. R., Papanicolaou, G. J., Paltoo, D. N., Levy, H. P., et al., Technical desiderata for the integration of genomic data into electronic health records. J. Biomed. Inform. 45(3):419–422, 2012.CrossRefPubMed Masys, D. R., Jarvik, G. P., Abernethy, N. F., Anderson, N. R., Papanicolaou, G. J., Paltoo, D. N., Levy, H. P., et al., Technical desiderata for the integration of genomic data into electronic health records. J. Biomed. Inform. 45(3):419–422, 2012.CrossRefPubMed
29.
Zurück zum Zitat Devine, E. B., Lee, C. J., Overby, C. L., Abernethy, N., McCune, J., Smith, J. W., and Tarczy-Hornoch, P., Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: A mixed methods approach. Int. J. Med. Inform. 83(7):473–483, 2014.CrossRefPubMedPubMedCentral Devine, E. B., Lee, C. J., Overby, C. L., Abernethy, N., McCune, J., Smith, J. W., and Tarczy-Hornoch, P., Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: A mixed methods approach. Int. J. Med. Inform. 83(7):473–483, 2014.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Peterson, J. F., Field, J. R., Shi, Y., Schildcrout, J. S., Denny, J. C., Mcgregor, T. L., Clayton, E. W., et al., Attitudes of clinicians following large-scale pharmacogenomics implementation. Pharm. J. 16(4):393–398, 2015. Peterson, J. F., Field, J. R., Shi, Y., Schildcrout, J. S., Denny, J. C., Mcgregor, T. L., Clayton, E. W., et al., Attitudes of clinicians following large-scale pharmacogenomics implementation. Pharm. J. 16(4):393–398, 2015.
31.
Zurück zum Zitat Ury, A. G., Storing and interpreting genomic information in widely deployed electronic health record systems. Genet. Med. 15(10):779–785, 2013.CrossRefPubMed Ury, A. G., Storing and interpreting genomic information in widely deployed electronic health record systems. Genet. Med. 15(10):779–785, 2013.CrossRefPubMed
32.
Zurück zum Zitat Squassina, A., Manchia, M., Manolopoulos, V. G., Artac, M., Lappa-Manakou, C., Karkabouna, S., Patrinos, G. P., et al., Realities and expectations of pharmacogenomics and personalized medicine: Impact of translating genetic knowledge into clinical practice. Pharmacogenomics 11(8):1149–1167, 2010.CrossRefPubMed Squassina, A., Manchia, M., Manolopoulos, V. G., Artac, M., Lappa-Manakou, C., Karkabouna, S., Patrinos, G. P., et al., Realities and expectations of pharmacogenomics and personalized medicine: Impact of translating genetic knowledge into clinical practice. Pharmacogenomics 11(8):1149–1167, 2010.CrossRefPubMed
Metadaten
Titel
Incorporating Pharmacogenomics into Health Information Technology, Electronic Health Record and Decision Support System: An Overview
verfasst von
Abdullah Alanazi
Publikationsdatum
01.02.2017
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 2/2017
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-016-0673-4

Weitere Artikel der Ausgabe 2/2017

Journal of Medical Systems 2/2017 Zur Ausgabe