The Genome-Based Knowledge Management in Cycles Model: A Complex Adaptive Systems Framework for Implementation of Genomic Applications

Abstract

The main mission of the Genomic Applications in Practice and Prevention Network™ is to advance collaborative efforts involving partners from across the public health sector to realize the promise of genomics in healthcare and disease prevention. We introduce a new framework that supports the Genomic Applications in Practice and Prevention Network mission and leverages the characteristics of the complex adaptive systems approach. We call this framework the Genome-based Knowledge Management in Cycles model (G-KNOMIC). G-KNOMIC proposes that the collaborative work of multidisciplinary teams utilizing genome-based applications will enhance translating evidence-based genomic findings by creating ongoing knowledge management cycles. Each cycle consists of knowledge synthesis, knowledge evaluation, knowledge implementation and knowledge utilization. Our framework acknowledges that all the elements in the knowledge translation process are interconnected and continuously changing. It also recognizes the importance of feedback loops, and the ability of teams to self-organize within a dynamic system. We demonstrate how this framework can be used to improve the adoption of genomic technologies into practice using two case studies of genomic uptake.

Structured approaches to implementation of clinical genomics: A scoping review

“…[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Studies/reports were categorized according to the level of clinical health care addressed: the health care system (ie, strategic), an organization (ie, operational), or a team (ie, operational). Most commonly, studies targeted both organization and team levels (n = 11), [16][17][18][19][30][31][32][33][34][35][36] followed by the health care systems and organizations (n = 8). 15,[21][22][23][24][25]27,29 Gray literature studies most commonly addressed health care systems and organizations (n = 7), [21][22][23][24][25]27,29 whereas peer-reviewed studies most commonly addressed the organization and team levels (n = 11) (Supplemental File 5).…”

“…15,[21][22][23][24][25]27,29 Gray literature studies most commonly addressed health care systems and organizations (n = 7), [21][22][23][24][25]27,29 whereas peer-reviewed studies most commonly addressed the organization and team levels (n = 11) (Supplemental File 5). [16][17][18][19]30,[32][33][34][35][36][37] Most studies/reports identified were driven by government bodies (n = 13), [21][22][23][25][26][27][28][29]31,[38][39][40][41] with 10 of these as government reports rather than research studies. [21][22][23][25][26][27][28][29]40,41 Another 13 were conducted by independent academics.…”

“…[21][22][23][25][26][27][28][29]40,41 Another 13 were conducted by independent academics. 15,[17][18][19]30,32,35,38,[42][43][44][45][46] Many of these independent academics received grant funding from government to conduct their study. A total of 7 studies were conducted by research groups (ie, a network of researchers collaborating on a project from different institutions) 14,16,20,24,33,36,47 and 1 was a commercial endeavor.…”

“…In total, we identified 30 newly created/proposed structured approaches to the implementation of clinical genomics presented in 30 studies/reports 4,14-22,24-33,35-37,39-44,47 and 4 pre-existing approaches in 4 studies/reports. 23,34,38,45 Most approaches were identified in peer-reviewed articles (n = 23), [14][15][16][17][18][19][20][30][31][32][33][34][35][36][37][38][39][42][43][44][45][46][47] whereas 11 were identified in gray literature. [21][22][23][24][25][26][27][28][29]40,41 The United States contributed the majority of structured approaches with 17 publications identified.…”

The Ethical Introduction of Genome-Based Information and Technologies into Public Health

“…As mentioned earlier, HTA processes can be used, and additional frameworks for genome translation have already been proposed: for example, the 4 phases of translation presented by Khoury et al [12] and the ‘Genome-based Knowledge Management in Cycles' model by the GAPPNeT group [13]. In addition, criteria for responsible population screening have been proposed as refinements of the Wilson and Jungner criteria.…”