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Are We There Yet? Using Genomic Information in EHR for Patient Care

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Genomic Medicine_Healthcare-Informatics

It’s Monday July 8 and you woke up feeling sick, and you know you better see your doctor. In the office, your doctor looks you over, listens to your symptoms, but before he prescribes a drug, the doctor said, “Lets get a sample of your blood so that I can take a look at your Deoxyribonucleic Acid”. You heard me right, your DNA!

Today, doctors usually give you an "average" dose of a medicine based on your body size and age. In 10 years from now, we are expecting that genetics—the study of how genes influence actions, appearance, and health—will pervade today’s medical treatment. Researcher and physicians have being predicting that the medicines of the future will work differently than those you take today, yes it will; tomorrow's medicines will be tailored to your genes. Future medicines will match the chemical needs of your body, as influenced by your genes. Hence, knowing your unique genetic make-up could help your doctor prescribe the right medicine in the right amount, to boost its effectiveness and minimize possible side effects. This is personalized medicine – for you only.

Well, how is this possible?  Or what’s the best way to use genomics to take care of patients you asked? Knowing the answer to this question is ninety percent of the challenge we face. Current research shows that it is crucial to answer this question to gain major advances in disease diagnostics, treatment and prevention. The National Human Genome Research Institute (NHGRI) gearing up to award approximately $12.8 million to four prominent scientists and physicians to find the answer to this question, and address the challenges. This is a tremendous push and acceptance towards personalized medicine, though is a long road ahead to better understand how to incorporate and use genomic medicine.

So are we there yet? Believe it or not, we are not far away from our destination. People around the world are working on some areas of genomic medicine (or personalized medicine). A quick search of PubMed (, returns over 2072 research work exploring new ways to incorporate and implement genomic results into electronic health records and clinical care. We have already experience how an electronic health records (EHR) system that incorporates decision support systems help guide physicians to make better decision by provides faster access to patient information and decision making. Now the challenge for genomic medicine is to show how feasible and valuable (translatable to provide physicians with new knowledge) it will be. But lets not forget another bigger challenge, genomic medicine is not just for physicians, researcher and patients acceptance, but also to the many EHR vendors who have their EHR systems in many different clinical environments and settings, such as networks of community health centers, large and small health systems and primary care physician offices.

Could EHR vendors be the next challenge to overcome in order for us to realized genomic/personalized medicine? Is this the next challenging questions needing to be answer, and how many million dollars will the NHGRI have to spend to bring the clinical use of pharmacogenomics closer to business as usual. Here’s a questions that I asked myself and also look towards my readers to answer. Are the researcher and physicians working to incorporate genomics into EHRs also working closely with each of the major EHR vendors, to collect information and/or relate questions that each vendor will need to answer, which are much broader questions about the incorporation and implementation of genomic medicine. Are they? Along with all the so-called pharmacogenomics approaches to get genomic medicine into EHRs, how many EHR vendors are pursuing research (in this directions) on their own dime and are willing to help guide the prescribing of medicines for the future?

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