How a Digital Platform Provides Genomic Data at the Point of Care

The emergence of next-generation sequencing technology has led to widespread genomic testing and the availability of genomic data, providing a way for clinicians and patients to better understand disease risk and health outcomes.

However, the rise of genomic data in clinical care has come with several informatics challenges. Provider organizations have to find ways of managing large amounts of data, interpreting genomic test results, and using these results to make more informed clinical decisions.

At NorthShore University HealthSystem, researchers recognized the need to implement a tool that could help integrate genomics with routine clinical care. After deploying a commercial solution, it became clear to leaders that the organization would have to build its own platform to advance its precision medicine efforts.

“Genomics is moving rapidly and the technology is changing quickly, so agility is very important. We decided we needed to build a solution internally to have competency in this area,” Kamalakar Gulukota, PhD, Director of the Center for Bioinformatics and Computational Biology at NorthShore, told HealthITAnalytics.

The NorthShore team developed Flype, an informatics platform that allowed the organization to securely accept data from multiple sources, send orders to a variety of destinations, and perform secondary analysis and annotation of genomic data. The platform also acts as a central repository for all genomic variants, and it can send signed out data to the EHR as both PDF and discrete elements.

The tool has enabled NorthShore to expand its next-generation sequencing services and collaborate with different vendors.

“Genomic data is not mature like radiology data or biochemistry data. It’s a resource that’s evolving very rapidly not just in terms of the sequencing technology, but also in terms of the format of the data and the way it’s interpreted,” said Gulukota.

“Having something internal that we control and can adapt to multiple different systems has helped us with genomics because the technology keeps changing. In the past five years as we've been ramping this up, we've had no less than six or seven different platforms and partners that we have worked with either internally or outside, and we've been able to seamlessly move among them.”

During the pandemic, the platform has been able to translate data as well as lab and diagnostic tests across systems – including COVID-19 test results.

“In the early days of the pandemic, we had to find out how to get COVID-19 test results into the EHR so that they were accessible to clinicians and other providers who need them. The test was very new – we were one of the first to develop it in the entire Midwest. And we found that there was some amount of red tape in getting there,” Gulukota said.

“With Flype, we were able to provide clinicians with an idea of when test results would be expected for each individual patient. Our connectivity to a large number of different systems allowed us to build that out.”

As the healthcare industry is well aware, the presence of COVID-19 doesn’t mean that all other diseases temporarily disappear. Gulukota noted that Flype has been an integral part of how genomic data comes back from vendors and is analyzed locally at NorthShore. The tool is able to present meaningful and actionable information within the EHR when providers need it.

“There are so many genomic data platforms coming up all the time. Sending a patient sample to get the genomic data isn't too big a challenge nowadays. But in the end, the question is how will it impact patient care at the right time? This is where Flype has been able to shine and where we go that last mile,” Gulukota explained.

“We take the data that exists and we're able to implement it as discrete data elements into the EHR. Within the EHR, there is a feature that triggers an alert when a drug being prescribed is unadvisable or when there is a drug that is better suited for the patient’s genome. So as a platform, Flype is not only doing the pipe lining and analysis, but it’s also connecting to the EHR to send the data in a discrete format. The tool provides helpful information in real time.”

Gulukota also pointed out that the tool has the potential to be deployed in other health systems as well.

“The solution has connections to some internal systems that are run in topology and microbiology, and obviously those systems would be different in different institutions. The main challenge would be to reconfigure these connections, but because we tried to build the platform using common standards, this is a challenge that can be overcome fairly easily,” he said.

With the field of genomics rapidly evolving, Gulukota noted that internal solutions will be key to delivering critical data to providers when they need it.

“As the technology, the data formats, and the knowledge base continue to change, we’re going to have to find ways to keep up with those changes. That kind of agility is absolutely important in order to be able to make progress in a rapidly evolving field,” he concluded.

“The EHR is very mature technology, and it isn't something that can be changed very quickly. Having a middleware platform like Flype not only takes care of this rapidly changing data, but also is able to connect to the EHR and deposit data in a way that is usable and can impact patient care. The agility of the platform and the ability to connect and disconnect to various systems has been the main strength that Flype has brought to our personalized medicine program.”