Abstract

The integration of electronic medical records (EMRs) and genomic research has become a major component of efforts to advance personalized and precision medicine. The Electronic Medical Records and Genomics (eMERGE) network, initiated in 2007, is an NIH-funded consortium devoted to genomic discovery and implementation research by leveraging biorepositories linked to EMRs. In its most recent phase, eMERGE III, the network is focused on facilitating implementation of genomic medicine by detecting and disclosing rare pathogenic variants in clinically relevant genes. Partners Personalized Medicine (PPM) is a center dedicated to translating personalized medicine into clinical practice within Partners HealthCare. One component of the PPM is the Partners Healthcare Biobank, a biorepository comprising broadly consented DNA samples linked to the Partners longitudinal EMR. In 2015, PPM joined the eMERGE Phase III network. Here we describe the elements of the eMERGE clinical center at PPM, including plans for genomic discovery using EMR phenotypes, evaluation of rare variant penetrance and pleiotropy, and a novel randomized trial of the impact of returning genetic results to patients and clinicians.

Highlights

  • As enthusiasm for the prospects of personalized or precision medicine has grown, there has been increasing interest in capitalizing on two parallel developments

  • In 2014, National Human Genome ResearchInstitute (NHGRI) issued a request for applications (RFA) for Electronic Medical Records and Genomics (eMERGE) Phase III with a primary goal of facilitating implementation of genomic medicine by defining health outcomes associated with rare variants in clinically relevant genes

  • The eMERGE III Network has brought together academic health centers around the nation to advance the integration of electronic medical records (EMRs)-linked biorepositories and evaluate the impact of genetic information on health outcomes

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Summary

Introduction

As enthusiasm for the prospects of personalized or precision medicine has grown, there has been increasing interest in capitalizing on two parallel developments. The increasing integration of electronic medical records (EMRs) into medical practice has created a growing repository of longitudinal data capturing real-world clinical phenotypes. In combination, these parallel developments provide a unique engine for discovery and implementation efforts in genomic medicine [1]. In 2014, NHGRI issued a request for applications (RFA) for eMERGE Phase III with a primary goal of facilitating implementation of genomic medicine by defining health outcomes associated with rare variants in clinically relevant genes.

Partners HealthCare Personalized Medicine
EMR Infrastructure
Partners HealthCare Biobank
Tools for EMR-Based Phenotypic Definition and Validation
Discovery
Evaluating Penetrance and Pleiotropy of Rare Variants
Cardiovascular Genes
Neuropsychiatric Genes
Selection of Immune Disease Genes
Implementation Research
Prior Experience with Return of Genetic Results at the Partners Site
Design
Findings
Conclusions
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