Genomic technologies are changing rapidly, and it is hard to predict how quickly new technologies will become adopted in routine clinical practice. Based, however, on the pace of adoption of clinical exomes from discovery to clinical availability, it seems likely that it will occur more rapidly than the typically observed 10–20-year translation time for most new approaches. It seems likely that, within the next decade, the ability to develop and tailor treatments on the basis of a person’s genome will increase significantly, and we suspect that within a decade a moderate percentage of patients will have their genome sequenced for at least one reason.
There is a strong need for an evidence-based approach to discerning when and where genomic medicine can impact patient outcomes. Indeed, evidence-based studies are already being undertaken to discern the degree to which these can impact patient outcomes. Federal regulation of DNA sequencing may have a significant impact by requiring an evidentiary basis for analytic and clinical validity. A recent proposal by the ACMG (American College of Medical Genetics and Genomics) to monitor the disclosure of genomic information may be helpful in this regard. There is also much work being carried out on electronic health records and the storage of genetic data, as well as developing point-of-service prompts to assist busy clinicians in identifying and utilizing relevant genomic data at the proper time in diagnostics or treatment planning. With luck, in 10 years, we will reach a point where the analytic validity of sequencing technologies is high, with easy ability to access and clinically interpret genomic information, and knowledge about patient responses to genomic information.