September 22, 2015

Featured Poster of the Day from Individualizing Medicine Conference 2015

By Jeff Briggs
Dr. Megan Landsverk

Dr. Megan Landsverk

Megan Landsverk, Ph.D., FACMG

Megan Landsverk, Ph.D., FACMG
Director, Molecular Genetics Laboratory
Sanford Health
Sioux Falls, South Dakota

Dr. Megan Landsverk is the director of the Molecular Genetics Division of the Sanford Medical Genetics Laboratory in Sioux Fall, South Dakota. She received Bachelors of Science degrees in both Biology and Chemistry from the University of North Dakota and went on to earn her Ph.D. in Biochemistry and Molecular Biology from Baylor College of Medicine. Following a postdoc in pediatric genetics, Dr. Landsverk returned to Baylor to pursue an American Board of Medical Genetics fellowship in Clinical Molecular Genetics.  She remained at Baylor as an assistant director of the Baylor Medical Genetics Laboratory prior to joining Sanford Health in 2013.

The work that Dr. Lansverk is doing is part of the Sanford Imagenetics initiative, a program that integrates clinical genetics into the everyday practice of primary care for adults across the entire Sanford enterprise.  As part of that initiative, Dr. Lansverk and Sanford are offering a pre-emptive pharmacogenetic screening panel to patients to provide physicians with the information they need for more precise prescription of medications.  The laboratory software that is used to perform the testing and analyze the data is completely integrated with the Electronic Health Record allowing for a seamless transfer of information including patient demographics and test results.

Dr. Landsverk’s poster for the Individualizing Medicine Conference 2015 highlights pharmacogenetics, the study of how genetic changes in a person’s body affect how they metabolize drugs.  The testing that Dr. Lansverk performs in her laboratory incorporates the results directly into a patient’s medical record.  This allows a physician to tailor a drug therapy based on a patient’s genetic makeup ensuring that they received the appropriate drug and dosage at the right time.

Here is the complete abstract from Dr. Lansverk’s Featured Poster of the Day.

Meagan - Poster2


Topic: E.H.R. implementations, pharmacogenomics, cloud based

Rapid implementation of a system-wide, high-throughput, EHR-integrated pharmacogenetics clinical service through cloud-based software automation

Track: Pharmacogenomic

Rapid implementation of a system-wide, high-throughput, EHR-integrated pharmacogenetics clinical service through cloud-based software automation

Adoption of precision medicine has the potential to improve quality of care while reducing toxicity, unnecessary treatments, and cost. In particular, availability of pharmacogenetics (PGx) data before a drug is ordered can improve patient safety. Sanford Health is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics. In 2014, we initiated a program to integrate genomic medicine into adult primary care. A priority was implementation of a system-wide PGx clinical service with 3 components: 1) Fast-turnaround in-house analysis of drug metabolism genes, 2) delivery of clinically actionable results to the electronic health record (EHR) system, and 3) integration of PGx results into clinical workflow via real-time alerts at the time of drug ordering. To ensure accurate decision support based on clinically valid gene-drug relationships, the in-house panel only contains genes with clear clinical dosing guidelines published by the Clinical Pharmacogenetics Implementation Consortium (CPIC), including CYP2C19, CYP2D6, CYP2C9, CYP3A5, VKORC1, TPMT, and DPYD. Syapse Precision Medicine Platform (PMP) software was used to automate receipt of test orders from the EHR, convert nucleotide-based genotyping results to corresponding star (*) alleles, and convert star alleles to enzyme metabolizer status. Results were then automatically delivered back to the EHR. To determine the efficacy of Syapse PMP for clinical PGx services, we compared manual entry, data review, and result reporting of 60 samples to automated processing by Syapse PMP. The manual process had a 5% error rate and took over 20 person-hours. One sample had an incorrectly spelled last name, one had the incorrect gender, and another was reported as wild-type for CYP2C19 instead of *1/*2 and thus would have been misreported as an extensive metabolizer instead of intermediate. Using Syapse PMP, no manual sample entry was required, eliminating the need for paper requisition forms. Data review and reporting were reduced to 2 hours, with no processing errors. Automation with Syapse PMP enabled Sanford Health to implement a clinical PGx service in less than 5 months and trigger best-practice alerts with patient-specific decision support content to fire upon ordering of a corresponding drug in the EHR.


Tags: center for individualized medicine, Dr. Megan Landsverk, Individualized Medicine Conference 2015, pharmacogenomics, Uncategorized

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