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PROMISE (Personal Medical Safe) was a German research project which aimed to provide the responsibility of genomic data to the patient via a mobile app. The patient should accept or decline study requests to use his/her genomic data via the app. In the evaluation of the app the experiences with mobile health as well as the opinion on being the genomic data manager were measured. Furthermore, the test patients were asked about their opinion and their concerns on the PROMISE app. Most of the 19 test patients were aware of the high sensibility of genomic data and thought that the PROMISE app was a suitable solution. The largest part found it good that they were the responsible data owner. However, several participants also found it important to have a permanent contact person when it comes to questions on inquiries or the app. [ABSTRACT FROM AUTHOR]

Background: Pharmacogenomic Clinical Decision Support Systems (CDSS) are considered to be the most feasible tool for adopting pharmacogenomic testing into clinical routine. Objective: To discuss important factors for implementing pharmacogenomic CDSS into German hospitals. Methods: We analyzed two relevant studies. Furthermore, we interviewed data privacy officers of three German university hospitals and examined relevant legal regulations in literature. Results: There are three major barriers for implementing pharmacogenomic CDSS into German hospitals: (i) the legal uncertainty; (ii) the lack of machine-readable data; (iii) the remaining knowledge gap of both genetics and pharmacogenomics among physicians. Conclusion: The implementation of passive clinical decision support (CDS) for somatic mutations in the form of structured pharmacogenomic reports might be the most feasible CDS feature for clinicians in German hospitals. [ABSTRACT FROM AUTHOR]

Background: Nutrition support is an important aspect regarding the care of critically ill patients. Malnutrition affects the recovery process negatively. However, the impact on the clinical outcome is often underestimated in complex clinical settings due to several factors hindering optimization of nutrition. Objective: To identify the requirements for a clinical decision support system that enables the medical staff to improve its patients' nutritional status. Methods: A literature review and interviews with two senior physicians were conducted to refine the requirements for the support system as well as to determine the inclusion criteria for a subsequent intervention study. Results: The analysis resulted in: (i) the identification of 4 measurement parameters for the assessment of the nutrition status; (ii) the graphical layout in adherence to the standards-based implementation approach for the creation of multi-patient dashboards; (iii) the definition of the study group. The nutrition dashboard will be implemented and integrated based on the set requirements, followed by an intervention study evaluating the dashboard's efficacy. [ABSTRACT FROM AUTHOR]

Background: German university hospitals have started to establish molecular tumor boards in order to enable physicians to make molecular-guided decisions. Objective: Our aim was to describe the organizational structure and procedures which are currently supporting the molecular tumor boards of five German university hospitals. Methods: We conducted semi-structured interviews with experts of five university hospitals between December 2016 and February 2017. Results: We observed heterogeneity in both the organization of genetic testing and the management of the molecular tumor boards among the five hospitals. They used free-text documents in most of their support procedures rather than machinereadable documents. Conclusion: There are three potentialities to support the process from genetic testing to reporting within the molecular tumor boards: (i) standardized pipeline to integrate automated variant calling and annotation; (ii) tools supporting the experts in creating their reports and presentations and (iii) implementing pharmacogenomic CDSS into clinical routine. [ABSTRACT FROM AUTHOR]