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Genetic Testing in the Cloud

May 31, 2014
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Saint Louis University working with Appistry on work flows around its CloudDx test-ordering system

Earlier this year I wrote one of our Tech Trend articles about the challenges health systems face in incorporating personalized medicine testing and results data in their clinical workflow.

For that article, Brian Wells, associate CIO of health technology and research computing at Penn Medicine in Philadelpia, told me: “We have not built the infrastructure in informatics to take it out of the genetic sequencing process and pipe it right into the EMR [electronic medical record]; and there aren’t really standards in the industry for how you would communicate genetic results. It’s not like typical standards for most lab results,” Wells said.

Yesterday I had the chance to talk to Raymond Tait, Ph.D., vice president of research at Saint Louis University (SLU), about its efforts on this front.

SLU has partnered with a company called Appistry Inc., which has recently launched a cloud-based service for ordering genomics tests. SLU is working with Appistry to develop a timely process that tracks and measures the impact of the tests on patient care. “We are providing feedback about the fit of the system to typical decision making and work flow, primarily among oncologists, who have the greatest use for genetic tests,” Tait said. “The focus is on maximizing utility and ease of use. Getting the genetic data tied to the rest of a complex clinical picture is another huge challenge.”

Appistry says its CloudDx provides a web-based dashboard for ordering established lab tests and tracking the status of individual orders across healthcare organizations. “The cloud-based system orchestrates the flow of data and logistics among the network of service providers often needed to sequence samples, analyze sequencing data, and interpret the results for physicians,” according to a company press release. “This orchestration ensures that data and physical samples are transferred and securely managed in accordance with HIPAA and CLIA guidelines and that all processes essential for the rapid delivery of results to physicians occur consistently and efficiently.”

Appistry estimates that 80 to 90 percent of oncology occurs in a community setting. Yet these physicians are the least likely to have access to the infrastructure to support genomics testing or the expertise to apply it to patient care. Physicians in community hospitals need easier ways to access tests and receive relevant results. “One of the goals of Appistry’s work is to drive the tools into the hands of doctors closer to patients in community hospitals,” Tait said.

“The possibility of using the data gathered from the Appistry partnership to do research on efficacy and cost effectiveness is what has me most excited about it,” he added. Evidence of improved patient care and cost reductions due to genomics testing could help convince insurance companies to cover the services.