Genomics

 

Genomic data can provide tremendous insight into variant alleles that predict disease risk, polymorphisms that determine drug efficacy and toxicity, and guide the course of therapeutic interventions. The goal of this group is to develop an implementation plan that addresses the following objectives:

 

 

  1. Develop the optimal technical strategy to embed or access genomic data, in the context of Protected Health Information (PHI), in the Electronic Health Record. This will include lessons learned from other implementations that have been successful, and involve stakeholders from federal health IT, academia and commercial entities, and provide a "safe harbor" in which to discuss different methodologies.
  2. Determine the most usable approach to present genomic data to the clinician in the Electronic Health Record, using decision support systems that support rapid, accurate and certain diagnostic and therapeutic determinations.
  3. Enable data exchanges from Disease Registries, NCBI resources, and other databases that allow the clinician and others to become more informed about important genotype-phenotype correlations.
  4. Focus on the immediate health needs of Veterans returning from combat, through HIE and other forums that utilize the OSEHRA, which focus on PTSD and TBI, cutting through and integrating silos of significant data repositories, which may exist in research, provider, payor and vendor environments.
  5. Develop an infrastructure that will be flexible enough to accommodate future advances in all "omics" domains that may provide value for patient care.
  6. Provide a platform where clinicians and patients can discuss pertinent health information.
  7. Ensure that PHI is adequately protected, so that mHealth applications can be used by the clinician for more efficient tracking of patient status.
  8. Facilitate the process of ordering gene and genome-based tests from the Electronic Health Record using a simple approach for easy and secure access to commercial providers of gene-based LDTs and IVDs.
  9. Provide a "blue-button" for the Veteran and members of the U.S. military to access their own gene-based test results and genomic data.
  10. Provide epidemiologists, pharmaceutical scientists and medical device manufacturers, and academic researchers access to a wealth of genomic information at the back end, using appropriate controls for the de-identification and anonymization of PHI, to perform better clinical and basic research that will not only improve medical outcomes for Veterans, but for the society as a whole.