Convergence of Implementation Science, Precision Medicine, and the Learning Health Care System: A New Model for Biomedical Research

Since the start of the Human Genome Project 25 years ago, basic discoveries related to genomics and other "-omic" fields have continued to advance exponentially. This progress has facilitated the 2015 launch of the US Precision Medicine Initiative (PMI). The PMI is intended to merge genomic, biological, behavioral, environmental, and other data on individuals to identify drivers of health that might support personalized health care decision making. In the cancer domain, for example, recognition of both inherited genetic susceptibility (eg, Lynch syndrome for colorectal cancer, and BRCA1/2 for breast cancer) and cancer genome sequence alterations that can pinpoint therapeutic agents (eg, National Cancer Institute's MATCH trials) has the potential to make clinical decisions more personalized both in prevention and treatment. The "National Cancer Moonshot Initiative" seeks to rapidly scale up these efforts. Here, Chambers et al discuss convergence of implementation science, precision medicine, and the learning health care system, a new model for biomedical research.