Local and Global Challenges in the Clinical Implementation of Precision Medicine
Advances in high-throughput genomic technologies and the growing number of clinically useful results have driven novel implementation programs in many nations around the globe. These efforts capitalize on unique local capabilities arising from the structure of their health care systems, their cultural or political milieu, as well as from their unusual burdens of disease or risk alleles. Four significant challenges stand in the way of widespread use of genomic and precision medicine (GPM): evidence generation, implementation into clinical care, data ownership, sharing, and infrastructure, and participant engagement and trust. Opportunities for collaboration in GPM abound in these areas as well as in health information technology, workforce development, pharmacogenomics, variant interpretation, and policy and regulation. Efforts to coalesce the global community to generate and assess evidence of the impact of genomic medicine, and to disseminate best practices for effective implementation, will enhance the use of genomics to improve clinical care worldwide.