Qualitative study of system-level factors related to genomic implementation.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Zebrowski, AM; Ellis, DE; Barg, FK; Sperber, NR; Bernhardt, BA; Denny, JC; Dexter, PR; Ginsburg, GS; Horowitz, CR; Johnson, JA; Levy, MA; Orlando, LA; Pollin, TI; Skaar, TC; Kimmel, SE

Published Date

  • July 2019

Published In

Volume / Issue

  • 21 / 7

Start / End Page

  • 1534 - 1540

PubMed ID

  • 30467402

Pubmed Central ID

  • PMC6533158

Electronic International Standard Serial Number (EISSN)

  • 1530-0366

Digital Object Identifier (DOI)

  • 10.1038/s41436-018-0378-9


  • eng

Conference Location

  • United States