Integrating Biomarker Testing into EHR Systems: Implications for the Laboratory Based on Findings from a Multistakeholder Summit

Abstract Introduction/Objective Guideline-driven tumor biomarker testing remains standard of care for precision oncology due to the increasing number of treatment decisions that can be made based on tumor-specific alterations. However, most electronic health record (EHR) systems lack bidirectional interfaces with labs that enable computerized order entry and tumor biomarker testing results. Without these integrations, cancer centers may experience delays in test ordering and resulting, manual data entry errors, and operational inefficiencies that impact patient care and survival outcomes. Methods/Case Report To explore how cancer centers, hospitals, oncology practices, and labs integrate EHRs to streamline cancer biomarker testing processes, the Association of Cancer Care Centers (ACCC), in partnership with LUNGevity, convened a multistakeholder summit on Oct. 4, 2023. The summit brought together clinicians, pathologists, genetic counselors, and administrators to discuss practical solutions to issues surrounding interoperability, clinical workflows, and access to clinical data. Results (if a Case Study enter NA) Key findings from the summit include: -EHR-integrated orders and results save time, reduce errors, and streamline clinical workflow. These electronic interfaces enable clear communication between multidisciplinary teams system-wide and ensure that required patient information is readily available at the time of therapy planning. -Standardized workflows that define test ordering, tracking, and resulting protocols for in-house and send-out testing offer important downstream benefits. Staff should clearly understand how specimens are handled for in-house and send-out testing. -Integrations should be planned and built based on the EHR/laboratory information systems (LIS) in place can incorporate solutions to integrate with reference labs using HL7 standards and/or add-on modules to enable discrete genomic data elements. Conclusion Clinicians, pathologists, and administrators should prioritize EHR/LIS integrations to enable more effective cancer biomarker test ordering and resulting. These pre/post-analytic processes have significant implications for patient care. Findings from this summit can enable cancer programs and labs to evaluate current processes, work collaboratively to build integrations, and streamline biomarker testing workflows to enhance the quality and efficiency of delivering precision oncology.