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The exponential rise in genomics research over the past decade has yielded a growing number of sequence variants associated with medication response that may have clinical utility. Despite existing barriers, attention is turning to strategies that integrate these data into clinical care. The CLIPMERGE PGx Program is establishing a best‐practices infrastructure for the implementation of genome‐informed prescribing using a biobank‐derived clinical cohort, preemptive genetic testing, and real‐time clinical decision support deployed through the electronic health record. Clinical Pharmacology & Therapeutics (2013); 94 2, 214–217. doi:10.1038/clpt.2013.72 [ABSTRACT FROM AUTHOR]

Background: Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little is known about emergency physicians' current perceptions of HIE.Objectives: This study sought to assess emergency physicians' perceived needs and knowledge of HIE.Methods: A questionnaire was developed based on heuristics from the literature and implemented in a Web-based tool. The survey was sent as a hyperlink via e-mail to 371 attending emergency physicians at 12 hospitals in New York City.Results: The response rate was 58% (n = 216). Although 63% said more than one quarter of their patients would benefit from external health information, the barriers to obtain it without HIE are too high--85% said it was difficult or very difficult to obtain external data, taking an average of 66 minutes, 72% said that their attempts fail half of the time, and 56% currently attempt to obtain external data less than 10% of the time. When asked to create a rank-order list, electrocardiograms (ECGs) were ranked the highest, followed by discharge summaries. Respondents also chose images over written reports for ECGs and X-rays, but preferred written reports for advanced imaging and cardiac studies.Conclusion: There is a strong perceived need for HIE, most respondents were not aware of HIE prior to this study, and there are certain types of data and presentations of data that are preferred by emergency physicians in the New York City region. [ABSTRACT FROM AUTHOR]

Objective: To examine the issues involved in mapping an existing structured controlled vocabulary, the Medical Entities Dictionary (MED) developed at Columbia University, to an institutional vocabulary, the laboratory and pharmacy vocabularies of the Yale New Haven Medical Center.Design: 200 Yale pharmacy terms and 200 Yale laboratory terms were randomly selected from database files containing all of the Yale laboratory and pharmacy terms. These 400 terms were then mapped to the MED in three phases: mapping terms, mapping relationships between terms, and mapping attributes that modify terms.Results: 73% of the Yale pharmacy terms mapped to MED terms. 49% of the Yale laboratory terms mapped to MED terms. After certain obsolete and otherwise inappropriate laboratory terms were eliminated, the latter rate improved to 59%. 23% of the unmatched Yale laboratory terms failed to match because of differences in granularity with MED terms. The Yale and MED pharmacy terms share 12 of 30 distinct attributes. The Yale and MED laboratory terms share 14 of 23 distinct attributes.Conclusion: The mapping of an institutional vocabulary to a structured controlled vocabulary requires that the mapping be performed at the level of terms, relationships, and attributes. The mapping process revealed the importance of standardization of local vocabulary subsets, standardization of attribute representation, and term granularity. [ABSTRACT FROM AUTHOR]