Characterizing healthcare provider experiences delivering genomic testing in a Federally Qualified Health Center

BACKGROUND: To maximize the potential benefits of genomic medicine for all, it is crucial to research and support the delivery of genomic medicine in under-researched healthcare settings. METHODS: This project investigated experiences of healthcare providers caring for low-resourced patients in a Federally Qualified Health Center in Phoenix, Arizona (FQHC) using a mixed-methods, cross-sectional case study. Interviews were conducted with 14 healthcare providers working in a FQHC, involved with delivering genomic testing (specifically, polygenic risk scores [PRS] and monogenic testing) to patients enrolled in the electronic Medical Records and Genomics (eMERGE) network, specifically the eMERGE IV study. RESULTS: Providers expressed a general confidence in genomic testing in practice. Quantitatively, most providers expressed confidence in communicating genomic test results to patients. However, qualitative findings emphasize time constraints, insufficient training, lack of human resources, and concerns for follow-up care and financial barriers, which are pronounced in FQHC settings. CONCLUSIONS: The potential of genomic testing to improve patient outcomes is strong, but system-level support for providers is necessary to strive towards sustainable and equitable implementation of genomic medicine, particularly in FQHC and other under-resourced primary care settings.