Information for Patients
Here at Mount Sinai’s Institute for Personalized Medicine, we have developed the CLIPMERGE system. CLIPMERGE stands for CLinical Implementation of Personalized Medicine through Electronic Heath Records and GEnomics.
What is CLIPMERGE?
The CLIPMERGE system is an advanced software application that analyzes patient data, both genetic and clinical, and decides whether there is a risk to a patient that should be communicated to their doctor. Genetic results will be made available to physicians through a process called Clinical Decision Support (CDS).
How CLIPMERGE works in the provider’s office?
CDS consists of computerized alerts that appear on the physician’s computer screen as they are entering information through the hospital’s Electronic Medical Record (EMR) system. CDS allows researchers to send a message to a physician when there is information that we think will help them make a decision in a particular situation, such as when they are prescribing a medication. CDS might alert the physician to the fact the patient has an allergy to that medication, or CLIPMERGE may advise them that there is something in a patient’s genetic makeup that means that the drug or dose they chose to prescribe may not be the best choice. CDS can also offer a list of alternative recommended medications or doses at the time the alert is displayed to the physician.
What can CLIPMERGE do at Mount Sinai today?
Today, patients at Mount Sinai can already benefit from personalized medicine. For example, with the CLIPMERGE Pharmacogenetics project led by Dr. Omri Gottesman, BioMe participants undergoing routine care at Mount Sinai Medical Center consent to test their DNA for differences in genes that may suggest greater risk of side effects or chance of increased benefit from certain medications. These results will be made available to the patient's treating physician at the time they are prescribing certain medications.
Though pharmacogenomics represents the first-wave of genomic medicine that can be used in clinical care with clinical decision support, it is hoped and anticipated that with advances in genomics research tests will emerge to estimate a person’s risk for developing a disease, such as type 2 diabetes or heart disease, ushering in the era of true preventive medicine where patients can be treated to prevent the onset of a disease that they are likely to develop.
For example, with the CLIPMERGE Renal Care project led by Dr. Erwin Bottinger, BioMe participants of African ancestry with hypertension who are at risk for or who have chronic kidney disease can benefit from genetic information that will help their physician to make the best possible decisions about treatments to reduce or prevent kidney disease.