eHealth as a Facilitator of Precision Medicine in Epilepsy

Cavalleri, Gianpiero L.; Petrovski, Steve; Fitzsimons, Mary; Delanty, Norman

doi:10.1159/000481793

Cited by 4 publications

(6 citation statements)

References 31 publications

(37 reference statements)

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“…Both eHealth and medical genomics are evolving technologies and are entering mainstream medicine. [19][20][21] Here we demonstrate the development and incorporation of a genomics module into a bespoke epilepsy EPR. This genomics module is now routinely used at our multidisciplinary EGRM, and it is envisaged that soon it will be incorporated as part of the main clinical EPR of our patients.…”

Section: Discussionmentioning

confidence: 90%

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Development of a genomics module within an epilepsy‐specific electronic health record: Toward genomic medicine in epilepsy care

et al. 2019

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Objectives Both clinical genomics and e‐Health technology are changing the way medicine is being practiced. Although the basic clinical methodology of good medical care will remain unchanged, the combined power of genomics and electronic health records has the capability of enhancing, and in some cases transforming, the practice of medicine. This is particularly true in the care of patients with complex long‐term medical conditions such as chronic refractory epilepsy, especially in those with related complex comorbidities including intellectual disability and psychiatric disease. Methods Herein we outline the development and integration of an epilepsy genomics module into a preexisting epilepsy electronic patient record (EPR) system. Results We describe how this EPR infrastructure is used to facilitate discussion at multidisciplinary clinical meetings around molecular diagnosis and resulting changes in management. Significance This work illustrates the role of eHealth technology in embedding genomics into the clinical pathway.

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Section: Discussionmentioning

confidence: 90%

“…Both eHealth and medical genomics are evolving technologies and are entering mainstream medicine . Here we demonstrate the development and incorporation of a genomics module into a bespoke epilepsy EPR.…”

Section: Discussionmentioning

confidence: 98%

Development of a genomics module within an epilepsy‐specific electronic health record: Toward genomic medicine in epilepsy care

et al. 2019

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“…As we move forward, it is critical that coordinated research efforts are directed at pharmacogenomic research in seizures in the ICU along with technology for integration into routine clinical care that will aid in decision-making and also capturing outcomes. 131 The emergence of machine-learning approaches and data available for accounting for the dynamic physiologic changes seen in ICU patients who experience seizures is leading us into a new era of critical care practice where data-driven individualized care can be realized. 132 Derivation of this data is also instrumental for inclusion into clinical research for better patient stratification and more targeted seizure therapy.…”

Section: Advances In Big Datamentioning

confidence: 99%

Personalized antiseizure medication therapy in critically ill adult patients

et al. 2023

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Precision medicine has the potential to have a significant impact on both drug development and patient care. It is crucial to not only provide prompt effective antiseizure treatment for critically ill patients after seizures start but also have a proactive mindset and concentrate on epileptogenesis and the underlying cause of the seizures or seizure disorders. Critical illness presents different treatment issues compared with the ambulatory population, which makes it challenging to choose the best antiseizure medications and to administer them at the right time and at the right dose. Since there is a paucity of information available on antiseizure medication dosing in critically ill patients, therapeutic drug monitoring is a useful tool for defining each patient's personal therapeutic range and assisting clinicians in decision‐making. Use of pharmacogenomic information relating to pharmacokinetics, hepatic metabolism, and seizure etiology may improve safety and efficacy by individualizing therapy. Studies evaluating the clinical implementation of pharmacogenomic information at the point‐of‐care and identification of biomarkers are also needed. These studies may make it possible to avoid adverse drug reactions, maximize drug efficacy, reduce drug–drug interactions, and optimize medications for each individual patient. This review will discuss the available literature and provide future insights on precision medicine use with antiseizure therapy in critically ill adult patients.

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“…Continuous evolution of the Epilepsy EPR aims to advance a model of PFCC. [28][29][30] A novel genomics module in the EPR is promoting precision care by supporting a multidisciplinary team of clinicians, geneticists, and bioinformaticians in their interpretation of genomic sequence data in the context of an individual's phenotype. 29 Epilepsy EPR-based clinical data analytics is enabling interrogation of large volumes of population data to derive insights regarding disease progression and response to treatment that can be used in future clinical decision support, thereby personalizing care.…”

Section: Introductionmentioning

confidence: 99%

“…It supports a range of clinical tasks including in‐patient and outpatient care, outreach services, telephone/virtual clinics, epilepsy surgery, and vagus nerve stimulation (VNS) treatment. Continuous evolution of the Epilepsy EPR aims to advance a model of PFCC 28–30 . A novel genomics module in the EPR is promoting precision care by supporting a multidisciplinary team of clinicians, geneticists, and bioinformaticians in their interpretation of genomic sequence data in the context of an individual's phenotype 29 .…”

Section: Introductionmentioning

confidence: 99%

The development of an epilepsy electronic patient portal: Facilitating both patient empowerment and remote clinician‐patient interaction in a post‐COVID‐19 world

et al. 2020

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Objectives: The current coronavirus disease 2019 (COVID-19) pandemic stresses an urgency to accelerate much-needed health service reform. Rapid and courageous changes being made to address the immediate impact of the pandemic are demonstrating that the means and technology to enable new models of health care exist. For example, innovations such as electronic patient portals (ePortal) can facilitate (a) radical reform of outpatient care; (b) cost containment in the economically constrained aftermath of the pandemic; (c) environmental sustainability by reduction of unnecessary journeys/transport. Herein, the development of Providing Individualised Services and Care in Epilepsy (PiSCES), an ePortal to the Irish National Epilepsy Electronic Patient Record, is demonstrated. This project, which pre-dates the COVID-19 crisis, aims to facilitate better patient-and family-centered epilepsy care. Methods: A combination of ethnographic research, document analysis, and joint application design sessions was used to elicit PiSCES requirements. From these, a specification of desired modules of functionality was established and guided the software development.

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eHealth as a Facilitator of Precision Medicine in Epilepsy

Cited by 4 publications

References 31 publications

Development of a genomics module within an epilepsy‐specific electronic health record: Toward genomic medicine in epilepsy care

Development of a genomics module within an epilepsy‐specific electronic health record: Toward genomic medicine in epilepsy care

Personalized antiseizure medication therapy in critically ill adult patients

The development of an epilepsy electronic patient portal: Facilitating both patient empowerment and remote clinician‐patient interaction in a post‐COVID‐19 world

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