title: Perspectives on genetic and genomic technologies in an academic medical center: the duke experience.
abstract: In this age of personalized medicine, genetic and genomic testing is expected to become instrumental in health care delivery, but little is known about its actual implementation in clinical practice.
  
  
  METHODS
  We surveyed Duke faculty and healthcare providers to examine the extent of genetic and genomic testing adoption. We assessed providers' use of genetic and genomic testing options and indications in clinical practice, providers' awareness of pharmacogenetic applications, and providers' opinions on returning research-generated genetic test results to participants. Most clinician respondents currently use family history routinely in their clinical practice, but only 18 percent of clinicians use pharmacogenetics. Only two respondents correctly identified the number of drug package inserts with pharmacogenetic indications. We also found strong support for the return of genetic research results to participants. Our results demonstrate that while Duke healthcare providers are enthusiastic about genomic technologies, use of genomic tools outside of research has been limited. Respondents favor return of research-based genetic results to participants, but clinicians lack knowledge about pharmacogenetic applications. We identified challenges faced by this institution when implementing genetic and genomic testing into patient care that should inform a policy and education agenda to improve provider support and clinician-researcher partnerships.
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. sara.katsanis@duke.edu.|Duke Science and Society, Duke University, Durham, NC 27708, USA. sara.katsanis@duke.edu.
authors: Sara Huston
authors: SH
authors: Katsanis
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. mollie.minear@duke.edu.|Duke Science and Society, Duke University, Durham, NC 27708, USA. mollie.minear@duke.edu.
authors: Mollie A
authors: MA
authors: Minear
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. allison.vorderstrasse@duke.edu.|Duke University School of Nursing, Durham, NC 27708, USA. allison.vorderstrasse@duke.edu.
authors: Allison
authors: A
authors: Vorderstrasse
authors: Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. nyyduke@gmail.com.
authors: Nancy
authors: N
authors: Yang
authors: Sanofi, Cambridge, MA 08807, USA. jason.reeves@sanofi.com.
authors: Jason W
authors: JW
authors: Reeves
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. teji.rb@duke.edu.
authors: Tejinder
authors: T
authors: Rakhra-Burris
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. bob.cd@duke.edu.|Duke Science and Society, Duke University, Durham, NC 27708, USA. bob.cd@duke.edu.|Sanford School of Public Policy, Duke University, Durham, NC 27708, USA. bob.cd@duke.edu.
authors: Robert
authors: R
authors: Cook-Deegan
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. geoffrey.ginsburg@duke.edu.
authors: Geoffrey S
authors: GS
authors: Ginsburg
authors: Center for Applied Genomics and Precision Medicine, Duke University School of Medicine and Health System, Durham, NC 27708, USA. leighann.simmons@duke.edu.|Duke University School of Nursing, Durham, NC 27708, USA. leighann.simmons@duke.edu.
authors: Leigh Ann
authors: LA
authors: Simmons