Evaluation: A Qualitative Pilot Study of Novel Information Technology Infrastructure to Communicate Genetic Variant Updates

Abstract

Background: 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.

Objectives: 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.

Methods: 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.

Results: 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.

Discussion: Participants agreed that GIC implementation increased efficiency and effectiveness of the clinic through increased access to genetic variant information at the point of care.

Conclusion: 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.

Trial registration: ClinicalTrials.gov NCT01225978.

Keywords: Clinical informatics applications; clinical decision support; genetics; laboratory software; personalized medicine.

Conflict of interest statement

Conflicts of Interest

This research was conducted at Brigham and Women’s Hospital, which is an affiliated entity of Partners HealthCare. Partners HealthCare licensed the GeneInsight technology involved in this study in November 2012, to a company in which both Partners Healthcare and Sunquest currently have ownership interests. The Committee on Conflicts of Interest reviewed this research in light of Partners acquisition of this financial interest, and the committee, consistent with Partners policy, required that notice of Partners financial interest in the technology be provided to journals and in publications and presentations resulting from the research. No authors had personal financial interest in the GeneInsight technology beyond that associated with being employed by Partners Healthcare.

Figures

Fig. 1

GeneInsight Lab (GIL) and GeneInsight Clinic (GIC) high level workflow

Fig. 2

Screenshot of GeneInsight Clinic (GIC) variant interpretation page