title: Evaluation: A Qualitative Pilot Study of Novel Information Technology Infrastructure to Communicate Genetic Variant Updates.
abstract: Partners HealthCare Personalized Medicine developed GeneInsight Clinic (GIC), a tool designed to communicate updated variant information from laboratory geneticists to treating clinicians through automated alerts, categorized by level of variant interpretation change.
  
  
  
  The study aimed to evaluate feedback from the initial users of the GIC, including the advantages and challenges to receiving this variant information and using this technology at the point of care.
  
  
  
  Healthcare professionals from two clinics that ordered genetic testing for cardiomyopathy and related disorders were invited to participate in one-hour semi-structured interviews and/ or a one-hour focus group. Using a Grounded Theory approach, transcript concepts were coded and organized into themes.
  
  
  
  Two genetic counselors and two physicians from two treatment clinics participated in individual interviews. Focus group participants included one genetic counselor and four physicians. Analysis resulted in 8 major themes related to structuring and communicating variant knowledge, GIC's impact on the clinic, and suggestions for improvements. The interview analysis identified longitudinal patient care, family data, and growth in genetic testing content as potential challenges to optimization of the GIC infrastructure.
  
  
  
  Participants agreed that GIC implementation increased efficiency and effectiveness of the clinic through increased access to genetic variant information at the point of care.
  
  
  
  Development of information technology (IT) infrastructure to aid in the organization and management of genetic variant knowledge will be critical as the genetic field moves towards whole exome and whole genome sequencing. Findings from this study could be applied to future development of IT support for genetic variant knowledge management that would serve to improve clinicians' ability to manage and care for patients.
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System , Wellesley, MA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Klinkenberg-Ramirez
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System , Wellesley, MA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Neri
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System , Wellesley, MA.
authors.forename: Lynn A
authors.initials: LA
authors.lastname: Volk
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System , Wellesley, MA.
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Samaha
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System , Wellesley, MA.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Newmark
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System , Wellesley, MA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Pollard
authors.affiliation: Information Systems, Partners HealthCare Personalized Medicine , Cambridge, MA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Varugheese
authors.affiliation: Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine , Cambridge, MA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Baxter
authors.affiliation: Information Systems, Partners HealthCare Personalized Medicine , Cambridge, MA.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Aronson
authors.affiliation: Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA.
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Rehm
authors.affiliation: Clinical and Quality Analysis, Partners HealthCare System, Wellesley, MA; Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA.
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
mesh_terms: D003142:Communication; D014644:Genetic Variation; D006801:Humans; D008490:Medical Informatics / Q000379:methods*; D010865:Pilot Projects; D019095:Point-of-Care Systems; D057285:Precision Medicine
keywords: Clinical informatics applications; clinical decision support; genetics; laboratory software; personalized medicine