IGNITE

Implementing Genomics into Clinical Practice (IGNITE)

This consortium of investigators was created to enhance the use of genomic medicine by supporting the development of methods for incorporating genomic information into clinical care and exploration of the methods for effective implementation, diffusion and sustainability in diverse clinical settings. It is comprised of investigators who receive funding through the Genomic Medicine Demonstration Project Cooperative Grant (U01) mechanism of NHGRI. MeTree was among the first of round of projects to be funded. There are currently six funded projects with anticipation of a second round of funding possibly in 2017. Learn more.

Implementation, Adoption, and Utility of Family History in Diverse Care Settings

This study has the following goals:

  • To develop an optimal strategy for implementing MeTree into routine clinical practice in diverse settings.
  • To demonstrate the effectiveness of MeTree in increasing uptake of risk stratified evidence-based prevention guidelines
  • To create a standardized family health history storage database that can integrate with electronic medical records for bi-directional communication of family and personal history data and risk assessment results

This study is taking place in 35 clinics across 6 states in 5 U.S. health systems: Duke University, Essentia Health, Medical College of Wisconsin, University of North Texas, and Travis Air Force base. These settings represent a diversity of populations (underserved, rural, migrant, and white collar), a diversity of clinics (academic, indigent health, and community based) and a diversity of data management (from paper-based medical records to 4 different electronic medical record systems). We will develop implementation guides based upon our experiences in each of these settings to facilitate adoption by providers who want access to MeTree for clinic care.

Study Design

 

This study is a cluster-randomized controlled Hybrid type II Implementation-Effectiveness study. At each site there is at least one control clinic to evaluate concurrent trends in screening and referral practices. Among the intervention clinics there is a pre-implementation, implementation, and post-implementation phase to the study.

 

Pre-implementation phase 
Data is gathered from clinical staff and administrators to identify the best method for integration of MeTree and education regarding how MeTree works and what to expect. Using the information gathered, an implementation plan is being developed with feedback from the site PIs and local physician champions. One key area is how providers receive their reports until EMR linkage is achieved (at Duke reports are imported as PDFs at study start).

Implementation phase
The system is integrated into the clinical sites and tested with feedback from local staff regarding problems and potential solutions. Patient recruitment has begun.

Post-implementation phase
The system will be fully optimized for each clinic and recruitment will continue until completed.

Study personnel

 

At Duke At collaborating institutions

Geoffrey S Ginsburg, MD PhD- PI
Lori Orlando, MD – Co-I and site PI (Duke)
Teji Rakhra-Burris, MA – Project Leader (Duke)
R. Ryanne Wu, MD- Duke implementation co-lead
Rachel Myers, PhD - Biostatistician
Michael Musty, Project Manager

Cathy McCarty, MD – Co-I (Essentia)
Joan Neuner, MD MPH
Kimberly Fulda DrPH
Lt Col Troy Chinevere, PhD - Co-I (USAF, Travis)