INTEGRATION OF GENOMICS AND CLINICAL DECISION SUPPORT FOR AGING PATIENTS

Implicit in the vision for Personalized Genomic Medicine is that Genomic and other Omic (e.g. proteomic, metabolomics, etc.) data will need to be integrated into the Electronic Health Records (EHRs) of the future. Omic data breaks the conventional EHR paradigm in a number of ways. The greatest paradigm shifts is that next-generation sequencing allows the collection of large amount of data about a patient, before the clinical significance of that data is known. Another shift is that the raw data are essentially uninterruptable without the aid of computer analysis, even for a domain expert. The multiple comorbidities of most elderly patients and the interactions among the treatments for these conditions further complicate the picture. A number of groups, including the The Electronic Medical Records and Genomics (eMERGE) Network, the Pharmacogenomics Research Network (PGRN) and the HL7 Clinical Genomics Workgroup, as well as individual EHR vendors, are tackling these challenge. This talk will discuss both the challenges and the progress that has already been made in incorporation high throughput Omics into clinical care.