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How Precision Medicine is Unlocking EHRs' Potential

   October 27, 2015

The prospect of incorporating human genomic data into electronic health records is closer than you think. Extensions to one system promise to improve patient safety, research, and clinical outcomes for 10 neurological disorders, research shows.

The healthcare IT industry has been vigorously touting President Obama's precision medicine initiative all year, ever since he announced it in the State of the Union address.

President Obama delivering the State of the Union address on Jan. 20, 2015. Photo: C-SPAN

No doubt, IT's enthusiasm for precision medicine is fueled by visions of extracting even more IT-oriented revenue from payers and providers. The assumption is that great medical breakthroughs are just around the corner.

Some restraint is in order. With the continuing struggle to simply stand up electronic medical records systems and get them exchanging information, the prospect of incorporating human genomic data into the EHR falls into the category of bright, shiny objects of the moment.

But in September, IL-based NorthShore University HealthSystem published findings about extensions to the Epic EHR which promise to improve patient safety, research and clinical outcomes for 10 neurological disorders, brain health risk assessments, and interventions for Alzheimer's disease. Precision medicine plays a role, and more than 2,000 NorthShore patients have already signed up to participate in a DNA biobank to support the effort.

The study was posted in the September 24 issue of Neurology Clinical Practice, a journal of the American Academy of Neurology. The initial project received funding from the Agency for Healthcare Research and Quality.

Most impressively, seven healthcare systems in addition to NorthShore have joined together to form a Neurology Practice-Based Research Network (NPBRN), to share de-identified data and best practices and to help move the state of the art forward that much faster: Dartmouth, University of Pennsylvania, Wake Forest Baptist Health System, Medical University of South Carolina, Ochsner Health System, University of Arkansas, and the University of Nebraska.

Demetrius "Jim" Maraganore, MD

Precision Medicine at the Point of Care
Leading all this enthusiastically is Demetrius "Jim" Maraganore, MD, medical director of NorthShore's Neurological Institute and director of the Center for Brain Health. "It's creating precision medicine at the point of care, through the EMR," he says.

Until now, like many other physicians, most neurologists have expressed frustration with EHRs, which seem designed to serve a broad spectrum of healthcare interests, including the meaningful use program, but not to add value for the practice of neurology, Maraganore says.

The problem was such that "on the one hand, the EMR is where medicine now takes place, and on the other hand, it really isn't designed with neurology in mind," he says.

Out of the box, today's EHRs do not allow neurologists to capture neurology-specific standardized information about their patients or to learn about their outcomes, Maraganore says.

Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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