Abstract

The integration of pharmacogenomics through whole-genome sequencing (WGS) into emergency department 
(ED) workflows represents a transformative approach to precision medicine in acute care. This study examines the 
clinical feasibility, workflow integration, patient outcomes, and cost-effectiveness of implementing rapid WGS to 
guide drug selection and dosing in time-critical settings. Pharmacogenomic insights derived from WGS enable 
clinicians to tailor therapies based on individual genetic profiles, thereby reducing adverse drug events and 
improving therapeutic efficacy. The study highlights how AI-assisted genomic interpretation and clinical decision
support systems can be embedded within existing ED processes without disrupting care delivery timelines. 
Evidence suggests that a significant proportion of emergency medications are influenced by gene–drug 
interactions, underscoring the clinical utility of comprehensive genomic testing over targeted panels. Despite 
operational and ethical challenges including data management, workforce readiness, and consent complexities, 
WGS-based pharmacogenomics demonstrates strong potential for improving patient safety, optimizing treatment 
decisions, and supporting rapid risk stratification. Economic analyses indicate that while initial implementation 
costs are substantial, long-term benefits in reduced adverse events and improved efficiency may offset these 
investments. Overall, this approach offers a scalable and forward-looking model for integrating genomics into 
acute healthcare systems.