title: Using Workflow Modeling to Identify Areas to Improve Genetic Test Processes in the University of Maryland Translational Pharmacogenomics Project.
abstract: Delivering genetic test results to clinicians is a complex process. It involves many actors and multiple steps, requiring all of these to work together in order to create an optimal course of treatment for the patient. We used information gained from focus groups in order to illustrate the current process of delivering genetic test results to clinicians. We propose a business process model and notation (BPMN) representation of this process for a Translational Pharmacogenomics Project being implemented at the University of Maryland Medical Center, so that personalized medicine program implementers can identify areas to improve genetic testing processes. We found that the current process could be improved to reduce input errors, better inform and notify clinicians about the implications of certain genetic tests, and make results more easily understood. We demonstrate our use of BPMN to improve this important clinical process for CYP2C19 genetic testing in patients undergoing invasive treatment of coronary heart disease.
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Cutting
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Casey L
authors.initials: CL
authors.lastname: Overby
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Banchero
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Toni
authors.initials: T
authors.lastname: Pollin
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Kelemen
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Shuldiner
authors.affiliation: Program in Personalized and Genomic Medicine and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
authors.forename: Amber L
authors.initials: AL
authors.lastname: Beitelshees
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D005820:Genetic Testing / Q000379:methods / Q000592:standards*; D006801:Humans; D017146:Models, Organizational; D010597:Pharmacogenetics / Q000379:methods / Q000458:organization & administration; D057285:Precision Medicine / Q000379:methods*; D058996:Quality Improvement; D057188:Workflow