Implementing Pharmacogenomics in Contemporary Hospital Care: Insights from Multidisciplinary Knowledge Exchange

Pharmacogenomics (PGx) is increasingly recognised as a cornerstone of personalised medicine, with established recommendations for many commonly prescribed medicines. Despite this, translation into real-world clinical practice remains inconsistent, reflecting persistent implementation and health-system gaps.

To provide a multidisciplinary perspective on the system-level conditions required to normalise PGx within contemporary hospital care, drawing on structured knowledge exchange and priority-setting across clinical, digital and governance domains.

A multidisciplinary knowledge exchange program convened clinicians, pharmacists, genetic services, informatics teams, researchers and health-service leaders across oncology, transplantation, peri-operative care and palliative care. Knowledge was exchanged through presentations, informing the generation and ranking of shared priorities in groups and individually using the Nominal Group Technique. Aggregate scores were calculated, and priorities further refined. Presentation insights were synthesised using a narrative, interpretive approach, to identify cross-cutting translational themes.

Eleven shared priorities were identified across four broad critical levers for sustainable integration: (1) computable, reusable PGx data embedded within electronic medical records (EMR); (2) coordinated and equitable testing and prescribing pathways; (3) workforce capability and stewardship; and (4) governance. Equity, access and data sovereignty were highlighted as foundational to responsible scale-up, particularly for First Nations peoples and under-represented communities.

Insights from this knowledge-exchange program highlight the feasibility and clinical relevance of PGx, and identify workforce capability, EMR integration, and system-level governance as critical implementation levers of adoption. Coordinated national investment and policy alignment will be central to realising the full value of PGx.