Qualitative study of system-level factors related to genomic implementation.
PURPOSE: Research on genomic medicine integration has focused on applications at the individual level, with less attention paid to implementation within clinical settings. Therefore, we conducted a qualitative study using the Consolidated Framework for Implementation Research (CFIR) to identify system-level factors that played a role in implementation of genomic medicine within Implementing GeNomics In PracTicE (IGNITE) Network projects. METHODS: Up to four study personnel, including principal investigators and study coordinators from each of six IGNITE projects, were interviewed using a semistructured interview guide that asked interviewees to describe study site(s), progress at each site, and factors facilitating or impeding project implementation. Interviews were coded following CFIR inner-setting constructs. RESULTS: Key barriers included (1) limitations in integrating genomic data and clinical decision support tools into electronic health records, (2) physician reluctance toward genomic research participation and clinical implementation due to a limited evidence base, (3) inadequate reimbursement for genomic medicine, (4) communication among and between investigators and clinicians, and (5) lack of clinical and leadership engagement. CONCLUSION: Implementation of genomic medicine is hindered by several system-level barriers to both research and practice. Addressing these barriers may serve as important facilitators for studying and implementing genomics in practice.
Duke Scholars
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Related Subject Headings
- Qualitative Research
- Patient Acceptance of Health Care
- Implementation Science
- Humans
- Genomics
- Genetics, Medical
- Genetics & Heredity
- Electronic Health Records
- Attitude to Health
- 3105 Genetics
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Qualitative Research
- Patient Acceptance of Health Care
- Implementation Science
- Humans
- Genomics
- Genetics, Medical
- Genetics & Heredity
- Electronic Health Records
- Attitude to Health
- 3105 Genetics