Clinician CME Tailored to Individual Patient's Whole Exome Results. M. A. Giovanni, M. F. Murray Genomic Medicine Institute, Geisinger Health System, Danville, PA.
Background: The Geisinger Health System Genome Sequencing Study (GSS) was launched in January 2014 and will generate whole exome sequence (WES) data on 100,000 unselected patient volunteers over a five-year period. The WES data is being generated in a research setting, and pathogenic or likely pathogenic variants are being identified in 75 clinically actionable genes. Variants will undergo CLIA validation by Sanger sequencing for clinical return of results to both patient and healthcare provider as well as documentation in the patients electronic health record. The clinician support infrastructure includes optional continuing medical education (CME) modules targeted specifically to their individual patients test result. Study Population: 100,000 Geisinger Health System patients will be consented and provide a sample in conjunction with a normal clinical blood draw. Geisinger clinicians throughout the healthcare system will be engaged in genomic results delivery due to their patients participation in the GSS. Methodology: A list of 75 genes for which a pathogenic or likely pathogenic variant would be clinically actionable was developed and vetted as the Geisinger 75. The Geisinger 75 represents 26 monogenic diseases with autosomal dominant, autosomal recessive, and X-linked inheritance patterns. Twenty-six 30-minute free-standing CME modules were developed to guide the non-geneticist clinician through the clinical evaluation of their patient in light of the genomic findings. The modules are electronically hosted on the health systems website and include pre- and post-module evaluation. Results: These 0.5 hour educational modules respond to the workflow constraints of busy clinicians by offering focused, electronic CME opportunities at the point of care. Further details on the participation and performance of clinicians following the return of results are being tracked. Conclusions: As genomic data becomes increasingly available to inform individual patient care, non-expert clinicians will most likely seek opportunities to augment their knowledge and understanding of applied genomics prior to delivering results to their patients. Individual CME modules targeted to patient-specific test results will improve clinician preparedness for delivering genomic results to their patients.
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