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Challenges to Personalized Medicine Implementation Explored in IGNITE Network Projects

NEW YORK (GenomeWeb) – A new analysis considered some of the current strategies and complications for those attempting to integrate personalized genomic information and/or pharmacogenomic clues into patient care.

A Duke University-led team brought together information from half a dozen projects being done at National Human Genome Research Institute "Implementing Genomics in Practice" (IGNITE) consortium network sites to scrutinize existing implementation approaches and impediments.

From insights gleaned from the IGNITE projects, the researchers highlighted three shared challenges related to electronic health record integration, clinician attitudes, knowledge, or awareness, and patient engagement, along with distinct schemes designed to tackle these issues depending on the project at hand. Their findings appeared online this week in BMC Medical Genomics.

"Findings suggest that strategies to facilitate integration of genomic data within existing [electronic health records] and educate stakeholders about the value of genomic services are considered important for effective implementation," first author Nina Sperber, a researcher with Duke University's Duke Center for Applied Genomics and Precision Medicine and the Duke University School of Medicine, and her colleagues wrote.

The team noted that challenges remain in clinician and health system uptake of personalized genomic data, even for individuals who carry genetic variants or features that are broadly considered clinically actionable.

"In order to optimize potential public health benefits from genetic and genomic innovations, there is a need to focus on developing both the evidence base for their impact on health outcomes and also strategies that can be used to put them into practice at a broad scale," the authors wrote.

To get a better sense of factors influencing implementation, the researchers used an established "Consolidated Framework for Implementation Research" approach to analyze and organize information from multiple case studies of six IGNITE projects spearheaded by investigators at Duke University, Indiana University, Mount Sinai's Icahn School of Medicine, the University of Florida, the University of Maryland, and Vanderbilt University.

Based on the main challenges identified, the team outlined strategies in place across various projects to overcome the issues. In the case of hurdles related to electronic health record integration of genomic data, for example, the group noted that several projects are working to produce central repositories to warehouse new and existing genomic and electronic health record data.

The researchers also touched on resources, educational materials, and outreach efforts being used to improve patient and health care provider knowledge of genomic medicine and prepare them to engage and participate in such projects.

"Policy implications can include support to accelerate linking data across systems and broader-based education of providers and the public about how to use genomic information to make personal health decisions," they noted.

The authors expect that findings of their analysis will prove useful "to guide development of future endeavors to design and evaluate implementation strategies, such as identifying how strategies relate to outcomes and conducting deeper evaluations of local environments and implementation adaptations."