Challenges in implementing genomic medicine: the Mayo Clinic Center for Individualized Medicine

Abstract

The Mayo Clinic Center for Individualized Medicine (CIM) is designed to discover and integrate the latest in genomic, molecular, and clinical science into personalized care for patients across a multiple-site academic medical center. Despite a highly integrated structure, fully electronic medical record, and strong administrative support, achievement of this goal has had challenges. This article will describe the activities of the CIM, with emphasis on the strategy being used to clinically implement genomics.

Figure 1

The position of the “Pharmacogenomics Task Force” within the structure of the multiple-site Mayo Pharmacy Formulary Program is depicted graphically. This task force is part of the Mayo Center for Individualized Medicine Pharmacogenomics Program and is led by the director of the Department of Laboratory Medicine and Pathology Nucleotide Polymorphism Laboratory. The task force selects, in consultation with existing disease-oriented task forces, clinically relevant drug–gene pairs for which there is evidence of clinical utility for inclusion in the electronic medical record, as shown in the figure.