title: Implementing and Improving Automated Electronic Tumor Molecular Profiling.
abstract: Oncology practice increasingly requires the use of molecular profiling of tumors to inform the use of targeted therapeutics. However, many oncologists use third-party laboratories to perform tumor genomic testing, and these laboratories may not have electronic interfaces with the provider's electronic medical record (EMR) system. The resultant reporting mechanisms, such as plain-paper faxing, can reduce report fidelity, slow down reporting procedures for a physician's practice, and make reports less accessible. Vanderbilt University Medical Center and its genomic laboratory testing partner have collaborated to create an automated electronic reporting system that incorporates genetic testing results directly into the clinical EMR. This system was iteratively tested, and causes of failure were discovered and addressed. Most errors were attributable to data entry or typographical errors that made reports unable to be linked to the correct patient in the EMR. By providing direct feedback to providers, we were able to significantly decrease the rate of transmission errors (from 6.29% to 3.84%; P < .001). The results and lessons of 1 year of using the system and transmitting 832 tumor genomic testing reports are reported.
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA matthew.j.rioth@vanderbilt.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Rioth
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA.
authors.forename: David B
authors.initials: DB
authors.lastname: Staggs
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Hackett
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA.
authors.forename: Erich
authors.initials: E
authors.lastname: Haberman
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA.
authors.forename: Mike
authors.initials: M
authors.lastname: Tod
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA.
authors.forename: Mia
authors.initials: M
authors.lastname: Levy
authors.affiliation: Vanderbilt University; Vanderbilt University Medical Center, Nashville, TN; and Foundation Medicine, Cambridge, MA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Warner
mesh_terms: D057286:Electronic Health Records / Q000592:standards*; D006801:Humans; D025202:Molecular Diagnostic Techniques; D009369:Neoplasms / Q000175:diagnosis* / Q000235:genetics; D058996:Quality Improvement
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