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Implementing Genomic Medicine in a Federally Qualified Health Center: Assessing Readiness through a Mixed-Methods
Emory William Heffernan1, Paramita Das2, Larry Hearld3
1Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Introduction:
Genomic medicine enables early detection of treatable conditions and supports personalized care across all populations; however, evidence guiding its implementation in resource-constrained healthcare settings remains limited.
Methods:
Using a mixed-methods approach, this study evaluated the readiness of an Alabama Federally Qualified Health Center (FQHC) to implement genomic medicine as part of routine clinical care. Staff members (e.g., physicians, nurses, medical assistants, and administrators) completed surveys, individual interviews, a concept mapping session, and a nominal group technique exercise.
Results:
Study participants included 13 clinic members. Interviews and mapping revealed three dominant barriers: staffing shortages, financial constraints, and language obstacles. Facilitators included a strong commitment to quality care, alignment with the clinical mission, and supportive leadership. Survey results (N = 12) revealed mean scores in the positive range for culture, learning climate, and leadership engagement, whereas scores for stress, available resources, and readiness for change were nearer to the neutral midpoint, suggesting potential practical constraints on genomic implementation. The use of the CFIR-ERIC Implementation Strategy Matching Tool allowed the team and participants to evaluate nine candidate strategies, prioritizing those with high feasibility and impact. The evaluation was visually developed into an impact matrix which placed patient and family involvement, tailored educational materials, educational meetings, and designated genomic medicine leadership in the high-feasibility/high-impact quadrant. These strategies directly address identified barriers and fit existing clinical strengths, which is important for equitable precision-medicine adoption.
Conclusion:
Findings indicate that FQHCs can advance genomic services through culturally attuned patient engagement, structured provider training, and clear leadership roles.
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