Enabling Personalized Medicine through Clincal Decision Support

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DESCRIPTION (provided by applicant): This five-year project seeks to develop a clinician-scientist with expertise in clinical decision support (CDS) into an independent investigator in genomic and personalized medicine. Personalized medicine entails the use of all available clinical, molecular, and genetic data to optimize patients' health, and genomic medicine - the use of genomic data to guide patient care - is an integral facet of personalized medicine. The candidate is an Assistant Professor of clinical informatics at Duke University with a Ph.D. in biomedical engineering. He will also earn an M.D. prior to the start of the award. The candidate is the architect of Duke University Health System's disease management system and the author of an international CDS standard. The candidate will be mentored by a group of established investigators headed by Dr. Huntington Willard, the Director of the Duke Institute for Genome Sciences & Policy. As the primary component of his career development activities, the candidate will pursue a mentored research project focused on the use of CDS to enable genomic medicine. The candidate will also pursue didactic and other structured learning activities, particularly in genomics; develop expertise in health IT standards relevant to personalized medicine; and prepare manuscripts and R01 grant applications based on the results of the mentored research project. The goal of the proposed training activities will be to develop a scalable and widely deployable CDS system that could serve as a prototype for a replicable approach to integrating genomic and personalized medicine into clinical practice. In pursuit of this goal, the research will be conducted in accordance with three specific aims: (i) to obtain expert consensus on how pharmacotherapy protocols for asthma, hypertension, and dyslipidemia could be enhanced based on the findings from pharmacogenomic research studies; (ii) to design, develop, and evaluate the usability of a scalable, widely deployable CDS system that supports the practice of genomic medicine; and (iii) to evaluate the clinical acceptability and potential impact of the personalized medicine intervention developed in aim 2 through a feasibility study. The CDS system developed in Aim 2 and evaluated in Aim 3 will support the personalized pharmacotherapy of asthma, hypertension, or dyslipidemia. The training and research will leverage unique scientific resources available at Duke University and will be conducted in the context of the mentors' ongoing research projects. This project seeks to improve public health by investigating how genomic information should be used to personalize and optimize the health care provided to individuals. The project directly addresses research areas identified as institutional priorities by the Department of Health and Human Services (the use of health information technology to enable personalized medicine) and by the National Human Genome Research Institute (the use of genetic information in clinical settings to improve health care).