Multidisciplinary model to implement pharmacogenomics at the point of care

Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model. The development and implementation of PGx were organized into eight interdependent co...

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Published in:Genetics in medicine Vol. 19; no. 4; pp. 421 - 429
Main Authors: Caraballo, Pedro J., Hodge, Lucy S., Bielinski, Suzette J., Stewart, A. Keith, Farrugia, Gianrico, Schultz, Cloann G., Rohrer-Vitek, Carolyn R., Olson, Janet E., St. Sauver, Jennifer L., Roger, Veronique L., Parkulo, Mark A., Kullo, Iftikhar J., Nicholson, Wayne T., Elliott, Michelle A., Black, John L., Weinshilboum, Richard M.
Format: Journal Article
Language:English
Published: New York Elsevier Inc 01.04.2017
Nature Publishing Group US
Elsevier Limited
Subjects:
631/208/1516
631/208/212/1728
631/208/212/2166
Biomedicine
clinical decision support systems
Decision Support Systems, Clinical
delivery of health care
Delivery of Health Care, Integrated - methods
Electronic Health Records
Human Genetics
Humans
Laboratory Medicine
medical informatics
Models, Theoretical
original-research-article
pharmacogenetics
Pharmacogenetics - education
Point-of-Care Systems
Precision Medicine
precision medicine
medical informatics
clinical decision support systems
delivery of health care
pharmacogenetics
ISSN:1098-3600, 1530-0366
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Abstract Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model. The development and implementation of PGx were organized into eight interdependent components addressing resources, governance, clinical practice, education, testing, knowledge translation, clinical decision support (CDS), and maintenance. Several aspects of implementation were assessed, including adherence to the model, production of PGx-CDS interventions, and access to educational resources. Between August 2012 and June 2015, 21 specific drug–gene interactions were reviewed and 18 of them were implemented in the electronic medical record as PGx-CDS interventions. There was complete adherence to the model with variable production time (98–392 days) and delay time (0–148 days). The implementation impacted approximately 1,247 unique providers and 3,788 unique patients. A total of 11 educational resources complementary to the drug–gene interactions and 5 modules specific for pharmacists were developed and implemented. A comprehensive operational model can support PGx implementation in routine prescribing. Institutions can use this model as a roadmap to support similar efforts. However, we also identified challenges that will require major multidisciplinary and multi-institutional efforts to make PGx a universal reality. Genet Med19 4, 421–429.
AbstractList Purpose:Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model.Methods:The development and implementation of PGx were organized into eight interdependent components addressing resources, governance, clinical practice, education, testing, knowledge translation, clinical decision support (CDS), and maintenance. Several aspects of implementation were assessed, including adherence to the model, production of PGx-CDS interventions, and access to educational resources.Results:Between August 2012 and June 2015, 21 specific drug-gene interactions were reviewed and 18 of them were implemented in the electronic medical record as PGx-CDS interventions. There was complete adherence to the model with variable production time (98-392 days) and delay time (0-148 days). The implementation impacted approximately 1,247 unique providers and 3,788 unique patients. A total of 11 educational resources complementary to the drug-gene interactions and 5 modules specific for pharmacists were developed and implemented.Conclusion:A comprehensive operational model can support PGx implementation in routine prescribing. Institutions can use this model as a roadmap to support similar efforts. However, we also identified challenges that will require major multidisciplinary and multi-institutional efforts to make PGx a universal reality.Genet Med 19 4, 421-429.
Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model. The development and implementation of PGx were organized into eight interdependent components addressing resources, governance, clinical practice, education, testing, knowledge translation, clinical decision support (CDS), and maintenance. Several aspects of implementation were assessed, including adherence to the model, production of PGx-CDS interventions, and access to educational resources. Between August 2012 and June 2015, 21 specific drug-gene interactions were reviewed and 18 of them were implemented in the electronic medical record as PGx-CDS interventions. There was complete adherence to the model with variable production time (98-392 days) and delay time (0-148 days). The implementation impacted approximately 1,247 unique providers and 3,788 unique patients. A total of 11 educational resources complementary to the drug-gene interactions and 5 modules specific for pharmacists were developed and implemented. A comprehensive operational model can support PGx implementation in routine prescribing. Institutions can use this model as a roadmap to support similar efforts. However, we also identified challenges that will require major multidisciplinary and multi-institutional efforts to make PGx a universal reality.Genet Med 19 4, 421-429.
PURPOSEDespite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model.METHODSThe development and implementation of PGx were organized into eight interdependent components addressing resources, governance, clinical practice, education, testing, knowledge translation, clinical decision support (CDS), and maintenance. Several aspects of implementation were assessed, including adherence to the model, production of PGx-CDS interventions, and access to educational resources.RESULTSBetween August 2012 and June 2015, 21 specific drug-gene interactions were reviewed and 18 of them were implemented in the electronic medical record as PGx-CDS interventions. There was complete adherence to the model with variable production time (98-392 days) and delay time (0-148 days). The implementation impacted approximately 1,247 unique providers and 3,788 unique patients. A total of 11 educational resources complementary to the drug-gene interactions and 5 modules specific for pharmacists were developed and implemented.CONCLUSIONA comprehensive operational model can support PGx implementation in routine prescribing. Institutions can use this model as a roadmap to support similar efforts. However, we also identified challenges that will require major multidisciplinary and multi-institutional efforts to make PGx a universal reality.Genet Med 19 4, 421-429.
Purpose: Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model. Methods: The development and implementation of PGx were organized into eight interdependent components addressing resources, governance, clinical practice, education, testing, knowledge translation, clinical decision support (CDS), and maintenance. Several aspects of implementation were assessed, including adherence to the model, production of PGx-CDS interventions, and access to educational resources. Results: Between August 2012 and June 2015, 21 specific drug–gene interactions were reviewed and 18 of them were implemented in the electronic medical record as PGx-CDS interventions. There was complete adherence to the model with variable production time (98–392 days) and delay time (0–148 days). The implementation impacted approximately 1,247 unique providers and 3,788 unique patients. A total of 11 educational resources complementary to the drug–gene interactions and 5 modules specific for pharmacists were developed and implemented. Conclusion: A comprehensive operational model can support PGx implementation in routine prescribing. Institutions can use this model as a roadmap to support similar efforts. However, we also identified challenges that will require major multidisciplinary and multi-institutional efforts to make PGx a universal reality. Genet Med 19 4, 421–429.
Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome with a comprehensive and systematic implementation model. The development and implementation of PGx were organized into eight interdependent components addressing resources, governance, clinical practice, education, testing, knowledge translation, clinical decision support (CDS), and maintenance. Several aspects of implementation were assessed, including adherence to the model, production of PGx-CDS interventions, and access to educational resources. Between August 2012 and June 2015, 21 specific drug–gene interactions were reviewed and 18 of them were implemented in the electronic medical record as PGx-CDS interventions. There was complete adherence to the model with variable production time (98–392 days) and delay time (0–148 days). The implementation impacted approximately 1,247 unique providers and 3,788 unique patients. A total of 11 educational resources complementary to the drug–gene interactions and 5 modules specific for pharmacists were developed and implemented. A comprehensive operational model can support PGx implementation in routine prescribing. Institutions can use this model as a roadmap to support similar efforts. However, we also identified challenges that will require major multidisciplinary and multi-institutional efforts to make PGx a universal reality. Genet Med19 4, 421–429.
Author Olson, Janet E.
Nicholson, Wayne T.
Weinshilboum, Richard M.
Hodge, Lucy S.
Roger, Veronique L.
St. Sauver, Jennifer L.
Stewart, A. Keith
Bielinski, Suzette J.
Rohrer-Vitek, Carolyn R.
Parkulo, Mark A.
Farrugia, Gianrico
Black, John L.
Elliott, Michelle A.
Schultz, Cloann G.
Caraballo, Pedro J.
Kullo, Iftikhar J.
AuthorAffiliation 4 Department of Health Sciences Research, Mayo Clinic, USA
10 Department of Laboratory Medicine and Pathology, Mayo Clinic, USA
5 Kern Center for the Science of Health Care Delivery, Mayo Clinic, USA
1 Division of General Internal Medicine, Mayo Clinic, USA
2 Office of Information and Knowledge Management, Mayo Clinic, USA
3 Center for Individualized Medicine, Mayo Clinic, USA
8 Department of Anesthesiology, Mayo Clinic, USA
11 Departments of Molecular Pharmacology and Experimental Therapeutics & Medicine, Mayo Clinic, USA
6 Division of Community Internal Medicine, Mayo Clinic, USA
9 Division of Hematology, Mayo Clinic, USA
7 Division of Cardiovascular Diseases, Mayo Clinic, USA
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  organization: Center for Individualized Medicine, Rochester, Minnesota, USA
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  surname: Olson
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  fullname: St. Sauver, Jennifer L.
  organization: Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
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  givenname: Veronique L.
  surname: Roger
  fullname: Roger, Veronique L.
  organization: Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
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  surname: Parkulo
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  surname: Kullo
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  givenname: Richard M.
  surname: Weinshilboum
  fullname: Weinshilboum, Richard M.
  organization: Department of Molecular Pharmacology and Experimental Therapeutics, Rochester, Minnesota, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/27657685$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright 2017 The Author(s)
American College of Medical Genetics and Genomics 2017
Copyright Nature Publishing Group Apr 2017
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Issue 4
Keywords precision medicine
medical informatics
clinical decision support systems
delivery of health care
pharmacogenetics
Language English
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Snippet Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be overcome...
Purpose: Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be...
Purpose:Despite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be...
PURPOSEDespite potential clinical benefits, implementation of pharmacogenomics (PGx) faces many technical and clinical challenges. These challenges can be...
SourceID pubmedcentral
proquest
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Index Database
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StartPage 421
SubjectTerms 631/208/1516
631/208/212/1728
631/208/212/2166
Biomedicine
clinical decision support systems
Decision Support Systems, Clinical
delivery of health care
Delivery of Health Care, Integrated - methods
Electronic Health Records
Human Genetics
Humans
Laboratory Medicine
medical informatics
Models, Theoretical
original-research-article
pharmacogenetics
Pharmacogenetics - education
Point-of-Care Systems
Precision Medicine
Title Multidisciplinary model to implement pharmacogenomics at the point of care
URI https://dx.doi.org/10.1038/gim.2016.120
https://link.springer.com/article/10.1038/gim.2016.120
https://www.ncbi.nlm.nih.gov/pubmed/27657685
https://www.proquest.com/docview/1884525508
https://www.proquest.com/docview/1835504472
https://pubmed.ncbi.nlm.nih.gov/PMC5362352
Volume 19
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