Designing an interoperable solution to support pharmacogenomic-guided prescribing in primary care: an implementer report.

Study objectives: Describe the implementation of an interoperable solution to support pharmacogenomic-guided prescribing in primary care in the National Health Service, England.

Methods: We used an iterative approach to software development going through clinical workflow mapping, architecture design and development, and pilot-testing.

Results: We configured a commercial health data management platform to store pharmacogenomic results in a structured format and created a knowledge base of pharmacogenomic guidance. This solution was deployed 'as-a-service' using an open application programming interface (API) specification, allowing third parties to receive pharmacogenomic results and guidance by querying the service using a patient identifier and medicine code. This was integrated with existing clinical decision support tools and presented contextual information to prescribers within their native electronic health record (EHR).

Discussion: Pharmacogenomic results and guidance will be used across care settings and have greatest utility at the point of prescribing. This requires a solution, which separates the data from the applications, allowing integration with different EHRs through APIs.

Conclusions: A vendor-agnostic standards-based solution can support the implementation of pharmacogenomic-guided prescribing across primary care.