I was recently briefed by company representatives about a relatively new lab IT product called GenoSpace. Broadly defined, it's a cloud-based application to which a molecular/genomics lab located, say, in a hospital, uploads test results for a patient. These results are then paired with relevant information stored within the GenoSpace cloud, enabling the hospital-based pathologist who logs on to the GenoSpace portal to interpret the patient's results. The oncologist treating the patient can also participate in this dialogue. The final step is the publication and dissemination of a report for local viewing. GenoSpace uses a white label business model whereby such reports are labeled with the name of the hospital.
I could not do justice here to the range and complexity of the genomic and molecular testing information provided by the company that was demonstrated for me. Suffice it to say that a large amount of information is wrapped around a patient's molecular/genomic data which enables a pathologist and oncologist to generate a diagnosis and therapeutic recommendation. I was told that the company does not want to be in the test interpretation business -- only to enable such interpretation by physicians at the hospital level.
The GenoSpace technical and business model closely adheres to what I have described as ideal for hospital-based pathologists and clinicians, namely an -omics cloud (see: The -Omics Cloud: A Healthcare IT Solution Already Developed for Genomics Research; Genomics-Based EHR: Is This a Realistic Expectation?; Cloud Based Genomics Launched by Baylor and Amazon Web Services). The company is relatively new but seems to have gotten nearly everything right from my perspective. However, greater LIS integration needs to be addressed. At the present time, I believe that the primary publication method is a PDF report.
In my opinion, the EHR is not, nor will ever be, an "engine" for generating new, unique clinical information such as that contained in the GenoSpace report. Moreover, many people would describe an EHR like Epic as a closed system (see: Will Epic End Up as a Victim of Its Own Success?; A Different Paradigm for Analyzing the Competition between Cerner and Epic). I have been told by a colleague that the Epic system will "grudgingly" accept a PDF report from the lab.
I doubt whether we will ever see complex genomic data tightly integrated into a monolithic database like that of Epic. The reason for this is that a company like GenoSpace will want to control its own cloud real-estate to keep up with genomic science and also to improve the functionality of its software. It seems very possible to me that much of the molecular/genomic test interpretation will continue to evolve separately in the cloud.