Purpose Pharmacogenomics is an important component of precision medicine. Informatics, especially clinical decision support (CDS) in the electronic health record (EHR), is a critical tool for the integration of pharmacogenomics into routine patient care. The purpose of this paper is to describe existing pharmacogenomic informatics models, identify key implementation steps, and discuss emerging resources to facilitate the development of pharmacogenomic clinical decision support in the EHR. Summary Effective integration of pharmacogenomic CDS into the EHR can address implementation barriers, including the increasing volume of pharmacogenomic clinical knowledge, the enduring nature of pharmacogenetic results, and the complexity of interpreting results. Both passive and active CDS provide point-of-care information to clinicians that can guide the systematic use of pharmacogenomics to proactively optimize pharmacotherapy. Key considerations for a successful implementation have been identified including clinical workflows, identification of alert triggers, and tools to guide interpretation of results. These considerations are described along with emerging resources from the Clinical Pharmacogenetics Implementation Consortium (CPIC) and National Academy of Medicine. Conclusion Pharmacogenomic CDS in the EHR is essential to curate pharmacogenomic data and disseminate patient-specific information at the point of care. These tools facilitate prescribing optimal drug therapy based on a patient’s inherited genetic profile and ensure that genotype-guided therapy is used whenever available. Multiple model practices have demonstrated the feasibility of developing pharmacogenomic CDS within commercially available EHRs. In some situations, ancillary systems and applications outside the EHR may be integrated to augment the capabilities of the EHR.

This survey found that informatics and medication-use system technologies are widely present in all steps of the medication-use process. These technologies touch all health care professionals in the hospital and demonstrate the significant responsibility the pharmacy department holds for these technologies.

This survey found widespread use of pharmacy informatics and technology across the entire medication-use process. Considerable progress was demonstrated in meeting meaningful-use measures for EHRs and meeting the recommendations of the ASHP PPMI.

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