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Opportunities to implement a sustainable genomic medicine program: lessons learned from the IGNITE Network.
Genetics in Medicine ( IF 6.6 ) Pub Date : 2018-07-12 , DOI: 10.1038/s41436-018-0080-y
Kenneth D Levy 1 , Kathryn Blake 2 , Colette Fletcher-Hoppe 3 , James Franciosi 4 , Daisuke Goto 5 , James K Hicks 6 , Ann M Holmes 7 , Sri Harsha Kanuri 1 , Ebony B Madden 8 , Michael D Musty 9 , Lori Orlando 9 , Victoria M Pratt 1 , Michelle Ramos 10 , Ryanne Wu 9 , Geoffrey S Ginsburg 9
Affiliation  

PURPOSE While there is growing scientific evidence for and significant advances in the use of genomic technologies in medicine, there is a significant lag in the clinical adoption and sustainability of genomic medicine. Here we describe the findings from the National Human Genome Research Institute's (NHGRI) Implementing GeNomics In pracTicE (IGNITE) Network in identifying key constructs, opportunities, and challenges associated with driving sustainability of genomic medicine in clinical practice. METHODS Network members and affiliates were surveyed to identify key drivers associated with implementing and sustaining a genomic medicine program. Tallied results were used to develop and weigh key constructs/drivers required to support sustainability of genomic medicine programs. RESULTS The top three driver-stakeholder dyads were (1) genomic training for providers, (2) genomic clinical decision support (CDS) tools embedded in the electronic health record (EHR), and (3) third party reimbursement for genomic testing. CONCLUSION Priorities may differ depending on healthcare systems when comparing the current state of key drivers versus projected needs for supporting genomic medicine sustainability. Thus we provide gap-filling guidance based on IGNITE members' experiences. Although results are limited to findings from the IGNITE network, their implementation, scientific, and clinical experience may be used as a road map by others considering implementing genomic medicine programs.

中文翻译:

实施可持续基因组医学计划的机会:从 IGNITE 网络中吸取的经验教训。

目的 虽然有越来越多的科学证据表明基因组技术在医学中的应用取得了重大进展,但基因组医学的临床采用和可持续性却存在显着滞后。在这里,我们描述了国家人类基因组研究所 (NHGRI) 实施基因组学实践 (IGNITE) 网络在确定与推动基因组医学在临床实践中的可持续性相关的关键结构、机遇和挑战方面的发现。方法 对网络成员和附属机构进行了调查,以确定与实施和维持基因组医学计划相关的关键驱动因素。统计结果用于开发和权衡支持基因组医学项目可持续性所需的关键结构/驱动因素。结果 前三大驱动利益相关者是(1)对提供者的基因组培训,(2)嵌入电子健康记录(EHR)中的基因组临床决策支持(CDS)工具,以及(3)基因组测试的第三方报销。结论 在比较关键驱动因素的当前状态与支持基因组医学可持续性的预计需求时,优先事项可能因医疗保健系统而异。因此,我们根据 IGNITE 成员的经验提供填补空白的指导。尽管结果仅限于来自 IGNITE 网络的发现,但其实施、科学和临床经验可被其他考虑实施基因组医学计划的人用作路线图。(3) 基因组检测的第三方报销。结论 在比较关键驱动因素的当前状态与支持基因组医学可持续性的预计需求时,优先事项可能因医疗保健系统而异。因此,我们根据 IGNITE 成员的经验提供填补空白的指导。尽管结果仅限于来自 IGNITE 网络的发现,但其实施、科学和临床经验可被其他考虑实施基因组医学计划的人用作路线图。(3) 基因组检测的第三方报销。结论 在比较关键驱动因素的当前状态与支持基因组医学可持续性的预计需求时,优先事项可能因医疗保健系统而异。因此,我们根据 IGNITE 成员的经验提供填补空白的指导。尽管结果仅限于来自 IGNITE 网络的发现,但其实施、科学和临床经验可被其他考虑实施基因组医学计划的人用作路线图。
更新日期:2018-07-12
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