When Genomics Meets the EHR:
How NonStop Unified Data, Workflows, and Decisions
NonStop helped a leading healthcare organization integrate genomics into the EHR ecosystem, transforming how clinicians, genetic counselors, and data systems work together to deliver faster, more precise patient care.
The Challenge
For genetic counselors, every patient case feels like a race against fragmentation.
Genomic data lives in one system, clinical notes in another, and counseling insights are often buried in emails or static PDFs.
With test results sitting outside clinician workflows, counselors spent valuable time switching between portals, EHRs, and spreadsheets just to piece together a complete picture.
Every context switch delayed care, introduced risk, and created frustration for both clinicians and patients.
The organization needed a way to:
- Centralize patient clinical, genomic, and counseling data into one unified platform.
- Embed genomic insights directly inside the EHR for real-time access.
- Reduce context switching and improve time-to-decision during visits.
The Approach
From Disconnected Systems to Unified Intelligence
NonStop partnered with the client's genomics and IT leadership to architect and implement a SMART-on-FHIR, AI-powered genomics dashboard built to sit natively inside their EHR.Our mission was to make complex data invisible by designing an experience that felt natural to clinicians and powerful for counselors.
Handling the Volume and Complexity of Data
Before we could integrate anything into the EHR, we had to solve this foundational problem. Our approach was to build a genomic data ingestion and normalization pipeline that could absorb data from multiple upstream sources. This became the backbone of everything else we built.
FHIR/HL7 Integration Layer
We built a robust integration layer that subscribes to lab orders and results in real time, enabling automatic synchronization between LIMS and the EHR.
Through SMART on FHIR, clinicians can launch the genomics dashboard with a single click, no extra logins, no switching systems.
Genomics Normalizer
Our team parsed VCF and JSON files to extract and map relevant variants into standardized FHIR Genomics resources, ensuring data becomes interoperable and analysis-ready.
Unified Patient Graph
We built a dynamic unified patient profile that connects everything: demographics, test orders, variants, phenotypes, encounters, and counseling sessions, giving teams a living, 360° view of each case.
Clinical Decision Support (CDS)
Using deterministic rule-matching, we integrated CDS tools that surface the most relevant variants, care pathways, and clinical guidelines right inside the counselor's view. Our tool flags high-impact variants and suggests evidence-based treatment guidelines. It reduces clinician 'noise' by mapping genetic results directly to clinical practice guidelines.
Counselor Workspace
To empower counselors directly, we created a tailored workspace within the platform.It features timelines, pedigree previews, result summaries, and task lists, allowing counselors to navigate seamlessly between counseling history, test results, and recommendations.
EHR App Shell (SMART on FHIR Launch)
Finally, the system was wrapped in an embedded EHR app shell, launched directly within the clinician workflow through SMART on FHIR with single sign-on and contextual awareness.It feels like a native part of the EHR, not another system to manage.
Security, Compliance & Reliability by Design
Since the system handles sensitive patient and genomic data, NonStop engineered compliance into every layer.
SMART on FHIR + OAuth2: Secure authentication with role-based access.
Least-Privilege Scopes: Granular permission controls for PHI access.
Audit Logging: End-to-end traceability for all user actions.
PHI Encryption: Both at rest and in transit, ensuring HIPAA compliance and SOC2 audit readiness.
Reliability was just as critical, built on a microservices architecture, the platform scales effortlessly
while maintaining uptime and security across environments.
The Impact
Measurable Results, Meaningful Change
Genomic insights became instantly available within the clinical workflow, eliminating delays in accessing critical patient data
Care teams moved from fragmented systems to a unified, reliable patient view, improving coordination and clarity
Clinical decision-making became faster and more confident with contextualized, actionable information
Counseling workflows became more efficient, allowing teams to focus on interpretation and patient engagement rather than system navigation
The platform strengthened trust across clinicians and stakeholders by delivering consistent, secure, and production-ready interoperability
Why It Matters
This project became a model for how to bring genomics to the point of care without disrupting existing
workflows or introducing new complexity. You don't just build another dashboard, you enable a smarter,
faster, and more empathetic kind of healthcare.
FHIR-based interoperability
AI-assisted clinical decision support
Human-centred UX design
