PURPOSE Precision medicine promises to improve patient outcomes, but much is unknown about its adoption within health-care systems. A comprehensive implementation plan is needed to realize its benefits. METHODS We convened 80 stakeholders for agenda setting to inform precision medicine policy, delivery, and research. Conference proceedings were audio-recorded, transcribed, and thematically analyzed. We mapped themes representing opportunities, challenges, and implementation strategies to a logic model, and two implementation science frameworks provided context. RESULTS The logic model components included inputs: precision medicine infrastructure (clinical, research, and information technology), big data (from data sources to analytics), and resources (e.g., workforce and funding); activities: precision medicine research, practice, and education; outputs: precision medicine diagnosis; outcomes: personal utility, clinical utility, and health-care utilization; and impacts: precision medicine value, equity and access, and economic indicators. Precision medicine implementation challenges include evidence gaps demonstrating precision medicine utility, an unprepared workforce, the need to improve precision medicine access and reduce variation, and uncertain impacts on health-care utilization. Opportunities include integrated health-care systems, partnerships, and data analytics to support clinical decisions. Examples of implementation strategies to promote precision medicine are: changing record systems, data warehousing techniques, centralized technical assistance, and engaging consumers. CONCLUSION We developed a theory-based, context-specific logic model that can be used by health-care organizations to facilitate precision medicine implementation.

中文翻译：

---

基于利益相关者观点和实施科学的精准医疗实施逻辑模型。

目的 精准医疗有望改善患者的治疗效果，但其在医疗保健系统中的应用尚不清楚。需要一个全面的实施计划来实现它的好处。方法 我们召集了 80 名利益相关者进行议程设置，为精准医疗政策、交付和研究提供信息。会议记录经过录音、转录和主题分析。我们将代表机遇、挑战和实施策略的主题映射到一个逻辑模型，两个实施科学框架提供了背景。结果 逻辑模型组件包括输入：精准医疗基础设施（临床、研究和信息技术）、大数据（从数据源到分析）和资源（例如，劳动力和资金）；活动：精准医学研究、实践和教育；输出：精准医学诊断；结果：个人效用、临床效用和医疗保健利用；和影响：精准医疗价值、公平和可及性以及经济指标。精准医疗实施的挑战包括证明精准医疗效用的证据差距、未做好准备的劳动力、改善精准医疗获取和减少变异的需要，以及对医疗保健利用的不确定影响。机会包括支持临床决策的综合医疗保健系统、合作伙伴关系和数据分析。推广精准医疗的实施策略示例包括：改变记录系统、数据仓库技术、集中技术援助和吸引消费者。结论 我们开发了一种基于理论的、