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Table 1 Comparison of CDS, Return of Results and Educational Strategies for IGNITE Projects

From: The IGNITE network: a model for genomic medicine implementation and research

Site/Project Characteristics of CDS Return of results Educational strategies
Duke University: Implementation, Adoption and Utility of Family History in Diverse Care Settings • Open source (OpenCDS)
• Bidirectional
• Based on HL7 Virtual Medical Record standard
• Epic-based system
• Directly to patients and providers via CDS within the EHR • English and Spanish language versions of FHH software
• Printed and web based materials
• Patient workbook and instructions for capturing FHH
• Patient report for FHH results
Indiana University - INGenious: INdiana Genomics Implementation: an Opportunity for the UnderServed • Eskenazi home-grown EHR system
• Automated identification and randomization of patients
• Capture of genetic variant data and reporting into EHR
• Automatic alerts
• Links to guidelines and supporting evidence for patients with pharmacogenomic results
• Directly to providers via CDS within the EHR • Personal engagement with Eskenazi patient representative organization
• Print materials in language-appropriate form in clinics
Icahn School of Medicine at Mount Sinai - Genetic testing to Understand and Address Renal Disease Disparities (GUARDD) • Epic-based system that incorporates CLIPMERGE
• Alert-based informed message for provider that integrates EHR and allele data
• Based on HL7 standards
• Integrated with Redcap
• CDS alert includes link to provider and patient education materials
• Directly to providers via CDS within the EHR
• To patients by research staff trained by genetic counselors
• Genetic counselor available for consultation with patients or research staff
• Print materials (low-literacy, culturally appropriate, co-developed with community leaders and APOL1-positive patients) provided to patients at return of result and available for download by clinicians
University of Florida – UF Health Personalized Medicine Program • Epic-based system
• Alert-based informed message for provider that integrates EHR and allele data
• Integrated with Redcap
• CDS alert includes link to patient education materials
• Directly to providers via CDS within the EHR • Print and online materials for patients and clinicians
• Continuing education and academic courses for health care professionals and students
University of Maryland - Genomic Diagnosis and Personalized Therapy for Highly Penetrant Genetic Diabetes • Epic-based system
• Interface of screening tool and algorithm with EHR to produce alert for testing
• Integration of actionable result report into EHR
• Genetic result-based diagnosis/treatment recommendation alerts
• Direct communication of results to patients and entry into medical record
• Customized materials provided to patients for communicating with other family members
• If a variant of unknown significance is found, patients will be informed and invited to participate in additional research
• In-person throughout the study process (e.g., patient informed consent conducted by genetic counselor and research coordinator)
• For patients with a pathogenic variant, study team and provider will discuss implications
• Print materials also provided to patients throughout study
Vanderbilt University - Integrated, Individualized and Intelligent Prescribing (I3P) Network • Multiple EHR systems (Epic, Veterans Affairs CPRS, McKesson, home-grown)
• Bidirectional
• Based on HL7 standards
• Incorporates newly developed HL7 genomic data standard
• Include interpretative recommendations
• Link out to external information sources (e.g., MyCancerGenome.org)
• Passive and active alerts
• Directly to providers via CDS within the EHR • Print and online materials for patients and clinicians
• Integrated with CDS
• Provider focus groups
  1. CDS clinical decision support, HL7 health level-7, EHR electronic health record, FHH family health history, CPRS computerized patient record system