Veterans Affairs Pharmacogenomic Testing for Veterans (PHASER) clinical program

Area of Science:

• Pharmacogenomics
• Clinical Implementation
• Healthcare Systems

Background:

• The Veterans Affairs (VA) initiated the Pharmacogenomic Testing for Veterans (PHASER) program in 2019, a large-scale clinical program providing multi-gene pharmacogenomic (PGx) testing.
• The program targets up to 250,000 veterans across approximately 50 sites, with a phased rollout over five years (2019-2023) to enable iterative quality improvements.

Discussion:

• The PHASER program addresses a gap in current resources by focusing on the multisite, remote implementation of panel-based PGx testing.
• Iterative program improvements are facilitated through Plan-Do-Study-Act cycles during the staggered site initiation.
• The program aims to develop a roadmap for maximizing the uptake and optimizing the use of PGx testing.

Key Insights:

• Large-scale implementation of pharmacogenomic testing within a major integrated healthcare system.
• Phased rollout strategy supports iterative quality improvement and adaptation.
• Focus on multisite, remote implementation challenges and solutions for PGx testing.

Outlook:

• The PHASER program is expected to provide a scalable model for integrating PGx testing into routine clinical practice.
• Development of best practices for maximizing PGx test utilization to enhance patient outcomes.
• Potential to significantly improve drug response and reduce adverse events for a large veteran population.