REFLECTION Making Personalized Health Care Even More Person- alized: Insights From Activities of the IOM Genomics Roundtable

Genomic research has generated much new knowledge into mechanisms of human disease, with the potential to catalyze novel drug discovery and develop-ment, prenatal and neonatal screening, clinical pharmacogenomics, more sensi-tive risk prediction, and enhanced diagnostics. Genomic medicine, however, has been limited by critical evidence gaps, especially those related to clinical utility and applicability to diverse populations. Genomic medicine may have the great-est impact on health care if it is integrated into primary care, where most health care is received and where evidence supports the value of personalized medicine grounded in continuous healing relationships. Redesigned primary care is the most relevant setting for clinically useful genomic medicine research. Taking insights gained from the activities of the Institute of Medicine (IOM) Roundtable on Translating Genomic-Based Research for Health, we apply lessons learned from the patient-centered medical home national experience to implement genomic medicine in a patient-centered, learning health care system. Ann Fam Med 2015;13:373-380. doi: 10.1370/afm.1772