The right pieces in place
There’s plenty of evidence that genomics works. But that’s not enough to create change. So we asked hard questions about what else was needed to make genomic care mainstream, equitable and cost effective.
Report from the Executive Director
Professor Clara Gaff
A change story isn’t an epic; it’s more like a daytime soap opera. Even as you resolve one problem, the next emerges.
When Melbourne Genomics began its final program in 2021, it was clear that genomics would benefit patients. The evidence was so compelling that several genomic tests had already been added to the Medicare Benefits Scheme.
But even overwhelming evidence and funding aren’t enough to create change. Genomic testing was still not being used at anywhere near expected levels.
So our Alliance set out to understand what else was needed. Research with doctors, consumers and genetic experts identified a range of individual, operational and systemic barriers. Together Alliance members designed and road-tested ways to remove these barriers: from teaching clinics and how-to guides, to new models of service delivery and collaborations between health services. As new questions arose – about safety, data management, cost and value – we sought the answers.
Most projects were completed in 2024, filling in many missing pieces. We now have insights on models of care that can work in regional and metropolitan contexts; road-tested ways to bring genomic expertise into relevant medical specialties; and tools to enable good clinical governance.
Assets created by the Alliance will continue to enhance genomic care. The Genomics and Your Hospital toolkit will help hospital leaders plan for safe, effective and high-value genomic care. Genomical, the software platform built by the Alliance, will continue to support genomic testing under the management of a spinout company. The education assets developed through our program will be taken forward by other organisations to ensure genomic education can endure.
Even as our role in the story comes to an end, new challenges are emerging. How will genomic care be provided within Victoria’s new Health Service Networks? How can genomics be truly equitable and culturally safe? Fortunately, there are many great minds – from hospital CEOs to health economists, Aboriginal healthcare leaders and many more – who are ready to take on these challenges.
I am grateful to Cathy Walter and our Board for their wise leadership, most especially during the commercialisation of Genomical. I present this report with pride in all the Alliance has accomplished, and hope for a bright future for genomic care.
What's in this report?
- How can it work in our hospitals? Ways to bring genomics into relevant specialties and support hospital-wide planning
- How can it work around the state? Ways to ensure any Victorian can get genomic care – onsite at their local hospital or via the right referral pathway
- How can the workforce manage the change? Strategies that help clinicians put genomics into practice
- How can we put a value on it? Where genomics offers value and how to measure that value
- How can our systems handle it? Ways to scale up and crucial challenges to address
- How can it work for everyone? How consumer involvement can make genomics more accessible and equitable