title: Ethical, legal, and social implications of incorporating genomic information into electronic health records.
abstract: The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk.
authors.affiliation: Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan, USA.
authors.forename: Ribhi
authors.initials: R
authors.lastname: Hazin
authors.forename: Kyle B
authors.initials: KB
authors.lastname: Brothers
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Malin
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Koenig
authors.forename: Saskia C
authors.initials: SC
authors.lastname: Sanderson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rothstein
authors.forename: Marc S
authors.initials: MS
authors.lastname: Williams
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Clayton
authors.forename: Iftikhar J
authors.initials: IJ
authors.lastname: Kullo
mesh_terms: D016494:Computer Security; D003219:Confidentiality; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records / Q000941:ethics* / Q000331:legislation & jurisprudence*; D030661:Genetic Privacy; D023281:Genomics / Q000941:ethics* / Q000331:legislation & jurisprudence*; D057220:Health Literacy; D055991:Health Records, Personal; D006801:Humans; D033162:Incidental Findings; D033283:Patient Access to Records; D057285:Precision Medicine
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