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Interoperability Proving Ground (IPG) submissions within the ONC Tech Lab are submitted by healthcare, technology and development organizations that are invested in Health IT and Interoperability and want to share, learn and collaborate with similar stakeholders in the US, and around the world.

To view all submissions, please view the IPG link located within the ONC Techlab.

Sync for Genes Phase 2 Pilot - Weill Cornell Medical Center (Weill Cornell)

Description 
The guidelines around genomic testing and approved medications by cancer type are still evolving and are extremely complex. The information lies in disparate sources including EHRs, societal guidelines, insurance payors, and using EHR infrastructure with FHIR® resources, Weill Cornell is able to bridge this gap and enhance oncology care delivery. Weill Cornell uses discrete genomic results for a variety of (CDS) support scenarios including pharmacological therapy selection, research recruitment and navigating insurance and pre-authorization requirements for genomic testing. 

Weill Cornell used discrete genomic results, which it is already collecting, and utilized those in conjunction with discrete results available in research repositories to correlate that with diagnosis and other patient data in the EHR. These are then supplemented with data available with the external entity, Mycancergenome, for CDS and knowledge delivery purposes so that when a clinician clicks a link in the EHR genomic result report, a chart event occurs launching a web services best practice advisory (BPA) that queries the research repository for results not in the EHR. If returned ‘yes’ the BPA will show up with a link to query the repository and generate the report returning query results in the EHR for review of recommendations for therapy guidance vs. trial enrollment.
Start Date 
09/22/2017
Projected End Date 
03/22/2019
Project Tags 
  • All of Us
  • Clinical Genomics
  • EHR
  • FHIR
  • genomics
  • HL7
  • interoperability
  • NGS
  • NIH
  • ONC
  • ONC-led
  • Pharmacogenomics
  • PMI
  • Precision Medicine
  • Sync For Genes
  • Clinical Decision Support (CDS)
Project Point of Contact: sam2032remove@removemed.cornell.edu
Project Results 
To provide actionable feedback to the HL7® Clinical Genomics Work Group (CG WG) and advance the maturity of FHIR® Genomics, Sync for Genes Phase 2 engaged four unique pilot sites implementing the current FHIR® Genomics profiles in Standard for Trial Use (STU) 3. To help advance the maturity level of selected FHIR genomics resources, pilot sites were also encouraged to actively participate in and provide feedback directly to the CG WG. Feedback to the CG WG from the pilot sites on STU 3 implementations, in turn, support the development of the FHIR® specifications in Draft STU 4, which is not currently supported in EHRs. Pilot sites also participated in the Sync 4 Genes Scenario under the Clinical Genomics Track at the January 2019 HL7® Connectathon to further support the development of the FHIR® Genomics specification in Draft STU 4. The goal was to demonstrate connectivity and exchange of clinical genomic data using the FHIR® Genomics specification within an EHR.