Clinical OMICS

MAY-JUN 2017

Healthcare magazine for research scientists, labs, pathologists, hospitals, cancer centers, physicians and biopharma companies providing news articles, expert interviews and videos about molecular diagnostics in precision medicine

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10 Clinical OMICs May/June 2017 www.clinicalomics.com Publisher & CEO MARY ANN LIEBERT President MARIANNE RUSSELL Group Publisher SANDE GIACCONE Editor in Chief CHRIS ANDERSON (canderson@clinicalomics.com) EVP, Strategic Development KEVIN DAVIES Commercial Director BILL LEVINE Production Editor ROBERT M. REIS Senior Editor KEVIN MAYER Technical Editor JEFFREY S. BUGULISKIS, Ph.D. Senior News Editor ALEX PHILIPPIDIS Chief Copy Editor STEVEN HERNACKI Contributing Editors HELEN ALBERT, MEGHAAN FERREIRA, DIANA KWON, DIANA MANOS Art Director JAMES LAMBO Online Product Manager THOMAS MATHEW Associate Director of Brand Marketing JENNIFER GATTI Online Coordinator KATHERINE VUKSANAJ Design & Layout NORA WERTZ Advertising Sales Manager DENIS SEGER US West & Asia Pacific (dseger@clinicalomics.com / 760-518-5222) Advertising Sales Manager LARRY MAHER US East, UK, & Europe (lmaher@clinicalomics.com / 312-342-0849) Sales Administrator FALLON MURPHY Advertising Material WANDA SANCHEZ (wsanchez@liebertpub.com) Clinical OMICs Advisory Board DANIEL H. FARKAS, Ph.D., HCLD Chief Clinical Laboratory Officer, Celmatix JEFFREY GIBBS, J.D. Director, Hyman, Phelps, and McNamara PETER HARRSCH, Ph.D. Executive Clinical/Forensic Specialist, Waters Corp. ROGER KLEIN, M.D., J.D. Medical Director, Molecular Pathology, Cleveland Clinic JASON PARK, M.D., Ph.D. Assistant Professor, Dept. of Pathology, University of Texas Southwestern Medical Center STEPHEN C. PEIPER, M.D. Professor & Chair, Dept. of Pathology, Anatomy & Cell Biology, Thomas Jefferson University AMIT RASTOGI Senior Vice President, Strategy, Growth, and Innovation, Inova DAVID SMITH, Ph.D. Professor of Laboratory Medicine and Pathology, Mayo Clinic KIMBERLY STRONG, Ph.D. Director, Program in Genomics and Ethics, Medical College of Wisconsin LARRY WORDEN Vice President and Senior Partner, Market Diagnostics International The views, opinions, findings, conclusions, and recommendations set forth in any article in Clinical OMICs are solely those of the authors of those articles and do not necessarily reflect the views, policy, or position of Clinical OMICs, its Publisher, or its editorial staff and should not be attributed to any of them. All advertisements are subject to review by the Publisher. The acceptance of advertisements does not constitute an endorsement of the product or service advertised. Clinical OMICs (ISSN-2334-1351) is published online bimonthly by GEN Publishing, 140 Huguenot St., 3rd Floor, New Rochelle, NY 10801-5215. For subscription information go to: www.clinicalomics.com Copyright © 2017 by GEN Publishing, New Rochelle, NY S carcely a day passes without a new announcement of some health system or diagnostics company launching a precision medicine initiative. Unfor- tunately, precision medicine isn't measured by what you could do in theory or hope to do, but by what can actually be delivered by a doctor to a patient. Perhaps the biggest limiter of the spread of precision medicine sits right in every doctor 's office, or on their tablets—the electronic health record (EHR). On the face of it, marrying a patient's genomic data with the phenotypic, medica- tion, imaging, and even unstructured data housed in the EHR is an elegant solution. Right now, it is anything but that. Granted, there are a handful of providers delivering a brand of precision medicine to their patients. Many have tackled the problem themselves— Penn Medicine's internally built pathway for incorporating genomic data in the EHR comes to mind—but these efforts have been relatively few, and sig- nificantly expensive. When it comes to delivering precision medicine to the masses, the EHR is the logical conduit, but there is still a mountain of work to be done. Luckily, significant players have taken notice. Witness the pilot project launched recently by the Office of the National Coordinator for Health Infor- mation Technology (ONC), called Sync for Genes (see story page 40). Quite simply, Sync for Genes will be looking for ways to leverage a data-sharing standard called FHIR (Fast Healthcare Interoperability Resources). It's a stan- dard that has received broad praise from a notoriously fractious lot—health- care data interoperability tech wonks. Better yet, the five pilots announced under Sync for Genes are backed by some healthcare and genomic high-flyers including Illumina, Foundation Medicine, and Intermountain Healthcare. The hope is these leaders in the field can find ways to crack two of the biggest problems standing in the way to incorporating genetic data into the EHR: the lack of a standard format for the capture of genetic data; and the sheer size of genomic data files. In the end, the success of implementing FHIR (pronounced "fire") for this task may come down to a simple change in method. FHIR is a "pull" tech- nology, meaning it asks for only the data it needs, only when it needs it, and pulls it in from wherever the data are stored. Older technologies were "push", meaning the holder of the data pushed the entire dataset to the user. Suffice to say, doctors are neither inclined, nor trained, to distill an entire 30-page genomic data report. Instead, using FHIR and an application-based approach, queries for much smaller portions of the data can be pulled back to the doctor 's EHR, ana- lyzed, then presented in a short digestable format to support the doctor 's care plan. It's a small change in thinking that could yield big results. —Chris Anderson, Editor in Chief Can EHRs Adapt to Share Genomic Data? FROM THE EDITOR Chris Anderson Editor in Chief

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