Pharmacogenetics has taught us that a person’s genes can play a major role in how that person will respond to different medications. In fact, the majority of patients have a genetic variant of some sort that is known to affect drug outcomes, and of the 100 most commonly prescribed medications in the U.S., 25 of them are known to have outcomes affected by pharmacogenetics. Dr. Jim Stevenson, assistant professor in the Division of Clinical Pharmacology, studies the effect of a patient’s drug metabolizing enzymes on their response to certain medications. Now, through the new pharmacogenetics eConsult in Epic, clinicians can contact Dr. Stevenson’s team directly to see if patients are a good fit for pharmacogenetics testing or to help interpret existing results.
From the Office of Telemedicine:
The Office of Telemedicine is excited to announce that Pharmacogenetics eConsults are live. These are available for both adult and pediatric patients. Check out the eConsult Workflow tip sheet.
eConsults are an Epic pathway for internal provider-to-provider consultation initiated by a JHM generalist (usually primary care) who submits a specific question to a JHM specialist for chart review and recommendations. Currently, eConsults are not available to providers at All Children’s Hospital. eConsults are a cost-effective way to reduce wait time and increase patient access to specialty care.
What kinds of clinical questions can be asked in a Pharmacogenetics eConsult?
This eConsult can be used to answer focused, non-urgent clinical pharmacogenetics questions. Pharmacogenetics refers to the influence of an individual’s genetics on medication efficacy or safety. The pharmacogenetics eConsult is intended for questions about germline genetics – not tumor genetics. The eConsult is available for pediatric and adult patients and will generally be answered by a pharmacogenetics pharmacist or clinical pharmacologist after reviewing the patient’s chart.
Examples of questions that would be appropriate for a Pharmacogenetics eConsult include:
From a Genetic Counselor
- I have a patient with pharmacogenetic results, and the report says a medication she is on is affected by her genetic result. Is this something I should counsel the patient on or inform their prescriber of?
From a Physician
- I have a patient with many drug allergies/intolerances. I am wondering if pharmacogenetic testing would help explain that.
- My patient is interested in pharmacogenetic testing. Can you help me determine what test to order, how to order it, and if it will be covered by insurance?
From a Pharmacist
- My patient handed me her pharmacogenetics results from an outside hospital. How do I document this?
Note – Historical eConsults for Dermatology and the OPAT program exist only for specific patient populations and is NOT for general use. If you have specific questions about their use, please contact the Office of Telemedicine at JHM_Telemedicine@jh.edu
Other available eConsults include (available for adult patients only):
- Neurology eConsult (Migraine, Neurovascular Imaging Abnormality, TIA)
- Vascular Surgery eConsult (Vascular Imaging Question)
- Adult Spine Surgery eConsult (Spine Imaging Question)
- Diabetes Mellitus eConsult
- Rheumatology eConsult (Positive ANA, Gout, Lyme Disease Rash)
- Genetics eConsult (also available to Pediatric patients)