The real-time reanalysis of raw genomic data supports clinical decision-making by keeping patient care in line with rapidly evolving guidelines. Since incorporating raw genomic data into EHR is fraught with performance impacts and regulatory restrictions, such reanalysis requires development of alternate solutions; also, it becomes vitally important to maintain an up-to-date knowledge base of current clinical knowledge. When we launched NorthShore’s pharmacogenomics program, we built a solution that solves both the real-time reanalysis and the knowledge base problems, allowing us to maintain and reanalyze genomic data. The solution involves in-house development leveraging resources at multiple partners like ActX, ThermoFischer, Golden Helix, the Broad Institute and the Mayo Clinic. We will discuss our solution, what holes in partner support we plugged through building our own technology, and how informatics promises to revolutionize medicine through genomics.