Faculty in the division of General Internal Medicine, Susanne Haga, PhD, and Ryanne Wu, MD, recently published with colleagues, “A Mixed-Methods Protocol to Identify Best Practices for Implementing Pharmacogenetic Testing in Clinical Settings.” The protocol appeared in the special issue of Personalized Medicine: The Future of Health Care issue.
The study will look at the use of pharmacogenetic testing in clinical settings, which has not been widely implemented at this point, to identify driving factors of higher and lower utilization.
The study will collect both quantitative and qualitative data organized by an implementation science framework to identify factors salient to implementation success. This data will then be analyzed using a Configurational Comparative Method (CCM), which uses a mathematical algorithm to identify the essential characteristics that distinguish institutions and individual providers with high versus low uptake of the intervention. The advantage of CCM is that it can be used in studies with relatively small sample sizes and is able to evaluate real-world data to understand how factors independently and collectively impact uptake. An additional advantage to this approach is that it can identify multiple pathways to the same outcome. It may be that the factors necessary for implementation in a large academic healthcare system may not be the same as what is important in a small community clinic. Understanding these distinct pathways and critical elements will allow future implementation to be tailored to the needs of the individual healthcare system.
“The concept of precision medicine does not only apply to the care we provide our patients and tailoring therapy to their individual differences but also to the ways in which we implement programs in healthcare systems.” says Wu. “Just as a one-size-fits-all approach does not always work in patient care, it also may not work in program implementation.”
To conclude, providing a systematic way to generalize across institutional settings while maintaining individual nuance, with common language and definitions provided by implementation science frameworks, help to build general knowledge and hopefully will lead to more successful implementation of precision medicine interventions.