Implementing genomic medicine in New Zealand.

Genomic sequencing is a transformative technology, and its integration and implementation in the practice of medicine requires systemwide change. Genomic technology is already influencing many areas of medicine: rare disease, reproductive health, cancer, pharmacogenetics and infectious disease. Ensuring genomic tests are available and are adopted in an effective and efficient way requires forethought and simultaneous change across multiple areas of health. Beyond the technical requirements of sequencing and bioinformatics capacity, planning will need to address data integration and interpretation, workforce capacity and capability, public acceptability, government engagement and ethical and legislative issues. To ensure all these considerations are managed, many states or nations have developed policy frameworks or strategies. Implementation science enables us to understand the factors that support adoption of new technologies. The lessons learnt from other jurisdictions who have implemented genomic medicine programmes clearly support the need for a coordinated whole of systems approach. New Zealand should heed these lessons. New Zealand needs a genomic medicine strategy.