Canada has launched a $5.4 million artificial intelligence initiative designed to solve one of genomic medicine's biggest operational challenges: the time-consuming process of preparing genetic test requests. The Clinical Intelligence for Phenotyping and Genomics Research (CIPHER) network, led by PhenoTips and IWK Health, is developing and validating SmartRequisition, an AI-assisted platform that automates a critical step in genomic test requisition . The project could accelerate diagnoses for over 10,000 Canadians annually by streamlining workflows that currently stretch clinical teams and overwhelm laboratory capacity.

What's the Real Bottleneck in Genomic Testing?

Genomic medicine is transforming disease diagnosis and treatment, but demand for genetic testing has outpaced the healthcare system's ability to process requests efficiently. The core problem lies in a deceptively simple but labor-intensive step: clinicians must create structured descriptions of a patient's symptoms using standardized medical vocabulary that computational tools can interpret . Genetics specialists perform this task well, but it requires deep specialist knowledge and consumes significant time. As genomic testing moves from a specialized service into mainstream medicine, non-genetics specialists increasingly need access to genetic testing, yet the current manual process cannot scale to meet that demand.

Patients currently wait months or even years for answers while clinical teams struggle to keep up with requisition volume and laboratories become overburdened. This bottleneck prevents many patients from accessing precision medicine benefits that could improve their diagnoses and treatment outcomes.

How Does SmartRequisition Solve This Problem?

SmartRequisition bridges the gap between clinical phenotyping and standardized digital test requisitions by automating the most time-consuming part of the process. The AI-assisted platform streamlines the path from patient symptom description to lab-ready test orders, making it easier for clinicians to order the right test with confidence and for laboratories to provide accurate results . By reducing the specialist knowledge required to initiate genetic testing, the platform enables primary care physicians and non-genetics specialists to confidently order genomic tests, dramatically expanding access across Canada's healthcare landscape.

The CIPHER network brings together five leading Canadian health institutions, each contributing specific expertise and scale to validate SmartRequisition across diverse clinical settings and patient populations :

• IWK Health: Co-leads the project and serves the clinical genetics provider for 2.4 million residents across the Maritime provinces with over a decade of sequencing experience
• Alberta Health Services: Contributes large-scale clinical genetics expertise and three-dimensional facial phenotyping capabilities
• CHU Sainte-Justine: Addresses mixed paper-and-electronic workflow challenges in clinical settings
• SickKids and CHEO: Focus on high-throughput laboratory integration and expanding access in underserved regions through Genome-wide Sequencing Ontario

Across four provinces and over 15,000 genomic cases annually, this network provides the scale and diversity necessary to validate SmartRequisition across Canada's healthcare landscape.

Why This Matters Beyond Canada

The initiative reflects a broader global challenge in healthcare technology: as AI and genomic medicine mature, the bottlenecks shift from scientific capability to operational workflow. Pharmaceutical and biotechnology companies are increasingly investing in AI-driven platforms to accelerate drug discovery timelines and reduce development costs, but clinical implementation of genomic testing faces different constraints . The AI in drug discovery market alone is projected to grow from $3.25 billion in 2026 to $10.29 billion by 2031, registering a compound annual growth rate of 25.94% . Yet without efficient clinical workflows to order and interpret genomic tests, that innovation cannot reach patients who need it.

"PhenoTips exists to help health systems deliver genetic testing to everyone who needs it, sustainably and at scale. With SmartRequisition, we're addressing one of the core bottlenecks by making it easier for clinicians to order the right test, and for labs to provide accurate results," said Dr. Orion Buske, PhenoTips CEO and Co-Founder.

Dr. Orion Buske, CEO and Co-Founder at PhenoTips

SmartRequisition builds on PhenoTips, the Genomic Health Record already trusted by more than 30 institutions worldwide, including National Health Service (NHS) Trusts in the United Kingdom and Canadian provincial health authorities . The platform integrates with existing electronic health records to provide specialized tools that genomic medicine demands: deep phenotyping, pedigree capture, risk assessment, and test ordering. By extending this platform into new territory for Canada, PhenoTips and its partners are making genomic testing accessible for clinicians beyond genetics specialists, at the scale that mainstreaming demands.

Steps to Implement AI-Assisted Genomic Testing in Your Health System

• Assess Current Workflows: Evaluate your institution's existing genomic test requisition process to identify bottlenecks where AI automation could reduce manual effort and specialist time requirements
• Integrate with Existing EHR Systems: Ensure any AI platform you adopt integrates seamlessly with your current electronic health record infrastructure to minimize disruption and maximize clinician adoption
• Train Non-Specialist Clinicians: Develop training programs to help primary care physicians and non-genetics specialists confidently use AI-assisted ordering tools to expand access beyond genetics departments
• Validate Across Patient Populations: Test the platform across diverse clinical settings and patient demographics to ensure accuracy and reliability before full-scale implementation

The CIPHER network's approach demonstrates that solving healthcare's AI bottlenecks requires more than technology; it requires collaboration across institutions, validation at scale, and integration with existing clinical workflows. As genomic medicine becomes routine rather than specialized, platforms like SmartRequisition will determine whether the benefits of precision medicine reach patients equitably or remain concentrated in well-resourced academic centers.

"Improving access to genomic testing starts with enabling every physician to order the right test with confidence," explained Lee Anne Boutilier, Director of Precision Medicine at IWK Health. "Through this collaboration with PhenoTips and partners nationwide, we're using AI to simplify that process and bring the benefits of precision medicine to more patients, faster."

Lee Anne Boutilier, Director of Precision Medicine at IWK Health

The initiative is funded through Genome Canada's Genomic Applications Partnership Program (GAPP), with support from Genome Atlantic and Ontario Genomics . By addressing the operational bottleneck in genomic testing, Canada's CIPHER network is demonstrating how AI can transform not just drug discovery or diagnosis, but the entire clinical workflow that connects patients to precision medicine.