Integrating genomic medicine into primary care: a precision health model from Riyadh, Saudi Arabia

OBJECTIVE: To describe the design, structure and first-year operational data of the Precision Medicine Clinic (PMC) at King Faisal Specialist Hospital & Research Centre (KFSHRC), a primary-care-embedded genomic medicine service launched in Riyadh, Saudi Arabia, in January 2025. DESIGN: Descriptive service report. SETTING: The Precision Medicine Clinic, an embedded subspecialty service within the Department of Family Medicine and Polyclinics at KFSHRC-a publicly funded, single-payer tertiary academic centre in Riyadh, Saudi Arabia. PARTICIPANT: Adult and paediatric patients evaluated at the PMC during its first calendar year of operation (January-December 2025), referred from primary care for predictive genomic testing, pharmacogenomic testing or genetic counselling. RESULT: The PMC evaluated 212 patients in 2025. Predictive genomic testing accounted for approximately 57% of evaluations and pharmacogenomics for approximately 43%, indicating a genuinely hybrid first-year caseload rather than one dominated by a single modality. Turnaround time from referral to results delivery was approximately 2-4 months. The predominant care model was two-visit (family-history capture and consent at visit 1; results disclosure at visit 2). Distinguishing features include embedding within a fully operational family-medicine department, a hybrid service scope spanning reactive pharmacogenomics, predictive Centres for Disease Control and Prevention (CDC) tier-1 actionable-gene screening and reproductive carrier screening under a single referral interface, integration with the Saudi Human Genome Program (SHGP) reference catalogue, and operation during the first year without routine medical-geneticist involvement. CONCLUSION: The PMC-KFSHRC offers a replicable organisational template for integrating genomic medicine into primary care within a publicly funded, single-payer system and a reference architecture for Gulf and emerging-economy health systems pursuing primary-care genomic integration under Vision 2030-aligned digital-health strategies.