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Strengthen federal and local policies to advance precision health implementation and nurses’ impact on healthcare quality and safety

      The American Academy of Nursing (The Academy) supports sustaining and building on institutional and regulatory policies to ensure that adequate infrastructure and workforce is in place for precision health implementation by nurses and other healthcare team members. In order to realize anticipated improvements in healthcare quality and safety, the Academy will continue to provide opportunities in the area of precision health policy development to Academy Fellows and nurses across the nation. In 2016, H.R. 34—the 21st Century Cures Act—was signed into law under the 114th Congress. This law supports the United States Department of Health and Human Services in the pursuit of precision health, with the goals of advancing disease prevention, diagnosis and treatment, as well as implementation of greater data sharing. Nurses are essential members of the health care team and continue to have a major role in precision health, however, more can be done if appropriate infrastructure is put into place to support precision health implementation and direct the goals toward improving healthcare quality and safety. The American Academy of Nursing (The Academy) fully endorses the policy recommendations that aim to strengthen nurses’ impact on advancing the implementation of precision health. The Academy supports nurses across the nation to: (a) participate in policy development and implementation of precision health across clinical and research settings; (b) ensure the routine collection of standardized nursing care data in electronic health records (EHRs), advocate for the collection and proper storage of additional data elements to more effectively apply genomic information, and demand that decision support mechanisms be developed and made available in EHRs to support the safe, secure, and effective use of genomic data; (c) understand and address gaps in what patients, research participants, and the public need to know about precision health implementation; and, (d) advocate for sufficient training, resources and continuing education on implementation of precision health including but not limited to, patient education and health literacy assessment, data security, decisions regarding return of genomic results, and clinical support for interpreting and acting upon genetic test results and clinically actionable findings. Furthermore, the Academy calls on the Department of Health and Human Services to strengthen requirements for electronic health records vendors and healthcare institutions to integrate precision health decision support technologies and data security measures that will improve nurses’ ability to make a positive and sustained impact on healthcare quality and safety.
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      References

        • American Academy of Nursing
        Strategic plan.
        American Academy of Nursing, Washington, D. C.2017
        • American Nurses Association
        Essentials of genetic and genomic nursing: Competencies, curricula guidelines, and outcome indicators.
        American Nurses Association, Silver Spring, MD2009 (2)
        • Caudle K.E.
        • Klein T.E.
        • Hoffman J.M.
        • Muller D.J.
        • Whirl-Carrillo M.
        • Gong L.
        • Johnson S.G.
        Incorporation of pharmacogenomics into routine clinical practice: The Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline development process.
        Current Drug Metabolism. 2014; 15: 209-217
        • Fossey R.
        • Kochan D.
        • Winkler E.
        • Pacyna J.E.
        • Olson J.
        • Thibodeau S.
        • Kullo I.J.
        Ethical considerations related to return of results from genomic medicine projects: The eMERGE Network (Phase III) experience.
        Journal of Personalized Medicine. 2018; 8: 2
        • Gaedigk A.
        • Ingelman-Sundberg M.
        • Miller N.A.
        • Leeder J.S.
        • Whirl-Carrillo M.
        • Klein T.E.
        • The PharmVar Steering Committee
        Pharmacogene Variation (PharmVar) Consortium: Incorporation of the human cytochrome P450 (CYP) allele nomenclature database.
        Clinical Pharmacology & Therapeutics. 2017; (epub ahead of print)https://doi.org/10.1002/cpt.910
        • Gottesman O.
        • Kuivaniemi H.
        • Tromp G.
        • Faucett W.A.
        • Li R.
        • Manolio T.A.
        • Williams M.S.
        The Electronic Medical Records and Genomics (eMERGE) Network: Past, present, and future.
        Genetics in Medicine. 2013; 15: 761-771
        • Hickey K.
        • Katapodi M.
        • Coleman B.
        • Reuter-Rice K.
        • Starkweather A.
        Improving utilization of the family history in the electronic health record.
        Journal of Nursing Scholarship. 2017; 49: 80-86
        • Hudson K.L.
        • Pollitz K.
        Undermining genetic privacy? Employee wellness programs and the law.
        New England Journal of Medicine. 2017; 24 (May; 2017 Epub-ahead of print)https://doi.org/10.1056/NEJMp1705283
        • Khoury M.J.
        • Iademarco M.F.
        • Riley W.T.
        Precision public health for the era of precision medicine.
        American Journal of Preventative Medicine. 2016; 50: 398-401
        • Maradiegue A.H.
        • Edwards Q.T.
        A primer: Risk assessment, data collection, and interpretation for genomic clinical assessment.
        in: Siebert D.C. Edwards Q.T. Maradiegue A.H. Tinley S.T. Genomic essentials for graduate level nurses. DESTech Publications, Inc, Lancaster, PA2016
        • McCormick K.A.
        Pharmacogenomics and documentation: New partnerships target optimized care quality and outcomes.
        Nursing Management. 2017; 48: 32-40
        • McCormick K.A.
        • Calzone K.A.
        The impact of genomics on health outcomes, quality, and safety.
        Nursing Management. 2016; 47: 23-26
        • Pharmacogenomics Research Network
        What is PGRN.
        (from)
        https://www.pgrn.org
        Date: 2017
        Date accessed: December 17, 2017
        • Pollitz K.
        • Rae M.
        Changing rules for workplace wellness programs: Implications for sensitive health conditions.
        Issue Brief Kaiser Family Foundation. 2017; (Retrieve May 29, 2017 from file:///C:/Users/vsmenzies/Desktop/FARES.OPA%202017/OPA/Expert%20panel/Pollitz.Rae.%202017%20brief%20on%20genetics.pdf)
        • Rehm H.L.
        • Berg J.S.
        • Brooks L.D.
        • Bustamante C.D.
        • Evans J.P.
        • Landrum M.J.
        • Watson M.S.
        ClinGen–the clinical genome resource.
        New England Journal of Medicine. 2015; 372: 2235-2242
        • Sperber N.R.
        • Carpenter J.S.
        • Cavallari L.H.
        • Damschroder L.J.
        • Cooper-DeHoff R.M.
        • Denny J.C.
        • Orlando L.A.
        Challenges and strategies for implementing genomic services in diverse settings: Experiences from the Implementing GeNomics In pracTicE (IGNITE) network.
        BMC Medical Genomics. 2017; 10: 35
        • U.S. Department of Health & Human Services
        (PharmGKB. Accessed December 17, 2017 from)
        • U.S. Department of Health and Human Services, The Office of the National Coordinator for Health Information Technology
        Precision Medicine Initiative (PMI) data security principles implementation guide.
        (2016; Accessed December 18 at)
        • U.S. Department of Health and Human Services
        (Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines. Accessed December 17 from)
        • U.S. Department of Health and Human Services
        (Sync for genes, 2016. Accessed December 18 from)
        • U.S. Department of Health and Human Services
        (Sync for Science (S4S), 2016. Accessed December 18 at)
        • Williams J.K.
        • Katapodi M.
        • Starkweather A.
        • Badzek L.
        • Cashion A.
        • Coleman B.
        • et al.
        Nursing engagement in genomic health for all individuals.
        Nursing Outlook. 2015; 64: 117-123