Abstract:
The present invention relates to a method and system for determining whether an ordered genetic test will duplicate at least one existing genetic test result. The method includes receiving an ordered genetic test that is for a particular genetic sequence or variant thereof for an individual. The method further includes determining whether the individual has at least one existing genetic test result for the particular genetic sequence or variant thereof. Upon determining that the individual has at least one existing genetic test result for the particular genetic sequence or variant thereof, a notification of the existence of the at least one existing genetic test result is provided.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims the benefit of priority of U.S. application Ser. No. 10/886,335 entitled “COMPUTERIZED METHOD AND SYSTEM FOR AUTOMATED CORRELATION OF GENETIC TEST RESULTS,” filed Jul. 7, 2004, which claims the benefit of priority of U.S. Provisional Application No. 60/509,006 filed on Oct. 6, 2003, the disclosures of which are hereby incorporated by reference as if set forth in their entirety herein. 
    
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     Not applicable. 
     BACKGROUND 
     Unlike many patient test results in a health care environment, genetic test results generally have life-long value. Current clinical information systems are not able to automatically recognize discrepant or duplicate genetic test results generated at any point in an individual&#39;s clinical care. Current clinical heath care information systems also cannot appropriately reconcile discrepant or duplicate genetic test results. 
     As genetic testing becomes more prevalent, tools and methods to ensure quality and accuracy of genetic test results stored in electronic records will become increasingly necessary. A method and system for automatically correlating and comparing genetic test result values for individuals would be beneficial. 
     SUMMARY 
     In one embodiment of the present invention, the invention relates to a method for automatically determining the primary genetic test result for an individual. The method receives a first genetic test result from an individual&#39;s genetic history. The first result is identified as a primary genetic test result for the individual. The method receives a second genetic test result for the individual. Based on at least one result criterion, the method determines if the second genetic test result should be identified as the primary genetic test result for the individual and, if so, identifies the second result for said primary genetic test result in the individual&#39;s genetic history. 
     In yet another embodiment of the present invention, a method for automatically correlating genetic test results for an individual based on the method employed to determine first and second genetic test results is shown. The method receives a first genetic test result from an individual&#39;s genetic history, the first result is identified as a primary genetic test result for the individual. The method receives a second genetic test result for the individual and identifies a method employed to determine the first and second genetic test results. The method determines if the technique employed to determine the second genetic test result is superior to the method employed to determine the first genetic test result and, if so, identifies the second genetic test result as the primary genetic test result in the individual&#39;s genetic history. 
     In still another embodiment of the present invention, a system for automatically determining the primary genetic test result for an individual is shown. The system includes a first receiving module for receiving a first genetic test result from an individual&#39;s genetic history, the first result is identified as a primary genetic test result for the individual and a second receiving module for receiving a second genetic test result for the individual. The system further includes a determining module for determining based on the at least one result criterion if the second genetic test result should be identified as the primary genetic test result for the individual. If so, the system identifies the second result as said primary genetic test result in the individual&#39;s genetic history. 
     In yet another embodiment, a method for determining whether an ordered genetic test will duplicate at least one existing genetic test result for an individual is described. The method receives an ordered genetic test for an individual, where the genetic test is for a particular genetic sequence or variant thereof. The method determines whether the individual has at least one existing genetic test result for the particular genetic sequence or variant thereof; and if so, provides notice of the at least one existing genetic test result for the individual. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWING 
       The present invention is described in detail below with reference to the attached drawing figure, wherein: 
         FIG. 1A  is a block diagram of a computing system environment suitable for use in implementing the present invention; 
         FIG. 1B  is a flow diagram of a method and system for automatically correlating genetic test result values in accordance with an embodiment of the present invention; 
         FIG. 2  is a flow diagram of a method for correlating genetic test result values based on method used to generate the genetic test results in accordance with an embodiment of the present invention; 
         FIG. 3  is a flow diagram of a method for correlating genetic test result values based on method used to generate the genetic test results in accordance with an embodiment of the present invention; and 
         FIG. 4  is a flow diagram of a method for providing notice as to whether relevant genetic results exist for an individual in accordance with an embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     The present invention provides a system and method for automatically correlating genetic test results or orders for genetic testing. The system and method of the present invention allows genetic test results to be used throughout a person&#39;s life rather than for one or more specific encounters. The system and method of the present invention automatically determines whether a new genetic test result value received by the system duplicates an existing result, disagrees with an existing result and/or extends an existing result when a new technique is applied. The invention also allows inbound orders for genetic tests to be evaluated against historic orders to determine if there is redundancy and to allow the user to determine whether to proceed with the order. 
     With reference to  FIG. 1A , an exemplary medical information system for implementing the invention includes a general purpose-computing device in the form of server  22 . Components of server  22  may include, but are not limited to, a processing unit, internal system memory, and a suitable system bus for coupling various system components, including database cluster  24  to the control server  22 . The system bus may be any of several types of bus structures, including a memory bus or memory controller, a peripheral bus, and a local bus using any of a variety of bus architectures. By way of example, and not limitation, such architectures include Industry Standard Architecture (ISA) bus, Micro Channel Architecture (MCA) bus, Enhanced ISA (EISA) bus, Video Electronic Standards Association (VESA) local bus, and Peripheral Component Interconnect (PCI) bus, also known as Mezzanine bus. 
     Server  22  typically includes therein or has access to a variety of computer readable media, for instance, database cluster  24 . Computer readable media can be any available media that can be accessed by server  22 , and includes both volatile and nonvolatile media, removable and non-removable media. By way of example, and not limitation, computer readable media may comprise computer storage media and communication media. Computer storage media includes both volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information, such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVD), or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage, or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by server  22 . Communication media typically embodies computer readable instructions, data structures, program modules, or other data in a modulated data signal, such as a carrier wave or other transport mechanism, and includes any information delivery media. The term “modulated data signal” means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, communication media includes wired media, such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media. Combinations of any of the above should also be included within the scope of computer readable media. 
     The computer storage media, including database cluster  24 , discussed above and illustrated in  FIG. 1A , provide storage of computer readable instructions, data structures, program modules, and other data for server  22 . 
     Server  22  may operate in a computer network  26  using logical connections to one or more remote computers  28 . Remote computers  28  can be located at a variety of locations in a medical or research environment, for example, but not limited to, clinical laboratories, hospitals, other inpatient settings, a clinician&#39;s office, ambulatory settings, medical billing and financial offices, hospital administration, veterinary environment and home health care environment. Clinicians include, but are not limited to, the treating physician, specialists such as surgeons, radiologists and cardiologists, emergency medical technicians, physician&#39;s assistants, nurse practitioners, nurses, nurse&#39;s aides, pharmacists, dieticians, microbiologists, laboratory experts, genetic counselors, researchers, veterinarians and the like. The remote computers may also be physically located in non-traditional medical care environments so that the entire health care community is capable of integration on the network. Remote computers  28  may be a personal computer, server, router, a network PC, a peer device, other common network node or the like, and may include some or all of the elements described above relative to server  22 . Computer network  26  may be a local area network (LAN) and/or a wide area network (WAN), but may also include other networks. Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets and the Internet. When utilized in a WAN networking environment, server  22  may include a modem or other means for establishing communications over the WAN, such as the Internet. In a networked environment, program modules or portions thereof may be stored in server  22 , or database cluster  24 , or on any of the remote computers  28 . For example, and not limitation, various application programs may reside on the memory associated with any one or all of remote computers  28 . It will be appreciated that the network connections shown are exemplary and other means of establishing a communications link between the computers may be used. 
     A user may enter commands and information into server  22  or convey the commands and information to the server  22  via remote computers  28  through input devices, such as keyboards, pointing devices, commonly referred to as a mouse, trackball, or touch pad. Other input devices may include a microphone, satellite dish, scanner, or the like. Server  22  and/or remote computers  28  may have any sort of display device, for instance, a monitor. In addition to a monitor, server  22  and/or computers  28  may also include other peripheral output devices, such as speakers and printers. 
     Although many other internal components of server  22  and computers  28  are not shown, those of ordinary skill in the art will appreciate that such components and their interconnection are well known. Accordingly, additional details concerning the internal construction of server  22  and computer  28  need not be disclosed in connection with the present invention. 
     Although the method and system are described as being implemented in a WINDOWS operating system operating in conjunction with an Internet-based system, one skilled in the art would recognize that the method and system can be implemented in any system supporting the receipt and processing of genetic test results. As contemplated by the language above, the method and system of the present invention may be implemented on a stand-alone desktop, personal computer or any other computing medical environment, solitary research lab or any of a number of other locations. 
     With reference to  FIG. 1B , a method of automatically correlating genetic test result values  100  is provided. At block  101 , the system receives a genetic test result for an individual. The system of the present invention retrieves genetic test results for an individual from an application or module in a healthcare information technology (HCIT) system. Alternatively, the system may receive a genetic test results directly from a user. 
     At block  102 , the system queries the data structure (e.g., database) to determine whether compatible genetic test results exist for the individual. Compatibility can be determined by: matching identifiers from a controlled vocabulary, string matching or application of a semantic network that organizes genomic information. For example, if the genetic test result for the individual is a specific mutation in the gene that causes cystic fibrosis, the system queries to determine if the individual has pre-existing genetic test results for any versions of the cystic fibrosis gene or any cytogenetic observations that would include the cystic fibrosis gene. If, at block  102 , the system determines that the individual does not have pre-existing genetic test results in the database, the system recommends that the new genetic test result be identified and stored as the primary genetic test result for the individual at block  103 . Alternatively, the system automatically identifies and stores in a database, table and/or the individual&#39;s electronic medical record the new genetic test result as the primary result for the individual. The primary result is the persistent value for a specific genetic result for an individual. The genetic test result stored as the primary result is given priority when the genetic data is used such as in a healthcare information technology system (e.g., in a decision support rule, presentation to the clinician, etc.). Supplemental genetic test results may be stored with equal value to one another or may be ranked relative to one another. 
     If, at block  102 , the system determines the individual has a pre-existing primary genetic test result for the particular gene, the system obtains or receives the pre-existing genetic test result for the individual. The system proceeds to block  106  and receives result criteria. In one embodiment, the system queries a data structure (e.g. database or external reference table) for the result criteria to be applied. At block  107  the system determines whether the result criteria are capable of prioritizing results. If at decision block  107  the system determines that the result criteria are capable of prioritizing results, the system proceeds to block  108 . 
     Some of the result criteria that can be applied to determine which genetic test result should be the primary genetic test result include: the technique employed to obtain the genetic test result, information regarding the user performing the genetic test, such as user qualifications, the most recent genetic test result, instrument maintenance status, status of controls, statistical probabilities, attributes of the original sample and combinations thereof. 
     Degrees of certainty can be assigned to the techniques that are used to generate results. Based on a ranked list of available techniques, the system can automatically make the primary result the result that was generated by the highest confidence technique. Among the factors that can be included in the ranked listing of results are quality measures associated with various instruments. The resolution of a molecular diagnostic test or technique refers to the accuracy and reliability of test. For example, DNA sequencing to determine if a nucleotide replacement has occurred at a specific position may be defined as a higher-resolution technique than running polymerase chain reaction (PCR) with a specific probe for the polymorphism mutation. 
     Some current techniques for identifying a human mutation, including genetic test results, are listed in the following order beginning with the highest quality: DNA sequencing, Restriction Fragment Length Polymorphism (RFLP) and Allele specific PCR. For example if an existing result is generated by RFLP and the new result is generated by DNA sequencing, the system will determine that the new result was generated by a higher confidence technique and in turn the new result is promoted to be the primary result for the individual. If the new result had been generated by Allele specific PCR, the existing result generated by RFLP would have remained as the primary result because in this example RFLP is considered to be a higher confidence technique. One of skill in the art will appreciate that the techniques may be ranked in varying order depending on the outcomes generated by each result and the order of confidence may vary. Further, new techniques may also be developed and added to the list of techniques for generating genetic test results. 
     In systems that store credentials, years of experience, training status, personnel test scores or other means that can be used to consistently evaluate the likely qualifications of the person performing the test, this information may be used as a result criterion to be applied to select a primary result. The most recent result may also be used as a result criterion such that the most recent result is stored as the primary by default. The system may be configured to provide a time window during which this criterion may be applied. For example, result criterion regarding user qualifications will only be applied to results that were performed more than a week apart. 
     In systems where the maintenance of a device or instrument is logged into the system, the status of the devices relative to one another may be used as a result criterion. For example, the result from the most recently maintained device is identified as being primary result. In one embodiment, this result criterion is applied when the same technique is applied to generate conflicting results. Another result criterion is the status of controls. For example, if either one result was associated with a batch that included either a failed positive control or a failed negative control and the other result is associated with successful controls, the result with successful controls would be identified as the primary result. 
     Another result criterion that may be applied is the likelihood that one result is more accurate than the other. For example, if one result is statistically more probable than the other, based on factors such as known population genetics, then the result with the greatest statistical likelihood would be identified as the primary result. 
     Additionally, the attributes of the original sample may be used as a result criterion. If, for example, quantifiable attributes, such as purity or a specimen grading scale, are associated with information about the original sample, these attributes can be used to determine which result should be identified as the primary result. 
     Each of the result criterion may be applied individually, collectively or in a cascading manner as may be pre-defined in the system. A collective use of result criteria may include a combinatorial rating in which values from each result criteria are combined to determine which genetic test result should be primary. A cascading approach would involve relative ranking of the result criterion. Lower ranked result criteria would only be used when higher ranked result criteria fail to make a recommendation. For example, if two genetic test results generated by the same technique disagree, the user qualification result criterion is applied. 
     With reference to  FIG. 1B , at decision block  106 , it is determined whether the system is defined to use result criteria to determine whether the newly received genetic test result or the pre-existing primary genetic test result should be stored as the primary genetic test result for the individual. If so, the system proceeds to decision block  108  and determines whether the new result is superior to the existing primary result by applying result criteria. 
     At block  108 , if the system determines that the new result is superior to the existing primary result based on the result criteria, the system recommends to the user that the new result be stored as the primary genetic test result for the individual at block  110 . However, at block  108 , if the system determines that the new result is not superior to the existing primary result, the system recommends to the user that the new result be stored as a supplemental genetic test result for the person and the existing primary genetic test result remain the primary genetic test result at block  112 . The system receives the user&#39;s selection of which result to store as the primary result for the individual. The system provides a recommendation to a user so that based on the recommendation and the user&#39;s knowledge and training, the user can select which result should be stored as the primary result. At block  116 , the system stores the user&#39;s selection as the primary result. Alternatively, the system automatically stores either the new result or the existing primary result without making a recommendation to the user. 
     Returning to decision block  106 , if the system is not configured to use result criteria to determine whether the newly received genetic test result or the pre-existing primary genetic test result should be stored as the primary genetic test result for the individual, the system prompts the user to select which result to save as the primary result at block  114 . At block  116 , the system stores the selected result as the primary genetic test result for the individual and the other result as the supplemental genetic test result. In another embodiment, the user is given the opportunity to determine which of the results is given primary status in the system using their training and knowledge in combination with the recommendation of the system. 
     With reference to  FIG. 2 , a method of automatically correlating genetic test result values  200  based on resolution technique used result criteria is provided. At block  201 , the system receives a genetic test result for an individual. Again, the genetic test result may be for any organism and may be entered by a user or transmitted from another system. 
     At block  202 , the system queries the data structure (such as a database and/or the individual&#39;s electronic medical record) to determine whether a genetic test result exists for an individual for the genetic test result received. For example, if the genetic test results received for the individual is a specific mutation or polymorphism of the gene known to cause Alzheimer&#39;s, the system queries to determine if the individual has pre-existing genetic test results for any versions of the Alzheimer&#39;s gene or cytogenetic observations that include the Alzheimer&#39;s gene. If, at block  203 , the system determines that the individual does not have pre-existing genetic test results for the particular gene in the database, the system stores the new genetic test result as the primary result for the individual for the particular gene at block  203 . 
     If, at block  202 , the system determines the individual has a pre-existing genetic test result for the individual, the system obtains the pre-existing genetic test result for the individual and compares the newly received genetic test result with the existing genetic test result at block  204  to determine if the new genetic test result is different from the primary genetic test result that exists for the individual. If the new genetic test result and the existing primary genetic test result are the same, the system continues at block  205 . If the new genetic test result and the existing primary genetic test result are different and if the techniques used to obtain the results are provided in the system, the system determines whether the system is defined to store the test result using the higher-resolution technique result as the primary genetic test result for the individual at block  206 . If the system is configured to store the result using the higher-resolution molecular diagnostic test as the primary genetic test results at block  206 , the system proceeds to block  208 . 
     At block  208 , the system determines whether the new result was generated using a higher-resolution technique than the existing primary result. The resolution of a molecular diagnostic test or technique refers to the accuracy and reliability of test. For example, DNA sequencing to determine if a nucleotide replacement has occurred at a specific position may be defined as a higher-resolution technique than running polymerase chain reaction (PCR) with a specific probe for the polymorphism mutation. 
     At block  208 , if the system determines that the new result was generated using a higher-resolution technique than was used to generate the existing primary result, the system recommends the new result be stored as the primary genetic test result for the individual for the particular gene at block  210 . However, at block  208 , if the system determines that the new result was generated using a lower-resolution technique than was used to generate the existing primary result, the system recommends the new result be stored as a supplemental genetic test result for the person and the existing primary genetic test result remains the primary genetic test result at block  212 . 
     Returning to decision block  206 , if the system is not configured to store the result generated by using the higher-resolution technique by default, the system prompts the user to select which result to save as the primary result at block  214 . At block  216 , the system stores the selected result as the primary genetic test result for the individual and the other result as the supplemental genetic test result. In this embodiment, the user is given the opportunity to determine which of the results is given primary status based on a recommendation from the system and the training and knowledge of the user. 
     With reference to  FIG. 3 , a method of automatically correlating genetic test result values  300  based on result criteria regarding resolution method used is provided. At block  301 , the system receives a genetic test result for an individual. 
     At block  302 , the system determines the individual has a pre-existing genetic test result for the individual. If not, the system recommends that the new result be stored as the primary result. If so, the system obtains the pre-existing genetic test result for the individual and compares the newly received genetic test result with the existing genetic test result at block  304  to determine if the new genetic test result is different from the primary genetic test result that exists for the individual. 
     If at decision block  304 , if the system determines that the genetic test results are different, the system continues at block  305 . If at block  304  the system determines the results are the same, the system proceeds to decision block  318 . At block  318 , the system determines whether the new genetic test result and the preexisting primary genetic test result were generated by the same technique. If, at block  218 , the new genetic test result and the existing primary genetic test result were generated the same technique or the technique is unknown to the system, the system recommends to the user that the new genetic test result be stored as the primary genetic test result for the individual at block  320 . The user can determine which result should be stored as the primary result based on the recommendation of the system and their knowledge and training. In an alternative embodiment, the system automatically stores the new genetic test result as the primary genetic test result for the individual without making any recommendations. 
     If at block  318 , the same technique was not used to generate the new genetic test result and the preexisting primary genetic test result, the system proceeds to decision block  322 . At block  322 , the system determines whether it is defined to store the higher-resolution technique result by default. If the system is configured to store the result using the higher-resolution molecular diagnostic test as the primary genetic test results at block  322 , the system proceeds to block  324 . 
     At block  324 , the system determines whether the new result was generated using a higher-resolution technique than the existing primary result. If at block  324 , the system determines that the new result was generated using a higher-resolution technique than was used to generate the existing primary result, the system recommends the new result be stored as the primary genetic test result for the individual at block  326 . However, if at block  324 , the system determines that the new result was not generated using a higher-resolution technique than was used to generate the existing primary result, the system recommends the new result be stored as a supplemental genetic test result for the person and the existing primary genetic test result remains the primary genetic test result at block  328 . The user can determine which result should be stored as the primary based on the recommendation of the system and the user&#39;s knowledge and training. Alternatively, the system automatically stores the primary result without making a recommendation. 
     Returning to decision block  322 , if the system is not configured to store the result generated by using the higher-resolution technique by default, the system prompts the user to select which result to store as the primary result at block  330 . The user may determine which result is assigned as the primary result based on the user&#39;s confidence in the quality of the sample submitted, confidence in the person or lab conducting the work, previous knowledge of the uncertainty with the result (i.e., whether the new result is known to be from a repeat test.) At block  332 , the system stores the selected result as the primary genetic test result for the individual and the other result as the supplemental genetic test result. 
     In another embodiment, a technique for informing or providing notice as to whether relevant genetic results exist for an individual is described in  FIG. 4 . At block  402 , the system receives an order for a particular genetic test for an individual. An application or module in a healthcare information technology (HCIT) system transmits to the system of the present invention orders for genetic tests for an individual. Alternatively, the system may receive an order for a genetic test directly from a user. At block  404 , the system obtains the relevant genetic history for the individual by querying a data structure. For example, relevant genetic results include actual genetic test results for the ordered genetic tests, cytogenetic results, and inferred genetic results based on population genetics or familial genetic history. The system proceeds to decision block  410  and determines if the ordered genetic test will duplicate one or more existing genetic test results for the individual. For example, an order for a genetic test for the cystic fibrosis gene will be duplicative if an existing genetic test result for the gene or any variants already exists for the individual. 
     If the individual does not have any actual genetic test results for the particular genetic sequences or variant thereof of the ordered genetic test at decision block  410 , the system proceeds to  411 . At block  411 , the system determines if the individual has any other genetic information that is relevant to the genetic test being ordered. The other relevant genetic information includes cytogenetic observations, inferred results based on population genetics and family genetic information. One of skill in the art will appreciate that a variety of other relevant genetic information may also be included. 
     If the individual does not have any relevant genetic information the system informs or provides notice that relevant genetic information does not exist for the individual at block  413 . If the individual has relevant genetic information relating to the particular genetic test being ordered at decision block  411 , the system proceeds to block  414 . At decision block  414  and determines whether the ordered genetic test will be beneficial based on the relevant genetic information. For example, if the relevant genetic results for the individual are cytogenetic results indicating that the individual is missing the chromosomal band where the cystic fibrosis gene is located, additional testing is unnecessary. If the genetic test ordered will not be beneficial at decision block  414 , the system proceeds to block  418  and informs or provides notice of the relevant genetic information and that the ordered genetic test may not be beneficial. In one embodiment, notice is provided to a user. 
     If at decision block  414  the genetic test ordered will be beneficial, the system proceeds to block  416 . Instances where genetic information is available but the genetic test ordered will still be beneficial include when the relevant genetic information is inferred genetic results based on population genetics of familial genetic history. At block  416 , the system informs or provides notice that the individual has relevant genetic information and that the ordered genetic test may still be beneficial. 
     With reference again to decision block  410 , if the order for the genetic test will duplicate an existing genetic test result for an individual the system proceeds to decision block  412 . At decision block  412  the system queries the database for a ranking of techniques for identifying mutations and determines whether the ordered genetic test will be generated using a higher-resolution technique than the technique used to generate the existing genetic test result. As discussed above, some current techniques for identifying a human mutation, including genetic test results, are listed in the following order beginning with the highest quality: DNA sequencing, Restriction Fragment Length Polymorphism (RFLP) and Allele specific PCR. One of skill in the art will appreciate that the techniques may be ranked in varying order depending on the outcomes generated by each result and the order of confidence may vary and new techniques may also be developed and added to the list of techniques for generating genetic test results. For example, a DNA sequencing technique that will be used to generate the ordered genetic test will be a higher-resolution technique than a PCR technique used to generate the existing genetic test result. If at block  412 , the ordered genetic test is generated using a higher-resolution technique, the system informs or provides notice at block  422  of the duplicative genetic test results and that the result was generated using a lower-resolution technique. 
     If at block  412  the ordered genetic test will not be generated using a higher-resolution technique, the system proceeds to block  420 . At block  420  the system provides notice or informs of the duplicative genetic test result and that it was generated using a high-resolution technique. If the ordered genetic test will be generated using the same resolution technique, as the existing test result the system will provide notice that the duplicative genetic test result was generated by the same technique to be used by the ordered genetic test at bock  420 . In one embodiment, after being provided notice at block  413 ,  416 ,  418 ,  420  or  422 , a user will have an opportunity to continue or cancel the order based on the information and/or recommendations provided by the system. The technique of the embodiment described in  FIG. 4  improves workflow, as the user does not need to request a review of prior genetic results each time they place an order. Furthermore, it prevents genetic tests from being performed when the may not be beneficial or appropriate given the individual&#39;s healthcare plan. 
     The present invention can be used with a semantic network describing biological relationships. The primary genetic finding would be linked to the specific DNA sequence, position, chromosome, genotype, and phenotype of an individual. For example, in a patient for whom an earlier result determined that an entire gene had been deleted, it could be appropriate to intercept orders or results for mutational analysis within the deleted gene. A semantic network would enable the system to make these complex associations. 
     One embodiment of the present invention utilizes a relational database to store individual results in a healthcare information system capable of performing a variety of tasks such as generating charges, managing an electronic medical record and other functions. Also included within the clinical information system is expert system capability to generate diverse responses to various user and system events. Alternative implementations of a relational database could include XML documents or an object oriented database integrated with a clinical information system. In the relational database system implementation, the system tracks the person demographics, person level results and the parameters that influence correlation events. The system of the present invention tracks the occurrence of the need for correlating genetic test results for an individual and the subsequent decisions made by the system and system users. 
     Tables 1-4 show an excerpt of exemplary fields and descriptions contemplated by the present invention to manage the information related to the aforementioned system and method. 
     
       
         
               
               
             
           
               
                 TABLE 1 
               
               
                   
               
               
                 Field 
                 Description 
               
               
                   
               
             
             
               
                 PersonId 
                 System generated identifier for a person. 
               
               
                 PersonName 
                 The person&#39;s name as entered by the registration system. 
               
               
                 BirthDateTime 
                 The person&#39;s birth date and time as entered 
               
               
                   
                 by the registration system. 
               
               
                   
               
             
          
         
       
     
     
       
         
               
               
             
           
               
                 TABLE 2 
               
               
                   
               
               
                 Field 
                 Description 
               
               
                   
               
             
             
               
                 ResultId 
                 System generated identifier for a result. 
               
               
                 PersonId 
                 System generated identifier for a person. 
               
               
                 ResultType 
                 Indicate the type of result. 
               
               
                 ResultValue 
                 Stores the result value. 
               
               
                 ResultDateTime 
                 Date and time the result was entered. 
               
               
                 ResultUserName 
                 The unique id of the user who recorded this 
               
               
                   
                 result. 
               
               
                 PrimaryIndicator 
                 Indicates if this result is the primary for this 
               
               
                   
                 PersonId/ResultType combination. Any result 
               
               
                   
                 not stored as primary would be considered 
               
               
                   
                 supplemental. 
               
               
                 ResultMethod 
                 Stores the method that was used to generate the 
               
               
                   
                 result value. 
               
               
                 ResultMethodResolution 
                 Stores the resolution of the ResultMethod. This 
               
               
                   
                 could be used to rank the supplemental results. 
               
               
                   
               
             
          
         
       
     
     
       
         
               
               
             
           
               
                 TABLE 3 
               
               
                   
               
               
                 Field 
                 Description 
               
               
                   
               
             
             
               
                 CorrelationEventId 
                 System generated identifier for a correlation 
               
               
                   
                 event. 
               
               
                 CorrelationEventType 
                 Indicates the type of correlation that occurred 
               
               
                   
                 (IE, Different Primary Result or Different 
               
               
                   
                 Method) 
               
               
                 DecisionType 
                 Indicates what the user chooses to do with 
               
               
                   
                 the correlation event. 
               
               
                 CorrelationComment 
                 Optional free text comment the user may enter 
               
               
                   
                 during the correlation documentation. 
               
               
                 CorrelationDateTime 
                 Date and time the correlation event occurred 
               
               
                 CorrelationUserName 
                 The unique id of the user who responded to the 
               
               
                   
                 correlation event. 
               
               
                 PreviousResultId 
                 The unique id of the existing primary result. 
               
               
                 NewResultId 
                 The unique id of the newly generated result. 
               
               
                   
               
             
          
         
       
     
     
       
         
               
               
             
           
               
                 TABLE 4 
               
               
                   
               
               
                 Field 
                 Description 
               
               
                   
               
             
             
               
                 HigherResolutionIndicator 
                 Indicates if the system should default a new 
               
               
                   
                 result with a higher resolution as the primary 
               
               
                   
                 result. 
               
               
                   
               
             
          
         
       
     
     Table 1 contains demographic information for the individual including, but not limited to, a system generated identifier of the individual, the individuals name and birth date. Table 2 contains information for storing individual genetic test results. The individual genetic test result information may include, but is not limited to, an identifier of the result, an identifier of the person, an identifier of the type of result, the genetic test result value, the date and time the result was entered, an identifier of the user who recorded the result, a primary indicator that indicates if the result is primary for the individual, the technique used to generate the result value and the resolution of the result technique (e.g., to rank supplemental results). 
     Table 3 contains correlation event information. Correlation event information includes a system generated identifier of the correlation event, the type of correlation that occurred (e.g., different primary result or different technique), the users decision regarding the correlation event, the data and time the correlation event occurred, an identifier of the user who responded to the correlation event, an identifier of existing primary genetic test results and an identifier of the new generated genetic test result. Table 4 contains information regarding correlation parameters for the method of the present invention. For example, the correlation parameters include a higher resolution indicator that indicates if the system should store a new genetic test result with a higher resolution as the primary genetic test result rather than the existing primary genetic test result for the individual. 
     In one embodiment, Tables 1-4 are combined into one relational database. One of skill in the art will realize that there are any number of ways for storing patient demographic information, individual genetic test result information, correlation event information, and correlation parameters. One of skill in the art will also understand that genetic test results may be for any organism. 
     The present invention is a method and system for automatically correlating genetic test results for an individual. Although the invention has been described with reference to embodiments of the invention in the attached drawing figure, it is noted that substitutions may be made and equivalents employed herein without departing from the scope of the invention as recited in the claims. For example, additional steps may be added and steps omitted without departing from the scope of the invention.