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Crossing the Omic Chasm A Time for Omic Ancillary Systems

Justin Starren, MD, PhD; Marc S. Williams, MD; Erwin P. Bottinger, MD
JAMA. 2013;309(12):1237-1238. doi:10.1001/jama.2013.1579.
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Despite the information gains from genome-wide association studies and next-generation sequencing (NGS), there remains a chasm between this scientific knowledge and daily clinical practice. Leveraging recent advances in genomics to improve patient care will require electronic health record (EHR) systems that incorporate genomic clinical decision support (CDS). The eMerge (Electronic Medical Records and Genomics)1,2 consortium is bridging this chasm by developing interoperable systems that can integrate large-scale genomic data with clinical workflows. According to a recent Institute of Medicine report,3 the current document-centric approach to omic (eg, genomic, epigenomic, proteomic, metabolomic) data will not scale, making storage of raw omic data in current-generation EHRs not feasible. Although commercial EHRs may eventually evolve to handle omic data efficiently, dedicated omic ancillary systems will be essential in the interim.

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Figure. Integration of Genomic Data With Electronic Health Records
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Integration depends on the format and complexity of the data. Note that data paths convey high-level data flows and do not necessarily imply point-to-point connections. CLIA indicates Clinical Laboratory Improvement Amendments.



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