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

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. 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. 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. 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.