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By Megan Schmidt, SVP of Product, Interoperability, ELLKAY
Reposted from Canadian Healthcare Technology, May 2026 issue
Across Canada, genomics and precision medicine are transforming the delivery of care, particularly in oncology. From somatic testing to targeted therapies and biomarker-driven treatment selection, the promise of precision medicine is clear: better outcomes through more informed, individualized decisions.
However, the success of precision medicine does not rely on science alone. It depends equally on the digital and operational infrastructure that connects ordering, specimen procurement, laboratory analysis, results delivery, and longitudinal patient data across the healthcare continuum.
Genomic laboratories across Canada are making significant investments in precision initiatives. Their work is evidence-driven and deeply committed to improving patient outcomes. Yet delivering genomic testing within real-world oncology workflows brings considerable operational complexity. It requires determining the appropriate test based on the patient’s diagnosis and stage of cancer, ensuring timely and accurate specimen procurement, tracking orders in real time, and delivering structured, actionable results back to the treating clinician. It also involves supporting tumor boards and multidisciplinary teams all while integrating results seamlessly into the longitudinal health record.
Each of these steps is critical, and each introduces potential friction. In oncology, timing is not an abstract concept. Minutes, days, and overall turnaround time directly influence treatment pathways as well as the lives of the patients. A delay in ordering or communicating results can alter the course of care and the patient’s overall wellbeing. Precision medicine depends on close coordination among pathologists, oncologists, laboratory professionals, and digital health teams to ensure that insights translate into timely, informed clinical decisions.
Technology must support, not complicate, these workflows.
One emerging challenge in genomics is fragmentation at the point of order entry. As testing options expand, providers are often asked to navigate multiple external portals or duplicative workflows. This increases administrative burden and introduces the risk of incomplete information transfer.
Long-term sustainability depends on integration: seamlessly incorporating genomic ordering and tracking into current clinical workflows, with results delivered as structured, actionable data that supports interpretation, longitudinal analysis, and searchability.
When ordering, tracking, and results management are aligned within the broader digital ecosystem, clinicians benefit from:
For Canadian health systems navigating provincial interoperability strategies and digital modernization efforts, integration also supports standardization and scalability across sites of care.
Precision medicine is inherently data driven, yet genomic insights must be accessible and actionable within everyday clinical workflows to truly support care delivery, research, and population health efforts. Through structured data exchange, organizations can conduct global cohort searches based on diagnosis, stage, and genomic findings, equip tumor boards to review complex cases with confidence, drive quality improvement and utilization analyses, and enhance collaboration between oncology programs and research networks.
Too often, genomic results are delivered in static formats that limit downstream use. Moving toward structured, interoperable data ensures that somatic testing results become part of the broader clinical narrative rather than remaining isolated artifacts.
ELLKAY processes 1.5 billion documents per month, connecting 750+ EHR systems to ensure genomic data reaches clinicians in structured, actionable form.
Pathology laboratories are foundational to effective genomics programs, yet genomic strategies sometimes fail to reflect the practical workflow, staffing, and system constraints present in hospital-based pathology and oncology environments.
Effective integration requires a deep understanding of laboratory information systems (LIS), hospital information systems (HIS), oncology workflows, and clinical decision support tools. It requires recognizing that precision oncology is not a standalone service line; it is embedded within complex care pathways.
By aligning digital solutions with existing clinical workflows, health systems can reduce unnecessary repeat testing, improve utilization of genomic testing, and support more informed therapeutic decisions.
Cancer care is rarely linear. Patients may move across institutions and provinces. Additional testing may be required at recurrence or progression. New targeted therapies continue to emerge. Precision medicine must be supported by a longitudinal view of the patient’s health journey.
Incorporating genomic data into the complete health record allows clinicians to review prior tests, interpret findings within the full clinical context, and reduce unnecessary repeat diagnostics. It also promotes seamless care coordination across community oncology practices, tertiary centers, and academic institutions.
This longitudinal approach is particularly relevant in Canada’s publicly funded healthcare system, where coordination across jurisdictions and care settings is essential to equitable access and sustainability.
The ultimate measure of precision medicine is not the sophistication of a test, but the impact on patient outcomes. Delivering the right therapy sooner can extend survival, reduce toxicity, and improve quality of life.
To achieve that impact at scale, Canada’s genomics ecosystem must continue to invest not only in scientific advancement, but also in the digital and operational frameworks that enable timely, accurate, and actionable information flow.
Precision medicine demands more than innovation. It demands integration, workflow efficiency, and a shared commitment to longitudinal, connected care.
By fostering collaboration between genomic laboratories, pathology services, hospitals, health systems, and digital health partners, Canada can continue to advance a precision medicine model that is analytically rigorous, operationally sound, and ultimately centered on improving lives.
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