GARDE (Genetic Cancer Risk Detector) is a population clinical decision support (CDS) platform based on Fast Healthcare Interoperability Resources (FHIR) and CDS Hooks standards. GARDE (i) screens and identifies patients who meet National Comprehensive Cancer Network (NCCN) criteria for evaluation of familial cancer risk based on their family history in the EHR; and (ii) promotes genetic testing with eligible patients through a rule-based conversational agent (chatbot) that minimizes genetic counseling workload by automating patient outreach and education. GARDE has been integrated with two market-leading EHR systems (Epic® and Cerner®). GARDE is open source software that can be deployed both through containerization and cloud-based services. GARDE has been deployed in clinical settings at two academic medical centers and their respective cancer centers (University of Utah Health/Huntsman Cancer Institute and New York University Langone Health) in support of the BRIDGE trial, funded by NCI’s Cancer Moonshot program.
