Progress toward Health System Readiness for Genome-Based Testing in Canada

Author:

Husereau Don1ORCID,Villalba Eva2ORCID,Muthu Vivek3,Mengel Michael4ORCID,Ivany Craig5,Steuten Lotte67,Spinner Daryl S.8,Sheffield Brandon9,Yip Stephen10,Jacobs Philip11,Sullivan Terrence1213,Arshoff Larry14ORCID

Affiliation:

1. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada

2. Coalition Priorité Cancer au Québec, Saint-Lambert, QC J4P 2J7, Canada

3. Marivek Healthcare Consulting, Epsom KT18 7PF, UK

4. Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB T6G 2S2, Canada

5. Provincial Health Services Authority, Vancouver, British Columbia, Vancouver, BC V5Z 1G1, Canada

6. Office of Health Economics, London SE1 2HB, UK

7. City University of London, London EC1V 0HB, UK

8. Menarini Silicon Biosystems Inc., Huntingdon Valley, PA 19006, USA

9. William Osler Health System, Brampton, ON L6R 3J7, Canada

10. Department of Pathology & Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada

11. Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada

12. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada

13. Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H4A 3T2, Canada

14. Diagnosis, Solutions & Results Inc., Thornhill, ON L4J 7N5, Canada

Abstract

(1) Background: Genomic medicine harbors the real potential to improve the health and healthcare journey of patients, care provider experiences, and improve the health system efficiency—even reducing healthcare costs. There is expected to be an exponential growth in medically necessary new genome-based tests and test approaches in the coming years. Testing can also create scientific research and commercial opportunities beyond healthcare decision making. The purpose of this research is to generate a better understanding of Canada’s state of readiness for genomic medicine, and to provide some insights for other healthcare systems. (2) Methods: A mixed-methods approach of a review of the literature and key informant interviews with a purposive sample of experts was used. The health system readiness was assessed using a previously published set of conditions. (3) Results: Canada has created some of the established conditions, but further action needs to be taken to improve the state of readiness for genome-based medicine. The important gaps to be filled are the need for linked information systems and data integration; evaluative processes that are timely and transparent; navigational tools for care providers; dedicated funding to facilitate rapid onboarding and support test development and proficiency testing; and broader engagement with innovation stakeholders beyond care providers and patients. These findings highlight the role of the organizational context, social influence, and other factors that are known to affect the diffusion of innovation within health systems.

Funder

Amgen Canada, Inc.

AstraZeneca Canada Inc.

Eli Lilly Canada, Inc.

GlaxoSmithKline Inc.

Hoffmann-La Roche Canada, Inc.

Janssen/J&J Canada Inc.

Pfizer Canada ULC

Thermo Fisher Scientific Inc.

Publisher

MDPI AG

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