Implementing Genomic Medicine in Primary Care: A Convergent Mixed Method Case Study

PURPOSE: Despite the growing interest in implementing genomic medicine into primary care, numerous barriers persist. Herein we present formative work conducted at three primary care clinics to identify barriers to implementation as part of a state-funded genomic medicine initiative. METHODS: A convergent mixed-methods case study was conducted across three family practice clinics participating in the Alabama Genomic Health Initiative. Quantitative, cross-sectional surveys evaluated clinic personnel attitudes, implementation climate, and feasibility. Additionally, qualitative, semi-structured interviews examined clinic personnel's perceptions of genomic medicine implementation into routine care, identified barriers to this integration, and investigated strategies for overcoming these barriers. RESULTS: Respondents exhibited positive attitudes towards genomic medicine while voicing concerns regarding time constraints, technological integration, lack of actionable results for certain patients, and inadequate implementation knowledge. Although the primary care climate was generally supportive of change, it was less conducive to the specific implementation of genomic medicine. External facilitators and educational resources were identified as critical for successful implementation. CONCLUSION: Despite primary care personnel acknowledging the preventive and diagnostic value of genomic medicine, the effective integration of this practice requires practical solutions to barriers such as resource limitations and specialized training needs, indicating that enhanced infrastructure and focused educational initiatives could facilitate its implementation.