NEW YORK (GenomeWeb News) – The National Human Genome Research Institute intends to fund projects that will test some of the ways that genomic information can be used in clinical care, particularly in concert with electronic health records, and plans to extend a program it began last year to support these efforts.
The institute expects to provide around $3 million per year between 2014 and 2017 to support a consortium of collaborative genomic medicine pilot demonstration projects that will test the feasibility of, and develop new methods for, incorporating genomic findings into patients' care. A year ago, NHGRI marked $2.6 million to fund such projects for this fiscal year.
In total, the institute intends to award three or four grants with up to $750,000 in Fiscal Year 2014 and up to $1 million per year from FY 2015 through 2017.
Other National Institutes of Health centers have supported similar programs, such as the Pharmacogenomic Research Network, headed by the National Institute of General Medical Sciences, and the National Cancer Institute's Comparative Effectiveness Research for Genomics and Personalized Medicine Program. Several medical centers around the country also have started programs to use individual patient genomic information, but they have encountered obstacles and independently developed some solutions at these various sites, according to NHGRI.
These early adopters of incorporating genomic data into medicine have encountered "skepticism, resistance, and/or inertia from institutions and clinicians," creating cultural barriers that go beyond the scientific problems at hand, said NHGRI.
Finding out how these kinds of programs work and helping to advance them into a range of settings and with different populations are high priorities for NHGRI, as it laid out in its strategic plan in 2011.
NHGRI believes that one way to get around these issues would be for more experienced or early adopter genomic medicine centers to collaborate with other centers or hospital systems who are interested but less experienced in implementing and integrating genomic medicine approaches in their care. A consortium of institutes and centers that are engaged in such collaborations could become a valuable resource that could show others how to make genomic medicine successful, by spreading detailed protocols involving clinicians, labs, departments, institutions, and patients, according to NHGRI.
This latest funding program will support pilot projects that aim to adapt ongoing, successful genomic medicine programs in new centers or to launch new ones. These could include efforts to implement screening for inherited conditions or highly penetrant germline mutations that pose diagnostic or therapeutic difficulties; collecting, validating, and assessing risk data from family history information that will be used to make clinical decisions; and surveying patient genotype or sequence data that was generated through clinical or research testing for known variants and using these findings in clinical care.
This funding will not support efforts to implement Mendelian disease variants that are already being used regularly in clinical settings, projects that incorporate genetic or genomic data or family history information into medical records but which do not use that information in care, and sequencing or genotyping projects of non-human genetic variation, such as the microbiome.