Precision medicine and the ethics of electronic health records and genomics

Precision Medicine and the use of the electronic health records and genomics results promises to transform healthcare. The legal and ethical landscape around the world is complex and could limit the ability to conduct research and realize the full potential of genomics. The evolution of the technology and the shift from exclusion of patients from decision-making to patient participation and engagement has transformed our ability to explore these new technologies. While the cultural landscape has shifted with the widespread use of these technologies, equity and inclusion remain critical to ensure all achieve the benefits of genomics. Structural inequities affect the data, the choice of research to be conducted, and the ultimate utility for patients. As genomics is deployed worldwide clinicians and researchers must develop an understanding of the legal and ethical issues raised and how to mitigate them.