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
Language
- eng
Conference Location
- United States