# Aligning policy and healthcare services with Veterans' values and preferences for results from Whole Genome Sequencing

> **NIH VA I01** · VA SALT LAKE CITY HEALTHCARE SYSTEM · 2021 · —

## Abstract

Over the past decade, genomic medicine has rapidly expanded from single gene testing to include next-
generation sequencing (NGS) tests, such as Whole Genome Sequencing (WGS), that reveal extensive
genomic information. During this same time period, the technical cost of sequencing a genome has fallen from
over $30 million in 2003 to approximately $1,000 in 2016. VA and the nation are making significant
investments in the research infrastructure needed to accelerate the translation of new genomic technologies to
support personalized healthcare where risk assessment, diagnosis, prognosis, and treatment are informed by
a person's genomics. The VA Genomic Medicine Program's Million Veterans Program (MVP) initiated in 2009
and the national $215 million Precision Medicine Initiative launched in 2015 are expected to further speed
genomic discoveries and translation in personalized healthcare. In step with the national Precision Medicine
Initiative, the VA is developing strategies to release the results of genomic analyses to the next 500,000
Veterans who will be enrolled in the MVP cohort and WGS and other genome-based testing is beginning to be
used beyond research, to inform disease risk, diagnosis, and treatment, in VA clinical settings.
Juxtaposed with government and public enthusiasm for the potential of NGS enabled applications, a
substantial gap exists between what WGS can deliver in terms of the quantity of genomic information, and
what results can be interpreted that patients would find meaningful. One of the challenges is the complexity of
WGS information that will include findings unrelated to the original purpose of testing and results that have
uncertain significance in preventing, diagnosing, and treating disease. With emerging use of WGS and other
genome-based testing in VA, there is an urgent need to understand what information Veterans think would be
important in their healthcare. However, little systematic quantitative information is available for VA leadership
decision making on how Veterans would assess the value of WGS information, or their preferences for the
healthcare services needed to interpret the findings and their implications for health and healthcare.
The proposed project is timely, addressing a significant gap in knowledge of Veterans' preferences and taking
advantage of an opportunity to engage key VA stakeholders--Veterans and VA executives--at a critical moment
when the introduction of new technologies will require the adaptation of clinical practices. In this project, our
goal is to establish a foundation for understanding 1) how Veterans value the findings from WGS and other
NGS enabled tests; 2) what healthcare services Veterans prefer to help them comprehend the information from
these tests and to use the findings in their healthcare; and 3) how VA clinical leaders and policy makers use
knowledge of Veterans' values and preferences for WGS in their development of clinical services that
incorporate information from ...

## Key facts

- **NIH application ID:** 10287486
- **Project number:** 5I01HX002315-04
- **Recipient organization:** VA SALT LAKE CITY HEALTHCARE SYSTEM
- **Principal Investigator:** Sara J Knight
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-05-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10287486

## Citation

> US National Institutes of Health, RePORTER application 10287486, Aligning policy and healthcare services with Veterans' values and preferences for results from Whole Genome Sequencing (5I01HX002315-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10287486. Licensed CC0.

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