Designing an interoperable solution to support pharmacogenomic-guided prescribing in primary care: an implementer report.

Abstract

Describe the implementation of an interoperable solution to support pharmacogenomic-guided prescribing in primary care in the National Health Service, England. We used an iterative approach to software development going through clinical workflow mapping, architecture design and development, and pilot-testing. We configured a commercial health data management platform to store pharmacogenomic results in a structured format and created a knowledge base of pharmacogenomic guidance. This solution was deployed 'as-a-service' using an open application programming interface (API) specification, allowing third parties to receive pharmacogenomic results and guidance by querying the service using a patient identifier and medicine code. This was integrated with existing clinical decision support tools and presented contextual information to prescribers within their native electronic health record (EHR). Pharmacogenomic results and guidance will be used across care settings and have greatest utility at the point of prescribing. This requires a solution, which separates the data from the applications, allowing integration with different EHRs through APIs. A vendor-agnostic standards-based solution can support the implementation of pharmacogenomic-guided prescribing across primary care.