title: Implementing individualized medicine into the medical practice.
abstract: There is increasing recognition that genomic medicine as part of individualized medicine has a defined role in patient care. Rapid advances in technology and decreasing cost combine to bring genomic medicine closer to the clinical practice. There is also growing evidence that genomic-based medicine can advance patient outcomes, tailor therapy and decrease side effects. However the challenges to integrate genomics into the workflow involved in patient care remain vast, stalling assimilation of genomic medicine into mainstream medical practice. In this review we describe the approach taken by one institution to further individualize medicine by offering, executing and interpreting whole exome sequencing on a clinical basis through an enterprise-wide, standalone individualized medicine clinic. We present our experience designing and executing such an individualized medicine clinic, sharing lessons learned and describing early implementation outcomes.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Lazaridis
authors.forename: Tammy M
authors.initials: TM
authors.lastname: McAllister
authors.forename: Dusica
authors.initials: D
authors.lastname: Babovic-Vuksanovic
authors.forename: Scott A
authors.initials: SA
authors.lastname: Beck
authors.forename: Mitesh J
authors.initials: MJ
authors.lastname: Borad
authors.forename: Alan H
authors.initials: AH
authors.lastname: Bryce
authors.forename: Asher A
authors.initials: AA
authors.lastname: Chanan-Khan
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Ferber
authors.forename: Rafael
authors.initials: R
authors.lastname: Fonseca
authors.forename: Kiley J
authors.initials: KJ
authors.lastname: Johnson
authors.forename: Eric W
authors.initials: EW
authors.lastname: Klee
authors.forename: Noralane M
authors.initials: NM
authors.lastname: Lindor
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McCormick
authors.forename: Robert R
authors.initials: RR
authors.lastname: McWilliams
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Parker
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Riegert-Johnson
authors.forename: Carolyn R
authors.initials: CR
authors.lastname: Rohrer Vitek
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Schahl
authors.forename: Cloann
authors.initials: C
authors.lastname: Schultz
authors.forename: Keith
authors.initials: K
authors.lastname: Stewart
authors.forename: George C
authors.initials: GC
authors.lastname: Then
authors.forename: Eric D
authors.initials: ED
authors.lastname: Wieben
authors.forename: Gianrico
authors.initials: G
authors.lastname: Farrugia
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000639:trends; D026688:Bioethical Issues; D019295:Computational Biology / Q000379:methods; D059472:Exome / Q000235:genetics*; D005817:Genetic Counseling / Q000379:methods; D005826:Genetics, Medical / Q000379:methods* / Q000639:trends; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000639:trends*; D057285:Precision Medicine / Q000379:methods* / Q000639:trends
keywords: genomic medicine; individualized medicine clinic; personalized medicine; whole exome sequencing