An integrated strategy for implementing infectious disease genomics

Laura Blackburn

9 July 2015

In the new report Pathogen Genomics Into Practice, we outline our recommendations for efficiently implementing pathogen genomics into infectious disease services. Although many small-scale pathogen genomics services currently exist, our work shows that a nationally coordinated system of service development and delivery is needed to amplify these efforts into an effective nation-wide service that will benefit patients and population health. 

A successful implementation strategy must feature data integration and strategic coordination and leadership, which form the basis of the policy roadmap and catalyst presented in the report. 

The roadmap: pathways to implementation

Maximising the effectiveness of current small-scale infectious disease genomics services is hampered by the current fragmented and unstable system for delivering health innovations. An absence of mechanisms and infrastructure to facilitate integration, development and exchange of data, knowledge and expertise compounds the challenge, and increases the risk that innovation will happen in silos and not benefit the whole population. 

The roadmap addresses these challenges. It provides a framework for improving two central aspects of pathogen genomics services:

  1. The service delivery pathway - outlining the steps to establishing and delivering effective genomics-enabled services that benefit patients and population health
  2. The research and development pathway - emphasising how to accelerate the development of genomic technology, methodology and knowledge, to form the basis of the expansion improvement of services

A coordinated, strategic approach is essential to bring together the many organisations involved in development and delivery of infectious disease genomics, one that takes into account their varying levels of awareness, engagement and capability whilst creating an environment where all are working together towards a common goal. 

The catalyst: amplification and integration

Integrated pathogen genomics services require structures – real or in some cases virtual, for example coordinating laboratories or committees to oversee practice and strategy - to bring together current efforts in pathogen genomics, amplify their effectiveness and integrate them into current activities. The third part of the roadmap sets out the creation of a catalyst that will be integral to effective and timely implementation of pathogen genomics services.

The catalyst has four main functions to help develop an integrated approach to the delivery of pathogen genomics services:

  • Repository function: to develop infrastructure for data, knowledge and samples
  • Collaborative function: to develop collaborations within and between the health services, academia and industry
  • Standardisation and expertise diffusion function: to facilitate the development of standards and sharing of expertise
  • Strategic coordination and development function: to form a leadership group to drive forward coordination and development of policies across all stakeholders

Impact on current and future infectious disease genomics service delivery

Developing the structures within the catalyst will have a direct impact on current services through two positive feedback loops. Firstly, deposited data and shared expertise are used to improve outbreak detection, diagnostics and disease surveillance. Secondly, shared expertise and methods support continuous improvement in services offered. In the longer term, future services will be enhanced through stakeholders depositing and sharing clinical data, samples and knowledge. The structures in the catalyst will facilitate access to this information by research and development organisations and enable them to collaborate. The knowledge and products developed can then be fed back to service delivery organisations. 

Ensuring equitable nationwide provision of pathogen genomics

The catalyst and the roadmap together provide a clear way forward for the development of pathogen genomics services. While some excellent services currently exist on a local level, a fragmentary approach will simply not result in the implementation of services that are equitably provided and consistent in quality across the country. Conversely, the effective implementation of pathogen genomics as outlined above represents an important opportunity to show that genomics can transform health services. If this is achieved, then the English health system will be a world-leader in the use of genomics in healthcare. 

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