They have established a coding vocabulary for genetic test results called CBO, or Clinical Bioinformatics Ontology. Genetic test results are associated with the concepts from the CBO, whereas a traditional observation like a pulse or blood pressure might be associated with a SNOMED (Systematized Nomenclature of Medicine) concept.
The CBO codes are open source and can be downloaded by anyone. SNOWMED and LOINC (Logical Observation Identifiers Names and Codes were evaluated for any duplicates efforts, but little or none were found, thus Cerner decided to create a vocabulary for genomics which began about 6 years ago.
The focus has been to make the presentation of the genomic information simple and not complicated and less focus on how the results were determined, which is good as that is what a physician needs is the information in the EHR quickly without the time involved searches on the web as the average office visit does not allow additional time for this. BD
November 11, 2008 | Molecular diagnostics laboratories that are doing clinical genomics “try to fit a round peg into a square hole, especially when it comes to workflow,” says Mark Hoffman, director of translational medicine at Cerner, the Kansas City-based health-IT player which has been targeting this market since 2005. “They try to use systems that were designed for traditional pathology and shoehorn those into a very unique and contemporary workflow, going into contortions to do that within their information system, especially with infectious disease testing.”
Cerner’s genomics solution is Millennium Helix, an offering that incorporates molecular diagnostic data into the electronic medical record, says Hoffman, who helped develop the bioinformatics system, which he says also streamlines processes and positions labs on the cutting edge of diagnostic medicine.
Say a patient has a genetic test for a gene that indicates whether they’re predisposed for an adverse drug reaction, within our architecture, the system can evaluate medication orders against both the genetic test results as well as other factors like drug allergy and drug interactions. So it enables us to take a very holistic approach to personalized medicine, where it’s not just genetic, not just allergy, but a combination of any factors that need to be taken into consideration.