title: Making Personalized Health Care Even More Personalized: Insights From Activities of the IOM Genomics Roundtable.
abstract: Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and development, prenatal and neonatal screening, clinical pharmacogenomics, more sensitive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the greatest impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, California Roundtable on Translating Genomic-Based Research for Health, Institute of Medicine (IOM) of the National Academies spdavid@stanford.edu.
authors.forename: Sean P
authors.initials: SP
authors.lastname: David
authors.affiliation: Roundtable on Translating Genomic-Based Research for Health, Institute of Medicine (IOM) of the National Academies Applied Pharmacogenomics, Kaiser-Permanente Colorado, Aurora, Colorado Department of Clinical Pharmacy, University of Colorado, Denver, Colorado.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Johnson
authors.affiliation: Applied Pharmacogenomics, Kaiser-Permanente Colorado, Aurora, Colorado.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Berger
authors.affiliation: Applied Pharmacogenomics, Kaiser-Permanente Colorado, Aurora, Colorado Maine-Dartmouth Family Medicine Residency Program, Augusta, Maine.
authors.forename: W Gregory
authors.initials: WG
authors.lastname: Feero
authors.affiliation: Roundtable on Translating Genomic-Based Research for Health, Institute of Medicine (IOM) of the National Academies Genetic Alliance, Washington, DC.
authors.forename: Sharon F
authors.initials: SF
authors.lastname: Terry
authors.affiliation: Department of Family Medicine, University of Colorado, Denver, Colorado.
authors.forename: Larry A
authors.initials: LA
authors.lastname: Green
authors.affiliation: American Board of Family Medicine, Lexington, Kentucky.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Phillips
authors.affiliation: Roundtable on Translating Genomic-Based Research for Health, Institute of Medicine (IOM) of the National Academies Center for Applied Genomics and Precision Medicine, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Geoffrey S
authors.initials: GS
authors.lastname: Ginsburg
mesh_terms: D023281:Genomics; D006801:Humans; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division / Q000458:organization & administration*; D018802:Patient-Centered Care; D057285:Precision Medicine; D057170:Translational Research, Biomedical; D014481:United States
keywords: clinical implementation science; genomics; personalized medicine; precision medicine; primary health care