A consensus model for implementation of genomics in Queensland Health - a Delphi study

BACKGROUND: As genomic technologies in healthcare expand, health systems face integration challenges. This study aimed to consolidate collective expertise, experiences, and existing knowledge from local, statewide, and national genomics projects to inform a model of care for integrating and delivering genomic services in the Queensland public health system. METHODS: We used a modified Delphi methodology with three survey rounds to achieve expert consensus on the model of care. We analysed quantitative data using descriptive statistics and qualitative data using content analysis. RESULTS: From 112 invited experts, 43 participants took part. The model of care comprised 30 actions across three phases: pre-test, testing, and post-test. Consensus (≥ 75% agreement) was achieved on 25 of the actions, with 5 included with specific considerations. Ten recommendations were developed, including building sustainability, improving access to specialists through a distributed model, and investing in clinical-pathology partnerships and infrastructures. CONCLUSION: These findings may inform a comprehensive, stakeholder-informed, system-level implementation effort for mainstreaming genomic medicine that is practical, feasible, and acceptable to key stakeholders across the system. The three-phase model of care provides a structured approach to genomic service delivery and has the potential to significantly improve patient access and healthcare delivery.