Implementing and Evaluating Genomic Screening Programs in Health Care Systems

Genomic applications are being integrated into a broad range of clinical and research activities at health care systems across the United States. This trend can be attributed to a variety of factors, including the declining cost of genome sequencing and the potential for improving health outcomes and cutting the costs of care. The goals of these genomics-based programs may be to identify individuals with clinically actionable variants as a way of preventing disease, providing diagnoses for patients with rare diseases, and advancing research on genetic contributions to health and disease. Of particular interest are genomics- based screening programs, which will, in this publication, be clinical screening programs that examine genes or variants in unselected populations in order to identify individuals who are at an increased risk for a particular health concern (e.g., diseases, adverse drug outcomes) and who might benefit from clinical interventions. On November 1, 2017, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to explore the challenges and opportunities associated with integrating genomics-based screening programs into health care systems. This workshop was developed as a way to explore the challenges and opportunities associated with integrating genomics-based programs in health care systems in the areas of evidence collection, sustainability, data sharing, infrastructure, and equity of access. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Evidence Considerations for Integrating Genomics-Based Programs into Health Care Systems 3 Financial Considerations for Implementing Genomics-Based Screening Programs 4 Exploring Approaches to Optimize Data Sharing Among Early Implementers of Genomics-Based Programs 5 Understanding Participant Needs and Preferences and Improving Diversity and Equity 6 Improving Health Through the Integration of Genomics-Based Programs: Potential Next Steps References Appendix A: Workshop Agenda Appendix B: Speaker Biographies Appendix C: Statement of Task Appendix D: Registered Attendees