Genomics-Enabled Learning Health Systems (gLHS)

Funding provided by:
National Human Genome Research Institute (NHGRI)
National Cancer Institute (NCI)

Incorporating genomics into learning health systems (LHS) is essential for advancing clinical care. LHS are designed to continuously improve the update of genomics into clinical care by analyzing patient data, implementing changes, and using the results to optimize medical care. LHS have gained traction due to advancements in electronic health records (EHRs) and health IT, which allow for improved data collection and rapid knowledge translation. Despite the increasing adoption of LHS in many aspects of clinical care, there has been a lack of adoption of genomics into LHS. By integrating genomics into this model, health systems can capture genomic information from every patient encounter, generating evidence that can enhance clinical decision-making and patient outcomes.

Background

The Genomics-Enabled Learning Health System (gLHS) Network investigators are at institutions with established LHS who are now working on integrating genomics into their LHS. The Network, consisting of one Coordinating Center (CC) and six Clinical Sites, is doing this by sharing their individual approaches and selecting those ready for implementation. The Network is working on up to four genomic medicine intervention projects for Network-wide implementation. The intervention projects are helping to improve interoperability and communication of genomic findings among clinicians, patients, and laboratories, and to demonstrate the value of these tools and resources in the adoption of genomics into clinical care.

To broaden the adoption of genomic medicine beyond the Network, Clinical Sites and the CC have partnered with champions from underserved healthcare settings. These partner champions are being incorporated early in the projects and are helping to provide the necessary input to ensure these approaches can be adopted in a wide range of health care settings. The intent of this approach is to understand and provide solutions that improve the feasibility of proposed implementation strategies beyond typically high-resourced LHS settings.

The CC will collect, organize, and promote the adoption of LHS tools and resources for the Network and broader research community, as well as coordinate Network logistics and dissemination, and contribute to data analysis and resource development. Dissemination of the tools and resources from the Clinical Sites will be publicized to the broader scientific community through a portal developed by the CC. Ultimately, the Network will develop successfully refined strategies and resources and will broadly disseminate them for adoption across diverse healthcare systems, including those in resource-limited clinical settings.

Coordinating Center and Clinical Sites

Coordinating Center

Awardees	Institution	Title	Grant Number
Josh F. Peterson, M.D., M.P.H. Carolyn Audet, Ph.D. Wesley Self, M.D., M.P.H.	Vanderbilt University Medical Center Nashville, TN	Coordination for Demonstrating Real-world Advancement in Genomics Operations Network (DRAGON)	1U01HG013771-01

Awardees

Institution

Title

Grant Number

Josh F. Peterson, M.D., M.P.H.

Carolyn Audet, Ph.D.

Wesley Self, M.D., M.P.H.

Vanderbilt University Medical Center
Nashville, TN

Coordination for Demonstrating Real-world Advancement in Genomics Operations Network (DRAGON)

1U01HG013771-01

Clinical Sites

Awardees	Institution	Community Partners	Title	Grant Number
Jason Vassy, M.D., M.P.H. Maren Scheuner, M.D., M.P.H. Deepak Voora, M.D. Lori Orlando, M.D.	Boston Veterans Administration Research Institute Boston, MA	VA Office of Rural Health VA Office of Primary Care	The VA Genomics Learning Health System: Implementing genomic medicine across diverse veteran communities	1U01HG013781-01
Adam Buchanan, M.P.H.	Geisinger Health System Danville, PA	Guthrie Clinic AtlantiCare	Making Genomic Medicine Routine in a Rural Healthcare System	1U01HG013796-01
Todd C. Skaar, Ph.D. Paul R. Dexter, M.D.	Indiana University School of Medicine Indianapolis, IN	Eskenazi Health Community Health Network	Implementing a genomics-enabled Learning Health System across Indiana	1U01HG013770-01
Patricia D. Franklin, M.D., M.P.H. Elizabeth M. McNally, M.D., Ph.D. Lucy A. Godley, M.D., Ph.D. Rinad S. Beidas, Ph.D.	Northwestern Medicine Feinberg School of Medicine Chicago, IL	AllianceChicago	Transforming health at the intersection of implementation science, learning health systems, and genomics at Northwestern Medicine	1U01HG013745-01
Kensaku Kawamoto, M.D., Ph.D. Mark Yandell, Ph.D. Martin Tristani-Firouzi, M.D.	University of Utah Health Salt Lake City, UT	Association for Utah Community Health	Empowering Interoperable Genomics-Enabled Learning Health Systems at Scale	1U01HG013784-01
Dan Roden, M.D. Sunil Kripalani, M.D. Alexander Bick, M.D., Ph.D.	Vanderbilt University Medical Center Nashville, TN	University of Miami Hospital	Vanderbilt Genomic Learning Health System Clinical Site	1U01HG013776-01

Goals

The central goal of the gLHS Network is to promote the broader adoption of genomics in clinical care where there is clear evidence supporting its need. The Network aims to achieve this by developing and validating tools and resources that can be widely applied. Once these tools and resources have been proven to enhance the adoption of genomics, they will be shared broadly to facilitate implementation across diverse healthcare settings. Additionally, the Network will gather evidence to assess the impact of these approaches on the integration of genomics into learning health systems.