The IGNITE network: a model for genomic medicine implementation and research

Kristin Wiisanen Weitzel, Madeline Alexander, Barbara A. Bernhardt, Neil Calman, David J. Carey, Larisa H. Cavallari, Julie R. Field, Diane Hauser, Heather A. Junkins, Phillip A. Levin, Kenneth Levy, Ebony B. Madden, Teri A. Manolio, Jacqueline Odgis, Lori A. Orlando, Reed Pyeritz, R. Ryanne Wu, Alan R. Shuldiner, Erwin P. Bottinger, Joshua C. Denny, Paul R. Dexter, David A. Flockhart, Carol R. Horowitz, Julie A. Johnson, Stephen E. Kimmel, Mia A. Levy, Toni I. Pollin, Geoffrey S. Ginsburg, on behalf of the IGNITE Network

Patients, clinicians, researchers and payers are seeking to understand the value of using genomic information (as reflected by genotyping, sequencing, family history or other data) to inform clinical decision-making. However, challenges exist to widespread clinical implementation of genomic medicine, a prerequisite for developing evidence of its real-world utility. To address these challenges, the National Institutes of Health-funded IGNITE (Implementing GeNomics In pracTicE; www.ignite-genomics.org ) Network, comprised of six projects and a coordinating center, was established in 2013 to support the development, investigation and dissemination of genomic medicine practice models that seamlessly integrate genomic data into the electronic health record and that deploy tools for point of care decision making. IGNITE site projects are aligned in their purpose of testing these models, but individual projects vary in scope and design, including exploring genetic markers for disease risk prediction and prevention, developing tools for using family history data, incorporating pharmacogenomic data into clinical care, refining disease diagnosis using sequence-based mutation discovery, and creating novel educational approaches. This paper describes the IGNITE Network and member projects, including network structure, collaborative initiatives, clinical decision support strategies, methods for return of genomic test results, and educational initiatives for patients and providers. Clinical and outcomes data from individual sites and network-wide projects are anticipated to begin being published over the next few years. The IGNITE Network is an innovative series of projects and pilot demonstrations aiming to enhance translation of validated actionable genomic information into clinical settings and develop and use measures of outcome in response to genome-based clinical interventions using a pragmatic framework to provide early data and proofs of concept on the utility of these interventions. Through these efforts and collaboration with other stakeholders, IGNITE is poised to have a significant impact on the acceleration of genomic information into medical practice.