Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov 5:2015:466-74.
eCollection 2015.

Using Workflow Modeling to Identify Areas to Improve Genetic Test Processes in the University of Maryland Translational Pharmacogenomics Project

Elizabeth M Cutting  1 , Casey L Overby  1 , Meghan Banchero  1 , Toni Pollin  1 , Mark Kelemen  1 , Alan R Shuldiner  1 , Amber L Beitelshees  1
Affiliations

Using Workflow Modeling to Identify Areas to Improve Genetic Test Processes in the University of Maryland Translational Pharmacogenomics Project

Elizabeth M Cutting et al. AMIA Annu Symp Proc. .

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.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Current Workflow Model. Circles denote start and end of events, diamonds denote decision nodes, and rectangles represent tasks performed by the actors in that respective lane. Actionable results are defined as a patient genotype of “poor” or “intermediate” metabolizer. EHR, electronic health record; TPP, translational pharmacogenomics project; UMMC, University of Maryland Medical Center.
Figure 2.
Figure 2.
Proposed Workflow Model. Circles denote start and end of events, diamonds denote decision nodes, and rectangles represent tasks performed by the actors in that respective lane. Actionable results are defined as a patient genotype of “poor” or “intermediate” metabolizer. EHR, electronic health record; UMMC, University of Maryland Medical Center; LIMS; Laboratory Information Management System.
See this image and copyright information in PMC

References

    1. Shuldiner AR, Palmer K, Pakyz RE, Alestock TD, Maloney KA, O’Neil C, Bhatty S, Schub J, Overby CL, Horenstein R, Pollin TI, Kelemen MD, Beitelshees AL, Robinson SW, Blitzer M, McArdle PF, Brown L, Zhao R, Ambulos N, Vesely M. Implementation of Pharmacogenomics: The University of Maryland Program for Personalized and Genomic Medicine. Am J Med Genet C Semin Med Genet. 2014 Mar;166(1):76–84. - PMC - PubMed
    1. Overby CL, Cutting E, Williams MS. Using genomic medicine resources under three prescribing scenarios: issues with information seeking; Society of Behavioral Medicine Annual Meeting and Scientific Sessions; San Antonio, TX: 2015. accepted.
    1. Institute of Medicine (US) and National Academy of Engineering (US) Roundtable on Value & Science-Driven Health Care . Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary. Washington, DC: National Academies Press (US); 2011. 3, Healthcare System Complexities, Impediments, and Failures; pp. 117–171. - PubMed
    1. National Academy of Engineering (US) and Institute of Medicine (US) Committee on Engineering and the Health Care System . 4 Information and Communications Systems: The Backbone of the Health Care Delivery System. In: Reid PP, Compton WD, Grossman JH, et al., editors. Building a Better Delivery System: A New Engineering/Health Care Partnership. Washington, DC: National Academies Press; 2005. pp. 63–83. - PubMed
    1. Scott SA, Sangkuhl K, Gardner EE, Stein CM, Hulot J-S, Johnson JA, Roden DM, Klein TE, Shuldiner AR. Clinical Pharmacogenetics Implementation Consortium Guidelines for Cytochrome P450–2C19 (CYP2C19) Genotype and Clopidogrel Therapy. Clin Pharmacol Ther. 2011;90(2):328–32. - PMC - PubMed

MeSH terms

LinkOut - more resources