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How UF Health Turns Genetics Into Actionable Info

The key is making genetic test data instantly relevant to physicians. One of seven profiles of IW 500 Business Innovation Award winners.

2013 InformationWeek 500
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When a healthcare provider's project transitions from research into clinical practice, it knows it has turned a corner. University of Florida Health turned that corner in June 2012 with a project that uses genetic testing to identify patients who can't metabolize certain meds.

UF Health created a pilot program around patients entering its cardiac catheterization lab who are prescribed the blood thinner Plavix (clopidogrel). One in four patients can't metabolize clopidogrel, which the lab prescribes to most entering patients.UF Health developed a test that identifies the gene responsible for clopidogrel metabolization and made the test a part of its standing orders.

DNA analyzers generate an overwhelming amount of data, and clinicians don't need most of that data. So UF Health IT pros used data-reduction techniques to format the data into a usable piece of clinical information to answer the original question: Will this drug work on this particular patient? "The struggle with genomics is how to make data readable for physicians who aren't used to dealing with data all the time," says Kari Cassel, UF Health's CIO. "The question is how to make the data relevant."

UF Health's programming team, not academic researchers, took the initial step of transforming single nucleotide proteins into genotypes. It then pushed the genomic test results to UF Health's Epic electronic health record system and created a physician alert for patients who lack the metabolizing gene. The alert, part of Epic's clinical decision support, will suggest alternative drugs. Because the genetic test result is valid for the patient's lifetime, the alert appears in all future visits.

Simplicity is key to UF Health's genetic alert
Simplicity is key to UF Health's genetic alert

"A lot of alerts we physicians don't know what to do with," says Dr. Don Novak, a pediatrician and assistant dean for clinical informatics at UF. "This is concrete."

In the first seven months of the pilot, UF Health performed the test on 80% of its cardiac cath lab patients -- more than 600 people. One hundred fifty-eight of them had genetic variants that led to a recommendation not to use clopidogrel.

UF Health plans to expand the program to other medical areas, both inpatient and outpatient, in the coming year. "We want the genetic alert to be as simple as any other alert that comes along," CIO Cassel says. "We can now look at this data without jumping through hoops."

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User Rank: Apprentice
6/9/2014 | 9:15:09 PM
re: How UF Health Turns Genetics Into Actionable Info
Great question. A handful of labs today offer testing at no cost to the healthcare provider. Medicare and many commercial insurers routinely reimburse for testing too. I serve as a pharmacogogenetic consultant. Please feel free to email me if you're interested in learning more - [email protected]
User Rank: Apprentice
9/13/2013 | 2:45:02 AM
re: How UF Health Turns Genetics Into Actionable Info
I wish more organizations took this approach with analyzing and presenting data to physicians. As Dr. Novak says, a lot of the data physicians don't know what to do. Presenting this to them in an alert format that tells them the patient cannot use this drug and suggesting other drugs to prescribe makes their jobs a whole lot easier and ultimately saves time and money.

Jay Simmons
Information Week Contributor
Alex Kane Rudansky
Alex Kane Rudansky,
User Rank: Author
9/10/2013 | 2:20:44 PM
re: How UF Health Turns Genetics Into Actionable Info
They developed the test to reduce cost so that it can be used routinely (though not for every patient entering the hospital).
David F. Carr
David F. Carr,
User Rank: Author
9/9/2013 | 9:11:41 PM
re: How UF Health Turns Genetics Into Actionable Info
Are these tests inexpensive enough to use on a routine basis?
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