13.4 Health System Readiness for the Genomic Era

Nursing & The Future of Genomics

The future of genomics in healthcare is poised to transform the prevention, diagnosis, and treatment of diseases through precision medicine. As healthcare evolves to integrate these technologies, nurses will play a pivotal role as educators, advocates, and leaders. They will guide patients in understanding genetic information, support informed decision-making, and bridge the gap between complex genomic data and patient-centred care. Additionally, nurses will contribute to interdisciplinary teams by addressing ethical considerations, ensuring equitable access to genomic interventions, and fostering genomic literacy within healthcare systems. Their holistic perspective positions them as vital contributors to the equitable implementation of genomics in improving population health outcomes.

What will the future of genomics look like?

Watch Siddhartha Mukherjee, biologist, physician, and Pulitzer Prize-winning author of the Gene: An Intimate History, describe 10 bold predictions for the future of genomics.

Note: This is an amazing book that everyone should read! There is also a full length PBS series by Ken Burns based on the book by Mukherjee.

Visit the NHGRI website for an interactive web-based application detailing the NHGRI 2020 Strategic Vision. You can also access the full document in .pdf format [PDF].

Canada’s Readiness for Genomics Integration

In this course, we have discussed the benefits of genomics, alongside the challenges associated with its implementation. In 2021, Canada committed $400 million dollars to the Pan-Canadian Genomics Strategy (PCGS), aiming to position Canada as a global leader in genomics innovation (Government of Canada, 2023). To guide this initiative, the government engaged interested parties to identify strategic priorities, resulting in publishing a consultation paper.

The consultation paper (Government of Canada, 2023) outlines that a major challenge to genomics integration lies in the fragmentation of genomics services due to federated health systems, which hinder a unified national approach. Addressing these gaps requires enhanced coordination and collaboration across jurisdictions. Building a robust genomics workforce is also critical, involving initiatives to develop expertise, create employment opportunities, and attract and retain top talent. Furthermore, the standardization and secure sharing of genomic data across regions must be prioritized to maximize the utility of genomics research. The Global Alliance for Genomics and Health (GA4GH, n.d) provides a framework for responsible sharing of genomic and health-related data. Additionally, the World Health Organization (2024) just released guidance for human genome data collection, access, use and data sharing.Overcoming barriers in transitioning genomics technologies from research to commercialization, including pharmaceuticals, is essential for Canada to lead in the genomic era. Finally, the integration of genomics across diverse sectors—such as healthcare, environmental stewardship, and the food industry—will be pivotal in realizing the full potential of genomics in advancing Canadian society (Government of Canada, 2023). The Canadian Institutes of Health Research strategic plan Sequencing Our Future: 2020-2027, mentioned in a previous unit, also commits to enabling genomic medicine through research, including streamlining data access through developing a Canadian Human Genome Library. Husereau et al. (2023) evaluated Canada’s readiness to adopt widespread genomic testing through a comprehensive literature review and interviews with key informants. Their analysis assessed the healthcare system against established readiness conditions, revealing that Canada remains in the early stages of preparing for a genomic future. Among the provinces examined by the authors (British Columbia, Alberta, Ontario, Quebec, and Nova Scotia), Alberta and Quebec have made the most significant strides in genomics integration, attributed to their establishment of centralized laboratories and service organizations, which mitigate fragmentation within these provinces. In contrast, provinces with multiple health authorities face heightened challenges in coordinating genomic services. These findings align with priorities identified in the consultation paper and underscore the need for provider education and navigation tools to facilitate integration into healthcare systems. A major barrier highlighted is funding, which will require substantial attention to ensure successful implementation (Husereau et al., 2023).

Attribution & References

Except where otherwise noted, this page is written by Andrea Gretchev, CC BY-NC 4.0

References

Global Alliance for Genomics & Health. (n.d). Framework for responsible sharing of genomic and health-related data . https://www.ga4gh.org/framework/

Government of Canada. (2023, August 24). Consultation paper: Developing a pan‑Canadian genomics strategy. https://ised-isde.canada.ca/site/genomics/en/consultation-paper-developing-pan-canadian-genomics-strategy

Husereau, D., Villalba, E., Muthu, V., Mengel, M., Ivany, C., Steuten, L., Spinner, D. S., Sheffield, B., Yip, S., Jacobs, P., Sullivan, T., & Arshoff, L. (2023). Progress toward Health System Readiness for Genome-Based Testing in Canada. Current oncology (Toronto, Ont.), 30(6), 5379–5394. https://doi.org/10.3390/curroncol30060408

World Health Organization. (2024, November 20). Guidance for human genome data collection, access, use and data sharing. https://www.who.int/publications/i/item/9789240102149