domingo, 2 de diciembre de 2018

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

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



 2018 Nov 23. doi: 10.1038/s41436-018-0378-9. [Epub ahead of print]

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

Abstract

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.

KEYWORDS:

clinical engagement; electronic health record; genomics; implementation; qualitative

PMID:
 
30467402
 
DOI:
 
10.1038/s41436-018-0378-9

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