Clinical implementation of preemptive pharmacogenomics testing for personalized medicine at an academic medical center.

IF 4.7 2区医学 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS

Journal of the American Medical Informatics Association Pub Date : 2024-12-12 DOI:10.1093/jamia/ocae293

Bani Tamraz, Jaekyu Shin, Raman Khanna, Jessica Van Ziffle, Susan Knowles, Susan Stregowski, Eunice Wan, Rajesh Kamath, Christopher Collins, Choeying Phunsur, Benjamin Tsai, Patsy Kong, Clari Calanoc, Aleta Pollard, Rajeev Sawhney, Jennifer Pleiman, Walter Patrick Devine, Rhiannon Croci, Aparna Sashikanth, Lisa Kroon, Russell Cucina, Aleks Rajkovic

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引用次数: 0

Abstract

Objective: This article describes the implementation of preemptive clinical pharmacogenomics (PGx) testing linked to an automated clinical decision support (CDS) system delivering actionable PGx information to clinicians at the point of care at UCSF Health, a large Academic Medical Center.

Methods: A multidisciplinary team developed the strategic vision for the PGx program. Drug-gene interactions of interest were compiled, and actionable alleles identified. A genotyping platform was selected and validated in-house. Following HIPAA protocols, genotype results were electronically transferred and stored in electronic health records (EHRs). CDS was developed and integrated with electronic prescribing.

Results: We developed a customized PGx program for 56 medications and 15 genes. Two hundred thirty-three pharmacogenomic prescribing alerts and 15 pharmacogenomic testing prompts, approved by clinicians, were built into EHR to deliver actionable clinical PGx information to clinicians.

Conclusions: Our multidisciplinary team successfully implemented preemptive PGx testing linked to point-of-care CDS to guide clinicians with precise medication decision-making.

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在某学术医疗中心进行个体化药物抢先性药物基因组学检测的临床实施。

目的：本文描述了先发制人的临床药物基因组学（PGx）测试的实施，该测试与自动临床决策支持（CDS）系统相关联，该系统向UCSF健康中心（一个大型学术医疗中心）的临床医生提供可操作的PGx信息。方法：一个多学科团队制定了PGx计划的战略愿景。编译感兴趣的药物基因相互作用，并确定可操作的等位基因。选择一个基因分型平台并进行内部验证。根据HIPAA协议，基因型结果以电子方式传输并存储在电子健康记录（EHRs）中。CDS被开发出来并与电子处方相结合。结果：我们开发了56种药物和15个基因的定制PGx程序。经临床医生批准的233个药物基因组学处方警报和15个药物基因组学测试提示被纳入电子病历，以便向临床医生提供可操作的临床PGx信息。结论：我们的多学科团队成功实施了与护理点CDS相关的预防性PGx检测，以指导临床医生进行精确的药物决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Medical Informatics Association 医学-计算机：跨学科应用

CiteScore

14.50

自引率

7.80%

发文量

230

审稿时长

3-8 weeks

期刊介绍： JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.