Written by Lauren Robertson, Science Writer.
A new study published in Genetics in Medicine has shown that integrating genetic testing into a patient’s electronic health records – rather than using third-party portals – saves a massive amount of time for clinicians. With an increasing focus being placed on integrating genomics data into a clinical setting, the potential impact of these results on the entire healthcare system could be enormous.
All in good time?
Genomic testing can provide a wealth of information about a patient’s condition. Sreamlining the delivery of genomic medicine is a key aim within the wider healthcare system. Unfortunately, genomics data is complex and includes information from various sources – this can be timely, difficult, and even expensive to deliver to clinicians in a usable form.
Therefore, in 2019, the multidisciplinary PennChart Genomics Initiative (PGI) was created at the University of Pennsylvania to tackle this challenge. Their aim? To link orders and results from genetic testing labs with discrete genetic data in electronic health records (EHR) – in other words, making the ordering and use of genomics data in the clinic much easier. This made PGI one of the first health systems in the US to integrate these processes.
“We know that there are many medical conditions where genetic testing would potentially change medical management of the patient,” said Marylyn Ritchie, Director of the Institute for Biomedical Informatics and a study co-author. “By making it easier to order the test and understand the results, we are improving care for our patients and reducing the burden on providers.”
Good for the clinic
In this recent study, the researchers wanted to measure exactly how much time they had managed to save through their innovative approach. To do this, they quantified the use of genomic data with the EHR, performed a time study with genetic counsellors, and then conducted interviews with them to see how much the new process had impacted genetics care delivery.
Overall, the PGI interfaced with 4 genetic testing labs, creating 420 unique computerised genetic testing orders in the process. So far, these orders have been used 4073 times. They found that in an analysis of 96 timed genetic testing activities, the new approach took just 2 minutes in comparison to the average 8 minutes it takes to go outside the EHR. And in terms of managing results, this took an average of 1 minute compared with 5 minutes for the traditional approach. Overall, the time savings were between 75-80%.
“Genetic counsellors order testing on multiple patients every day,” said the study’s lead author, Katherine Nathanson. “So, if you order tests on three patients per day and return results on three patients per day – which is a very reasonable estimate– that means you save 45 minutes per day, based on what we saw. That is a big deal.”
Looking ahead
The results from this study could significantly aid the ever-approaching reality of personalised medicine within the healthcare setting. Easing the workload for clinicians ordering and consulting genomics data now will have a huge impact on their ability to keep pace with developments in this space down the line.
As for their plans for future work? “We plan to further streamline the process so that genetic counsellors can work to the top of their scope of practice,” Nathanson said. A new grant from the National Human Genome Research Institute will help in this effort, funding a trial to examine whether specialists would prefer to order genomic testing with one click on the EHR or if they’d still prefer to delegate to genomics clinics via referral.
