J. Pers. Med. 2014, 4(2), 176-199; doi:10.3390/jpm4020176
Concept Paper

A Proposed Clinical Decision Support Architecture Capable of Supporting Whole Genome Sequence Information

1,2,* email, 3email, 2email and 2email
Received: 11 December 2013; in revised form: 22 February 2014 / Accepted: 14 March 2014 / Published: 4 April 2014
(This article belongs to the Special Issue Bringing Personalized Medicine into Clinical Practice)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: Whole genome sequence (WGS) information may soon be widely available to help clinicians personalize the care and treatment of patients. However, considerable barriers exist, which may hinder the effective utilization of WGS information in a routine clinical care setting. Clinical decision support (CDS) offers a potential solution to overcome such barriers and to facilitate the effective use of WGS information in the clinic. However, genomic information is complex and will require significant considerations when developing CDS capabilities. As such, this manuscript lays out a conceptual framework for a CDS architecture designed to deliver WGS-guided CDS within the clinical workflow. To handle the complexity and breadth of WGS information, the proposed CDS framework leverages service-oriented capabilities and orchestrates the interaction of several independently-managed components. These independently-managed components include the genome variant knowledge base, the genome database, the CDS knowledge base, a CDS controller and the electronic health record (EHR). A key design feature is that genome data can be stored separately from the EHR. This paper describes in detail: (1) each component of the architecture; (2) the interaction of the components; and (3) how the architecture attempts to overcome the challenges associated with WGS information. We believe that service-oriented CDS capabilities will be essential to using WGS information for personalized medicine.
Keywords: clinical decision support systems; medical genetics; genomics; genetic testing; electronic health records; health information technology; personalized medicine; service-oriented architecture
PDF Full-text Download PDF Full-Text [629 KB, uploaded 4 April 2014 10:00 CEST]

Export to BibTeX |
EndNote


MDPI and ACS Style

Welch, B.M.; Loya, S.R.; Eilbeck, K.; Kawamoto, K. A Proposed Clinical Decision Support Architecture Capable of Supporting Whole Genome Sequence Information. J. Pers. Med. 2014, 4, 176-199.

AMA Style

Welch BM, Loya SR, Eilbeck K, Kawamoto K. A Proposed Clinical Decision Support Architecture Capable of Supporting Whole Genome Sequence Information. Journal of Personalized Medicine. 2014; 4(2):176-199.

Chicago/Turabian Style

Welch, Brandon M.; Loya, Salvador R.; Eilbeck, Karen; Kawamoto, Kensaku. 2014. "A Proposed Clinical Decision Support Architecture Capable of Supporting Whole Genome Sequence Information." J. Pers. Med. 4, no. 2: 176-199.

J. Pers. Med. EISSN 2075-4426 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert