Coordination for Demonstrating Real-world Advancement in Genomics Operations Network (DRAGON)

The Network of Genomics-Enabled Learning Healthcare Systems (gLHS) Coordinating Center will support a national, highly functional, integrated genomic medicine implementation infrastructure that will enhance the quality, efficiency, and scientific rigor required to deploy and refine interventions chosen by the Network. We are a team composed of leading content and

methods experts at Vanderbilt University Medical Center. We propose that a Demonstrating Real- world Advancement in Genomics Operations Network (‘DRAGON’) will allow us to “we learn from what we do and do what we learn.” We will support the clinical sites (CSs) in appropriately embedding genomic medicine into routine workflows to promote more ready access to testing for

patients who would benefit. This requires assurance that clinicians understand and are willing to act upon a strong evidence base utilizing vetted, established best practices. It necessitates a landscape survey to identify the barriers and facilitators that the selected CSs may encounter. It also demands engagement with patients and communities to help the Network communicate

genetic risk and how testing will improve their care. Functionally, 1) we will coordinate all Network activities via our Operations Unit to ensure the collective is able to set, monitor and reach programmatic goals. This will include supporting site communications, establishing oversight committees, defining channels for NHGRI interaction, and facilitating network evolution. 2) We

will work with the CSs to select and optimize Network projects through our Design and Outcomes Unit. This group will offer statistical, methodologic, and operations expertise to promote both master protocol development and tailored local context modifications. We will cooperatively determine how best to refine and redeploy interventions after evaluation to foster cycles of true

learning. 3) We will institute and co-produce a shared technical gLHS architecture with our Data and Informatics Unit and CSs. This standardized approach will be essential to enabling effective collaboration, monitoring, and evaluation across sites. 4) We will implement the Engagement Unit. This group will promote bidirectional, longitudinal engagement from diverse communities; help

CSs build and sustain trust; ensure strengths of each CS are nurtured and shared; facilitate dissemination of findings; and encourage engagement with payors, providers, and health systems. DRAGON efforts will broaden the clinical availability, appropriateness, and actionability of genomic medicine interventions by creating a community of practice dedicated to continual

accountability, improvement, and enhancement in genomic testing utilization.