Table 3 Main topics and findings discussed relating to pharmacogenomics and potential unintended negative consequences

Major points raised during discussion

The results summary is generally sufficient

Physicians do consult the full report if:

Unfamiliar with vendor

Desire in-depth analysis

Clinical consideration

PGx is generally not used as a first step

Generally saved for poor responders or bizarre symptoms

Can be used to satisfy worried parents and patients

Providers-PGx trust is important to act on PGx results

Providers are more likely to trust familiar vendors

Allele and metabolizer information is important

Physical PGx reports may be handed to patients

To serve as a prop

To allow patients to supply other providers with PGx results

Current shortcomings with using PGx at the point of care

Clinicians have difficulty incorporating PDF reports in their workflow

PGx information does not integrate with patient information such as current and prospective medications at the point of prescribing

Alert fatigue

Unnecessary alerts should be avoided to limit distraction from important alerts

However, a lack of critical alerts is also negative

Difficulty to input relevant information

This type of information includes:

Ratings/scores from third party vendors

Hand-written lab reports

Addition of time to the length of visit

Providers generally only have 30 min for an examination

Providers are unlikely to use tools that increase time

Proper position of the CDS within the workflow will increase efficiency

Clinicians may lack trust in displayed data

Past experiences with CDS suggest not all relevant data are surfaced properly

Confirmation of the accuracy of information will ease some of these concerns

Frustration using CDS

Clinicians often deal with slow and inconsistent CDS

Clinicians will discard cumbersome CDS