Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

dc.contributor.author

Sperber, Nina R

dc.contributor.author

Carpenter, Janet S

dc.contributor.author

Cavallari, Larisa H

dc.contributor.author

J Damschroder, Laura

dc.contributor.author

Cooper-DeHoff, Rhonda M

dc.contributor.author

Denny, Joshua C

dc.contributor.author

Ginsburg, Geoffrey S

dc.contributor.author

Guan, Yue

dc.contributor.author

Horowitz, Carol R

dc.contributor.author

Levy, Kenneth D

dc.contributor.author

Levy, Mia A

dc.contributor.author

Madden, Ebony B

dc.contributor.author

Matheny, Michael E

dc.contributor.author

Pollin, Toni I

dc.contributor.author

Pratt, Victoria M

dc.contributor.author

Rosenman, Marc

dc.contributor.author

Voils, Corrine I

dc.contributor.author

W Weitzel, Kristen

dc.contributor.author

Wilke, Russell A

dc.contributor.author

Ryanne Wu, R

dc.contributor.author

Orlando, Lori A

dc.coverage.spatial

England

dc.date.accessioned

2017-09-05T01:11:00Z

dc.date.available

2017-09-05T01:11:00Z

dc.date.issued

2017-05-22

dc.description.abstract

BACKGROUND: To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. METHODS: We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies. We describe challenges and strategies in an implementation framework and typology to enable consistent definitions and cross-case comparisons. Strategies were linked to challenges based on expert review and shared themes. RESULTS: Three challenges were identified by all six projects, and strategies to address these challenges varied across the projects. One common challenge was to increase the relative priority of integrating genomics within the health system electronic health record (EHR). Four projects used data warehousing techniques to accomplish the integration. The second common challenge was to strengthen clinicians' knowledge and beliefs about genomic medicine. To overcome this challenge, all projects developed educational materials and conducted meetings and outreach focused on genomic education for clinicians. The third challenge was engaging patients in the genomic medicine projects. Strategies to overcome this challenge included use of mass media to spread the word, actively involving patients in implementation (e.g., a patient advisory board), and preparing patients to be active participants in their healthcare decisions. CONCLUSIONS: This is the first collaborative evaluation focusing on the description of genomic medicine innovations implemented in multiple real-world clinical settings. Findings suggest that strategies to facilitate integration of genomic data within existing EHRs and educate stakeholders about the value of genomic services are considered important for effective implementation. Future work could build on these findings to evaluate which strategies are optimal under what conditions. This information will be useful for guiding translation of discoveries to clinical care, which, in turn, can provide data to inform continual improvement of genomic innovations and their applications.

dc.identifier

https://www.ncbi.nlm.nih.gov/pubmed/28532511

dc.identifier

10.1186/s12920-017-0273-2

dc.identifier.eissn

1755-8794

dc.identifier.uri

https://hdl.handle.net/10161/15443

dc.language

eng

dc.publisher

Springer Science and Business Media LLC

dc.relation.ispartof

BMC Med Genomics

dc.relation.isversionof

10.1186/s12920-017-0273-2

dc.subject

Electronic health record

dc.subject

Implementation

dc.subject

Patient engagement

dc.subject

Pharmacogenomics

dc.subject

Precision medicine

dc.subject

Provider engagement

dc.title

Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.

dc.type

Journal article

duke.contributor.orcid

Sperber, Nina R|0000-0001-6640-2510

duke.contributor.orcid

Ginsburg, Geoffrey S|0000-0003-4739-9808

duke.contributor.orcid

Orlando, Lori A|0000-0003-2534-7855

pubs.author-url

https://www.ncbi.nlm.nih.gov/pubmed/28532511

pubs.begin-page

35

pubs.issue

1

pubs.organisational-group

Basic Science Departments

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Duke

pubs.organisational-group

Duke Cancer Institute

pubs.organisational-group

Institutes and Centers

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Cardiology

pubs.organisational-group

Medicine, General Internal Medicine

pubs.organisational-group

Nursing

pubs.organisational-group

Pathology

pubs.organisational-group

Population Health Sciences

pubs.organisational-group

School of Medicine

pubs.organisational-group

School of Nursing

pubs.publication-status

Published online

pubs.volume

10

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Challenges and strategies for implementing genomic services in diverse settings: experiences from the Implementing GeNomics In pracTicE (IGNITE) network.pdf
Size:
440.82 KB
Format:
Adobe Portable Document Format
Description:
Published version