Engaging Implementation Scientists in Precision Medicine

From the State of the Union through a number of NIH-led workshops to a report from the Advisory Committee to the NIH Director [PDF 1.05 MB], and the recently launched NIH funding announcements,  the Precision Medicine Initiative has the potential to reimagine how we can use information on our biology, our environment, our experiences, our priorities, and our behaviors to optimally benefit our health and our health care. While much of the discussion has been on the discovery end, implementation scientists at the National Cancer Institute are already imagining the benefits of considering implementation issues from the beginning.

One aspect of precision medicine that continues to grow rapidly is the use of genetic and genomic testing to improve prevention, diagnostics, and treatment planning. As more and more genetic and genomic tests reveal clinically actionable information for individuals and their families, particularly within the cancer field, we need to understand the best ways to implement the testing and the appropriate decision-making that follows at as broad a scale as possible. Implementation scientists are primed to support this endeavor, bringing understanding of context, of clinical and community practice change, or effective dissemination strategies, and of facilitators and barriers to precision medicine uptake. One upcoming workshop, hosted by the National Academy of Medicine, will bring together researchers, practitioners and other stakeholders to consider how implementation science can better inform genomics research across the translational pathway.

Implementation scientists can also benefit from the opportunity to engage in the challenging integration of a rapidly changing evidence base, far more complex than the more traditional role of integrating manualized, evidence-based interventions. Precision medicine is, at its core, dynamic and individualized. Our research and practice communities can help consider existing models, measures and methods to identify what leads to population health improvement.

At the upcoming 8^th Annual Conference on the Science of Dissemination and Implementation, the planning committee has chosen to spotlight the implementation of precision medicine as one of the major themes to be discussed. This will include a plenary panel on the second day, as well as an informal lunchtime discussion on the first day. If the implementation science community can augment the discovery agenda with proactive inquiry on how precision medicine can be implemented, we may stand a greater chance of scaling up successes so that optimal care can be standard care. Join us in the conversation on Research to Reality and share your thoughts about key implementation science questions that can maximize the overall value of a precision medicine agenda for cancer and beyond.