FastTrack Pharmacogenomics and EHR Integration: Q&A with Rona Margaret Relova of the U.S. Department of Veterans Affairs
Dr. Rona Margaret Relova of the U.S. Department of Veterans Affairs pharmacogenomics (PGx) team on the team’s innovation, FastTrack PGx, winner of an InterSystems Impact Award 2025
Q1: What opportunity gave rise to the FastTrack PGx initiative (also called the PGx-Data Arch innovation), and what was the initial motivation behind it?
Dr. Relova: This innovation was primarily driven by the lack of interoperability of external sources and VA’s electronic health records (EHR) system. The reference laboratory could not send the PGx results directly into the patient’s electronic health records. The clinician would need to leave their normal interface and login to another resource. This process often dissuaded clinicians from utilizing PGx. Now, the clinician has FastTrack PGx (also called Data Arch) platform that allows easy access of PGx results. This enables the clinician to tailor prescriptions based on the patients’ genes, while removing the burden of manually pulling the PGx results.
Q2: What specific features of the FastTrack PGx (PGx-Data Arch) platform are contributing to the revolution in pharmacogenomics testing?
Dr. Relova: FastTrack PGx (also called Data Arch) platform allows data from external sources (reference laboratory) to integrate directly into the EHR system, enabling clinicians to access important information all in one place and have a more complete view of Veterans’ health.
Q3: How does the FastTrack PGx initiative integrate genetic testing results into the VA’s electronic health record system, what database and data platform technologies are used to support this integration, and what challenges did this initiative face?
Dr. Relova: Two microservices make up the Data Arch pipeline—one that receives and transforms the data (PGx results) into the correct format and the other pushes the results into the EHR as an unsigned note for the clinician to review. This process replaces the less reliable manual data entry that had to occur before.
Because the PGx results are easily accessible and obtained in a timely manner, clinicians end up utilizing PGx more. Consequently, the patients get the benefit of precision medicine. The Data Arch pipeline uses the Veterans Health Information Systems and Technology Architecture (VistA) for sharing data in the clinician’s workflow. Standardization was a challenge that was quickly overcome by bringing together stakeholders early in the design process.
Dr. Rona Margaret Relova is a Research Health Scientist from the Precision Health Service, VA Palo Alto, CA. She is making significant strides in delivering precision medicine nationally. As the 2024 Senior Innovation Fellow and the 2025 Diffusion of Excellence Fellow, she spearheads the FastTrack PGx (PGx-Data Arch) innovation.
This groundbreaking innovation is revolutionizing the integration of pharmacogenomics (PGx) into electronic health records. By resolving the lack of interoperability between systems, FastTrack PGx is ensuring Veterans receive tailored prescriptions based on their genetic makeup. The FastTrack PGx team’s health information exchange (HIE) innovation makes PGx easily accessible to prescribing clinicians, thereby minimizing side effects, and enhancing treatment outcomes of Veterans.
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PUBLIC SECTOR & HIE
Organization: U.S. Department of Veterans Affairs
Innovation Name: FastTrack PGx
World Winner – Realized Impact Regional Winner – North America
Pharmacogenomics (PGx) harnesses patient’s DNA (genetic profile) to prevent harmful side effects and to avoid the use of ineffective medications. Clinicians use PGx testing to avoid adverse drug events or to reduce the trial-and-error process of identifying a more effective medication. The FastTrack PGx (or the PGx-Data Arch integration) automates the steps that accelerate PGx results availability, shorten clinician interpretation time, and eliminate human data entry. This innovation reduces time and labor hours to resolve potentially fatal drug-gene interactions by at least half. FastTrack PGx plans enterprise-wide expansion.
Sponsored by InterSystems and selected by an independent panel of judges from Massachusetts Institute of Technology (MIT).