From 2017 to 2021, I worked at Kaiser Permanente Northwest (KPNW). There, I worked on the Cancer Health Assessments Reaching Many (CHARM) study (MPIS: Drs. Benjamin Wilfond and Katrina Goddard), a part of the NHGRI-funded CSER consortium with co-funding from the NCI. On that project, I led the adaptation of the PREMM5™ provider-facing application and the B-RST™ 3.0 into a patient-facing risk assessment web application for use by the low-literacy, low-resource study population. I coordinated two multi-site workgroups and an onsite software development team that collaborated with patient stakeholders from Denver Health in an iterative design process to ensure the application was accessible to patients from medically underserved populations. I also led the development of a data model that supported structured capture of participant interactions with the tool and trained the multi-site recruitment team in its use. In my mentored supplement to CHARM, I led an interdisciplinary qualitative and quantitative evaluation of these patient-facing web tools and trained in qualitative interview and analysis techniques.
In my post at KPNW, I was a member of the Clinical Genome Resource (ClinGen) Actionability Working Group (PI: Dr. Katrina Goddard). In this role, I assisted with adaptation of an actionability protocol from the adult setting to the pediatric setting. These protocols outline a standardized process to identify and synthesize evidence regarding the clinical actionability of genes and disorders associated with secondary findings during genetic testing. I applied both protocols to curate reports that were scored by experts and disseminated to the public on clinicalgenome.org. I also applied my experience with structured genomic data models and ontologies to provide user specifications for the actionability curation interface. The results of this work are used by the ACMG Secondary Findings WG and the Centers for Disease Control to provide professional recommendations about the return of secondary findings to patients undergoing genome-wide sequencing in both the adult and pediatric settings.
At KPNW, I have participated in the CDC-funded Vaccine Safety Datalink (VSD) project at the Research Associate III and co-investigator levels at the Kaiser Permanent Northwest site (PI: Dr. Allison Naleway). I was actively involved in workgroups and proposal development that addressed safety outcomes associated with adolescent vaccination. In this role, I have contributed to the development of two VSD proposals and designed the data model for evaluation of outcomes for one of these funded proposals. I also contributed to work on the association of primary ovarian insufficiency/infertility with adolescent vaccinations, published in Pediatrics.
In my current post, I'm leading integration of research components into the electronic health record (EHR) for the Vanderbilt University Medical Center (VUMC) site of the NHGRI-funded Electronic Medical Records & Genomics (eMERGE) Network (MPIs: Drs. Dan Roden, Wei-Qi Wei, and Digna Velez Edwards). This role involves working directly with VUMC HealthIT and other technical development roles to integrate study-generated discrete and non-discrete data, including family history and genomic data, directly into the EHR. I am also directing the integration of study-generated clinical decision support to the EHR. I am key personnel on the Oncology Knowledge Rapid Alerts (OKRA) project (MPIs: Drs. Christine Micheel and Travis Osterman), which seeks to develop an open-source algorithm and API for computing and storing biomarker-driven CDS from the My Cancer Genome (MCG) knowledgebase and to develop methods for integration of biomarker-driven, human-readable CDS statements into the EHR. I support the Family History and Cancer Risk Study (FOREST) as study personnel; my primary responsibilities are manuscript drafting and methodology design. Additionally, I was recently added as co-investigator on the PREMMplus™ grant (PI: Dr. Sapna Syngal, Dana Farber Cancer Institute) to facilitate development of a web application akin to the PREMM5™ web application. At VUMC, I also support research conducted through a partnership between GE Healthcare and VUMC, research conducted through AACR Project Genie, and research in implementation science at the Hereditary Cancer Clinic at Vanderbilt-Ingram Cancer Center. Finally, I have served as a committee member and a research advisor to students in the Vanderbilt Master of Genetic Counseling (MGC) program.