Reportable actionability versus pragmatic actionability: Implementing precision medicine at three large health systems.

6539Background: Precision medicine (PM) molecular panel (MP) testing report actionable findings with associated targeted therapies (including immunotherapies). However, these actionable findings “reported actionability” by molecular testing companies are often not realized as “pragmatic actionability” in the real world setting. We explored the concordance among PM MP therapy recommendations and subsequent drug treatment orders by clinicians at Aurora Health Care (AHC), Henry Ford Health System (HFHS), and Hoag Memorial Hospital Presbyterian (HMHP). Methods: Structured clinical, genomic report data, and treatment orders were obtained from the Syapse database. At AHC, HFHS, and HMHP, we identified 996 MP reports from 748 patients who received testing between 2014 and 2018. Results: 713 MP reports had “reported actionable” (positive) treatment recommendations and a subsequent treatment order across all 3 health systems. 24.4% (174/713) of MP reports were followed by a treatment order that matched to at least...