Integrating electronic health records (EHRs) to facilitate cancer biomarker testing: Real-world implementation barriers and solutions.

Abstract

e13649 Background: Effective integration between EHRs and cancer biomarker testing processes is an unmet need across academic and community settings. Despite the benefits of EHR-integrated workflows and the desire for streamlined test results, as supported by a recent ASCO Workforce Survey, many health systems do not currently have this capacity, especially when reference labs are external to the ordering institution. Methods: The Association of Cancer Care Centers (ACCC) convened a live summit on October 4, 2023 to understand facilitators and barriers to integrating biomarker orders and results into the EHR. To capture a comprehensive perspective, ACCC convened 37 oncologists, pathologists, nurse navigators, and administrators from diverse settings using a range of EHRs, patient advocacy groups, and EHR/testing companies. Thematic analysis of the summit transcript and a post-summit assessment was employed to identify common experiences among participants. Results: The key benefits of EHR integration include increased efficiency with test ordering/result retrieval, streamlined communication, and improved clinical decision-making. Factors associated with successful EHR integration include strong clinical champions, creation of a precision medicine oversight committee, buy-in from administrative leadership, IT support to build EHR customizations, support from EHR vendors/reference labs, and coordinated project management. Notable barriers include variations in EHR interoperability, utilization of multiple reference labs, lack of consistent nomenclature, resistance to change, allocation of time for post-integration updates/maintenance, lack of internal IT capabilities/resources, and a need to establish different clinical workflows depending on which clinician places the biomarker order. Conclusions: The rapid expansion of biomarker-driven cancer treatments requires oncologists to have timely access to guideline-concordant clinical information to inform complex clinical decision-making. While EHRs can streamline clinical workflows, these results underscore the need to address operational and human factors to facilitate successful EHR-laboratory integration. Strategies to address barriers and build successful EHR integrations across diverse clinical oncology settings are crucial for optimizing how cancer biomarker tests are ordered, reported and used in clinical practice.