Under the leadership of Drs. Caitlin G. Allen and Lori Orlando, the Precision Health Research Program applies implementation science to design, implement, and rigorously evaluate precision health and genomic interventions in collaboration with our community and health system stakeholder partners in the following areas:
- Implementation of genomic medicine
- Population-based genomic screening
- Communication of genomic information
- Workforce development
Vision
To create a future where precision health is accessible, equitable, and seamlessly integrated into everyday care for every community.
Mission
To advance precision health by developing, implementing, and evaluating innovative stakeholder-informed implementation science solutions for genomic medicine that improve care for all.
Projects
- Advancing Translational Science Through the Implementation of Population Based Genomic Screening (ASPIRE): In this project, we are building and testing innovative, technology-enhanced approaches to make population-based genomic screening (PGS) more efficient at Atrium Health. By co-designing recruitment and results-return strategies with patients and community partners, and piloting tools such as automated e-consent, electronic patient portal outreach, educational videos, and the use of a chatbot to deliver information and education, ASPIRE aims to reduce barriers, streamline participation, and generate real-world evidence to scale genomic medicine programs for public health impact.
- Building Evidence for Optimal Genomic Screening Implementation in Primary Care (BEACON): Population-based genomic screening (PGS) has the potential to identify millions of individuals at risk for serious conditions, such as cancer and cardiovascular disease, yet it remains underutilized in primary care settings. Building off the multi-year PGS program “In Our DNA SC”, BEACON will identify the barriers and facilitators to the implementation of PGS across primary care providers (PCP) in South Carolina. (U01HG01498)
- Creating the Next Generation of Molecular Tumor Board (MTB) Platform to Empower Rural Communities to Precision Cancer Medicine: This project, funded by the Duke Endowment, will build a Next Generation (NextGen) Molecular Tumor Board (MTB) using generative AI to support clinical cancer decisions. The NextGen platform, designed for regional and then national usage, will leverage the capability and experience gained from current MTBs and clinical trials to build a system that supports wide-ranging oncologist communities, decreases inequities in screening and diagnosing, and improves care for all. This project will improve accessibility for rural oncologists to access expert guidance in use of targeted immunotherapy in cancer patients; enhance patient care by providing rural oncologists with easy access to better tools to interpret complex genomic data; improve patient outcomes in rural areas; decrease inequities of care among underrepresented groups by improves access to precision cancer medicine; and improve efficiency and decrease workforce and time required to provide guidance in precision oncology by using AI and machine learning.
- Expanding Cancer Genetics Access through CHW-Genetic Counselor Partnerships (EMPOWER): Since 2022, our team has collaborated closely with numerous partners in the Southeast United States (US) to train more than 175 community health workers (CHWs) in genomic competencies. Building from these partnerships, EMPOWER, funded by the Fullerton Foundation will develop and test a first of its kind model to establish a CHW-genetic counselor partnership designed to improve access to genetic care across the Southeast US.
- Facilitating the Implementation of Population-based Genomic Screening (FOCUS): This project is establishing the gold standard approach for integrating population-based genomic screening (PGS) into community and clinical settings. FOCUS is identifying generalizable methods and knowledge about how clinical settings can implement PGS into daily routines, operations, and workflow. In collaboration with our partners, FOCUS will apply implementation mapping to conduct a needs assessment of PGS programs, create an implementation toolkit, and evaluate the utility of the implementation toolkit using a stepped wedge cluster randomized trial design. (R01HG013851).
- FOCUS Partners include University of North Carolina Chapel Hill, University of Texas Health Science Center – Houston, University of South Florida, University of Southern California, Geisinger Clinic, and the Medical University of South Carolina.
- Scalable Clinical Decision Support for Individualized Cancer Risk Management (GARDE): GARDE is a scalable clinical decision support (CDS) tool for individualized cancer risk management. Evidence supports individualizing cancer screening based on each person’s risk. This study will enhance and disseminate software that scans electronic health records (EHRs) of target patient populations to 1) automatically identify those at high risk to develop hereditary cancers according to guidelines from the National Cancer Institute (NCI), and 2) reach out to patients via automated “chatbots” offering patient education and the opportunity to receive at home genetic testing for hereditary cancers. Through wide dissemination, the GARDE platform has the potential to enable evidence-based, individualized cancer screening to reduce cancer burden (5U24CA274582-02).
- GARDE Partners include the University of Utah
- For more information, visit the GARDE website
- Genomic medicine Risk Assessment Care for Everyone (GRACE): Family health history (FHH), a critical component of genomic medicine that is essential for both identifying individuals at risk for hereditary conditions and for contextualizing results of genetic testing, continues to be broadly underutilized and underappreciated in clinical care. GRACE is designed to: 1) develop and deploy a FHH collection model using pre-implementation assessments at clinical sites with highly diverse patient populations to select the most appropriate integration options and pathways for both patients and providers; and 2) perform a randomized implementation-effectiveness pragmatic hybrid trial to assess implementation and effectiveness outcomes relevant to these diverse populations. Outcomes will include reach, uptake, clinical utility, accessibility, genetic testing frequency, genetic testing results, and cost-effectiveness (5R01-HG011794-03).
- Precision Public Health Network: Established in 2019, PPHN is an international, transdisciplinary community dedicated to advancing the research agenda for precision cancer care and control. The PPHN is a collaborative hub for researchers to develop methods and evidence needed to advance population-level genomics health. (R13CA261073).
- PaRtnEring to build understanding oF gEnomics Responsibly (PREFER) CHW Genomics Research Education Program (PREFER CHW): The PREFER CHW program is designed to fill the gap in available resources to train CHWs in basic competencies related to genomics. We are working with CHW training programs in North Carolina, South Carolina, Tennessee, and Mississippi to develop and implement the program (1R25HG013479-01).
- Research on Improving Systems of Education (RISE): RISE is a collaboration among four CTSA hubs (the University of Buffalo, the University of Pennsylvania, the Medical University of South Carolina, and the University of Alabama Birmingham) that seek to evaluate the impact of remote vs. in-person methods on clinical trial efficiency (accrual) and quality (retention, treatment adherence, biospecimen completion rates) across 3 RCTs on 3 different use cases (smoking, depression, and SUD). (1UG3TR004797-01A1).
- Southeastern Genomic Medicine eConsult Network (SEGMENT): The purpose of SEGMENT is to build, launch, and evaluate an online eConsultation informatics platform to help build the knowledge base of the diagnosis of disease using socio-technical engineering to share knowledge across state lines among a community of clinical partners to improve access to complex care in rural and underserved areas in North and South Carolina and Georgia. SEGMENT will increase access for rural and underserved populations in the south. (1U01HG014142-01).
- Training Institute for the Implementation of Genomics Research (TIGER): TIGER aims to provide participants with a thorough understanding of in conducting dissemination and implementation (D&I) science research with a specific focus on genomics, genomics research, and precision medicine. Through a competitive process, public health researchers, practitioners, and policy makers will participate in a 10-week hybrid training program. (1R25HG014753-01).
- The VA Genomics Learning Health System: Implementing genomic medicine across diverse veteran communities: The VA will bring its national learning health system (LHS) infrastructure and genomic medicine implementation strategies to a network of other genomics-enabled LHS. The gLHS network will conduct implementation projects centered on a mainstream model for delivery of genomic medicine that promotes the use of evidence-based guideline-concordant genetic testing by frontline clinicians. (U01HG013781).
Lucas Beckett IA, Emery KR, Wagner JT, et al. Geno4ME Study: Implementation of Whole Genome Sequencing for Population Screening in a Large Healthcare System. npj Genom. Med. 2025. 10(50). https://doi.org/10.1038/s41525-025-00508-1
Lacaze P, Tille J, Brotchie A, et al. Feasibility and Outcomes of the DNA Screen Nationwide Adult Genomic Screening Pilot. Nat. Health 2026. 1. 90–98. https://doi.org/10.1038/s44360-025-00020-x.
Saylor KW, Rasmussen SA, and Murray MF. DNA-Based Population Screening for Adults. NEJM Evidence. 2026. 5(2). DOI: 10.1056/EVIDra2500218
Brown BL, Ramos PS, Ueberroth LA, Moultrie LA, Goodwine ML, Werner RJ, Karim ST,Wagner IM, Cunningham MA, Kamen DL, Wolf BJ, and Allen CG. Factors Influence Participation in Precision Health Research Among Diverse Individuals in South Carolina. Journal of Racial and Ethnic Health Disparities. 2026. Epub Apr 23, 2026. DOI: https://doi.org/10.1007/s40615-026-02916-0
Del Fiol G, Borsato E, Bradshaw RL, Bian J, Woodbury A, Gauchel C, Eilbeck KL, Maxwell W, Ellis K, Madeo AC, Schlechter C, Kukhareva PV, Allen CG, Kean M, Elkin EB, Sharaf R, Ahsan MD, Frey M, Davis-Rivera L, Kohlmann WK, Wetter DW, Kaphingst KA, Kawamoto K. GARDE-Chat: a scalable, open-source platform for building and deploying health chatbots. J Am Med Inform Assoc. 2026 Mar 1;33(3):593-602. doi: 10.1093/jamia/ocaf211.
Allen CG, Hunt KJ, McMahon LL, Thornhill C, Jackson A, Clark JT, Kirchoff K, Garrison KL, Foil K, Malphrus L, Norman S, Ramos PS, Perritt K, Brown C, Lenert L, and Judge DC Using implementation science to evaluate a population-wide genomic screening program: Findings from the first 20,000 In Our DNA SC participants. American Journal of Human Genetics. March 7, 2024. Vol 111(3). https://doi-org.wake.idm.oclc.org/10.1016/j.ajhg.2024.01.004
W. Saylor KW, Allen CG, Marable J, Whitcomb C, Olstad DL, Steinberg J, Smit A, Turbitt E, Foss K, Landry L, and Roberts MC. Proceedings from the 2023 transdisciplinary conference for future leaders in precision public health “Applying Implementation Science to Precision Public Health” BMC Proceedings. 2025. 19(Suppl 14):17. https://doi.org/10.1186/s12919-025-00332-6
Orlando LA, Mittendorf KF, Bihlmeyer NA, et al. Streamlining Inherited Cancer Identification via an EMR-Integrated Risk Assessment Platform: A Nonrandomized Clinical Trial. JAMA Netw Open. 2026;9(4):e269816. doi:10.1001/jamanetworkopen.2026.9816