Coriell Life Sciences Uses the Cloud for Medication Decision Support

Coriell Life Sciences uses the AWS Cloud to provide patients, physicians, and pharmacists insight into the safest, most effective medications based on an individual’s DNA and other factors.

More than 131 million people—66% of all adults in the United States—use prescription medicines to manage health conditions, according to Georgetown’s Health Policy Institute. Utilization is highest among older people and those with chronic disease. Unfortunately, prescribing errors can cause adverse drug events (ADEs) that can result in costly emergency department visits, hospitalizations, and even death.

To evaluate medication safety, multiple variables must be weighed to find the balance between risk and therapeutic success for each individual patient. The answers are usually buried in a mountain of sources and data that are challenging and time consuming for doctors to review. To help tackle this challenge, Coriell Life Sciences (CLS)—a Philadelphia-based precision medicine company—launched GeneDose LIVE, a cloud-based decision support modeling tool for medication planning.

Until now, understanding prescription drug risks has often been medication-centric rather than patient-centric. GeneDose LIVE approaches the problem with the patient at the center. Patients simply go online to request an at-home DNA test kit, input basic healthcare information, and provide consent for the test. When the test arrives, they provide a saliva sample and simply mail the kit back to the lab. Data related to genetics, demographics, lifestyle, and medical conditions—all of which is de-identified for patient privacy—is then analyzed to assist healthcare providers in developing a medication action plan (MAP) uniquely tailored to a single individual. To date, more than 2,000,000 tests have been processed through the cloud-powered tool.

Drawing on decades of genetic research, GeneDose LIVE provides individuals, their physicians, and pharmacists insights into the safest, most effective medications for the patient based on DNA and dozens of other factors. Medicines that data show may be ineffective or harmful for an individual are flagged in the system. This allows physicians to evaluate the safety and efficacy of alternate drugs in near real-time based on risk factors that are specific to that patient. This information informs personalized prescribing decisions which are more likely to yield successful therapeutic results and reduce the risk of adverse drug effects.

“Helping clinicians make the most informed prescribing decisions doesn’t only improve how individuals feel every day,” says Scott Megill, President and CEO of Coriell Life Sciences. “Our research proves it can lead to a consistent reduction in inpatient visits, emergency department visits, and outpatient visits—eliminating needless waste and costs throughout the healthcare system.”

Physicians and pharmacists need access to a resilient, scalable, decoupled, and secure tool to guarantee consistent performance when evaluating patients. CLS meets these needs by building atop core Amazon Web Services (AWS) serverless, compute, storage, security, and database services. GeneDose LIVE’s near real-time modeling and personalization capabilities are powered by the speed and agility of the AWS cloud.

GeneDose LIVE collects, processes, and analyzes near real-time, streaming data so clinicians can receive timely insights and react quickly to new information. It accomplishes this using Amazon EventBridge, a serverless event bus that lets you receive, filter, transform, route, and deliver events. Using EventBridge, CLS is able to quickly sync patient data with GeneDose LIVE and update CLS’ extensive backend drug database as soon as new research is uncovered.

“GeneDose LIVE is a model example for the future of clinical decision-making tools,” says Zachary Wilson, PharmD, MBA, a clinical pharmacist with the Know Your Rx Coalition. “GeneDose LIVE makes pharmacogenomics data readily accessible to pharmacists and other healthcare professionals thanks to its intuitive user interface. The robust toolset offered by GeneDose LIVE allows the user to quickly highlight gene-drug, drug-drug, and lifestyle-drug interactions and then counsel patients using clinically backed recommendations.”

Amazon EventBridge and AWS Step Functions (Step Functions)—a service that provides serverless orchestration for modern applications—are also a key part of CLS’ DNA collection kit tracking system. They help ensure kit creation, shipping, and tracking happen seamlessly. As an example, using Step Functions, the system notifies CLS when there is an issue that requires human intervention.

AWS services like Amazon Elastic Container Service (Amazon ECS) and AWS Fargate facilitate resiliency by providing robust failover. They also help CLS scale on-demand as they serve a growing number of labs and health systems nationwide, all while maintaining a predictable pricing model. By leveraging Infrastructure as Code patterns that are easily implemented within AWS, CLS can concentrate on its core products and not worry about its infrastructure.

Furthermore, the GeneDose LIVE application is HITRUST certified and leverages AWS security best practices. To maintain a secure environment, CLS uses AWS WAF to protect against common web exploits and bots, VPC Flow Logs to log and view network traffic flows, Amazon CloudWatch to observe and monitor AWS resources and applications, and Amazon GuardDuty for intelligent threat detection. According to Kevin Livelsberger, Director, IT Security and Compliance at Coriell Life Sciences, this suite of advanced security tools provides a straightforward, referenceable audit trail.

“All of this convenience makes our jobs easier and enables our team to focus on our core business,” said Livelsberger.

Through GeneDose LIVE, CLS is leading the way in combatting adverse drug events. With the power of the AWS cloud, GeneDose LIVE is able to extract meaningful insights from vast pools of data and help deliver precision medicine at scale.

Learn more about Coriell Life Sciences and GeneDose LIVE at https://www.coriell.com/physicians-providers/.

Learn more about how AWS is helping power personalized medicine at https://aws.amazon.com/health/.