Applying an Implementation Science Approach to Genomic Medicine Workshop Summary (2016) / Chapter Skim
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6 Achieving the Vision
6 Achieving the Vision
Pages 55-64
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From page 55... ...
. Several workshop speakers pointed out that in order to ensure equitable access to genomic medicine, greater efforts will be required to address health inequities across low income and minority groups.1 To maximize the benefits of genomic medicine across populations, patients and study participants will need adequate knowledge about genomics that allows them to make well-informed health decisions (Hurle et al., 2013)
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(Chambers, Shields) • Engage leaders across health care systems in a discussion about how the tools and approaches of implementation science can be part of a cultural change to make the introduction of genomics into the clinic more efficient.
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. One important contribution that could be made toward addressing health disparities, Shields said, would be to research and share information on a case study that successfully applied implementation science to avoid such disparities.
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SOURC Alexandra Shields, Nat CE: a tional Academ mies of Scienc ces, Engineerinng, and Medicine workshop presentati ion, November 19, 2015. Fi r igure was devveloped in discussions with Harvard n d/Massachusett General Hospital Center on ts Genommics, Vulnerab Populations and Health Disparities.
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The need for greater literacy in genomics and implementation science among all stakeholders was a topic addressed by individual speakers including Coleman, Jane Perlmutter of the Gemini Group, Consuelo Wilkins of the Meharry-Vanderbilt Alliance and Vanderbilt University Medical Center, and David Chambers of the National Cancer Institute. Efforts to enhance genomic literacy would benefit the public and potentially prevent future misunderstandings about genomic medicine, Perlmutter said.
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It will be very important to be upfront with the public about the current benefits and limitations of genomic medicine, Perlmutter cautioned. Genomic information is different from other health care data in that some of it is not currently clinically actionable, Shields observed.
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A nascent field known as reimbursement science is aimed at standardizing the way that payers, guideline developers, and health care policy makers create reimbursement parameters, McDonough said. One of the goals of reimbursement science is to create tools and approaches for assessing the effectiveness and value of products that are covered by public and private health plans.
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. The cffDNA test received recommendations from major professional societies, leading to consistent reimbursement among payers and rapid adoption into clinical practice.
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Secondly, within existing implementation science efforts, stakeholders can gather useful knowledge from case studies of "exceptional implementation," instances of rapid uptake of genomic applications, as well as of failures -- or "unsuccesses," as Chambers called them. Assessing the qualities of highly nimble and adaptive implementation processes will be useful for future efforts, Chambers said.
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From page 64... ...
"Sometimes we get lost in tests," Chambers said, but "the reality is that there are a lot of people who we are trying to help." We need to think of the young girl, for example, still searching for a diagnosis with her family, "who has interfaced with the health care financing system and has found that there are still tests that are not currently insured.
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