Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Implementing precision medicine in a regionally organized healthcare system in Sweden

Nature Medicine volume 28, pages 1980–1982 (2022)Cite this article

Subjects

Access through your institution
Buy or subscribe

An important step toward leveraging new technologies, including genomics, in diagnostics was the launch of a national infrastructure for molecular biosciences, the Science for Life Laboratory (SciLifeLab), in 2010. SciLifeLab provides expertise and services through a range of technology platforms, and established the Clinical Genomics platform in 2014 to further advance the translation of genomic sequencing into clinical utility. The platform, with nodes at all medical faculties in Sweden, supports translational and clinical research projects and adapts and optimizes new technologies for diagnostics (Table 1). Illustrating its cutting-edge activities, Sweden became one of the first healthcare systems to implement whole-genome sequencing in rare disease diagnostics4,5.

Table 1 Key services provided by the SciLifeLab Clinical Genomics platform and Genomic Medicine Sweden
Full size table

To further leverage genomics into clinical practice, the Clinical Genomics platform in 2017 initiated Genomic Medicine Sweden (GMS). To achieve nationwide access to precision medicine, all university healthcare regions and medical faculties agreed to collaborate. GMS received governmental funding from the Swedish innovation agency, Vinnova, and public co-funding from collaborating parties. A national steering board was formed with representation from academia, healthcare, industry and patient organizations. Genomic Medicine Centres (GMCs) were established at the university hospitals to facilitate nationally harmonized implementation, while taking into consideration regional requirements and strengths.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Key phases of the research-implementation framework developed in Sweden for precision diagnostics and medicine.

References

  1. Investigators, G. P. P. et al. N. Engl. J. Med 385, 1868–1880 (2021).

    Article  Google Scholar 

  2. Levy, Y. Lancet 388, 2872 (2016).

    Article  Google Scholar 

  3. Stenzinger, A. et al. Semin. Cancer Biol. 4, 242–254 (2022).

    Article  Google Scholar 

  4. Lindstrand, A. et al. Genome Med. 11, 68 (2019).

    Article  Google Scholar 

  5. Stranneheim, H. et al. BMC Genomics 15, 1090 (2014).

    Article  Google Scholar 

  6. Stranneheim, H. et al. Genome Med. 13, 40 (2021).

    Article  Google Scholar 

  7. Grigelioniene, G. et al. Nat. Med. 25, 583–590 (2019).

    Article  CAS  Google Scholar 

  8. Olive, M. et al. Nat. Commun. 10, 1396 (2019).

    Article  Google Scholar 

  9. Berglund, E. et al. Front. Med. 9, 842507 (2022).

    Article  Google Scholar 

  10. Molnar-Gabor, F. et al. Semin. Cancer Biol. 84, 271–283 (2022).

    Article  Google Scholar 

  11. Franks, P. W. et al. J. Intern. Med. 290, 602–620 (2021).

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We would like to thank T. Åkerblom for her assistance with the preparation of the manuscript. We thank the patient associations Rare Diseases Sweden and the Network Against Cancer for our close collaboration, as well as the GMS Steering Board and SciLifeLab for their continuous support. The Clinical Genomics platform is supported by national grants from SciLifeLab and the medical faculties at Gothenburg University, Linköping University, Lund University, Karolinska Institutet, Umeå University, Uppsala University and Örebro University. GMS is supported by the strategic innovation program Swelife and Vinnova, the Swedish Innovation Agency; the Ministry of Health and Social Affairs; SciLifeLab; the Swedish Childhood Cancer Fund; funding from the participating healthcare regions Region Skåne, Region Västra Götaland, Region Östergötland, Region Stockholm, Region Uppsala, Region Västerbotten and Region Örebro län; and the medical faculties at Gothenburg University, Linköping University, Lund University, Karolinska Institutet, Umeå University, Uppsala University and Örebro University.

Author information

Authors and Affiliations

  1. Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden

    Thoas Fioretos, Hans Ehrencrona & David Gisselsson

  2. Department of Clinical Genetics, Pathology and Molecular Diagnostics, Office for Medical Services, Region Skåne, Lund, Sweden

    Thoas Fioretos, Hans Ehrencrona, David Gisselsson, Sofia Gruvberger-Saal & Anders Edsjö

  3. Clinical Genomics Lund, Science for Life Laboratory, Lund University, Lund, Sweden

    Thoas Fioretos & Markus Heidenblad

  4. Department of Microbiology, Tumor and Cell Biology, Clinical Genomics Stockholm, Science Life Laboratory, Karolinska Institutet, Solna, Sweden

    Valtteri Wirta, Michael Akhras, Anna Lyander & Henrik Stranneheim

  5. Genomic Medicine Center Karolinska, Karolinska University Hospital, Stockholm, Sweden

    Valtteri Wirta, Maria Johansson Soller, Anna Lindstrand, Henrik Stranneheim, Anna Wedell & Richard Rosenquist

  6. School of Engineering Sciences in Chemistry, Biotechnology and Health, Clinical Genomics Stockholm, Science Life Laboratory, KTH Royal Institute of Technology, Stockholm, Sweden

    Valtteri Wirta & Anna Lyander

  7. Department of Immunology, Genetics and Pathology, Clinical Genomics Uppsala, Science for Life Laboratory, Uppsala University, Uppsala, Sweden

    Lucia Cavelier, Eva Berglund, Johan Botling, Ulf Gyllensten & Malin Melin

  8. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    Lucia Cavelier, Mikaela Friedman, Maria Johansson Soller, Anna Lindstrand, Ann Nordgren, Henrik Stranneheim, Anna Wedell & Richard Rosenquist

  9. Clinical Genetics, Karolinska University Hospital, Solna, Sweden

    Lucia Cavelier, Maria Johansson Soller, Anna Lindstrand, Ann Nordgren & Richard Rosenquist

  10. Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research, Karolinska Institutet, Solna, Sweden

    Lars Engstrand

  11. Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

    Gisela Helenius

  12. Innovation Partnership Office, Uppsala University, Uppsala, Sweden

    Therese Fagerqvist

  13. Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden

    Kina Höglund, Lovisa Lovmar, Ann Nordgren & Per Sikora

  14. Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

    Bo Jacobsson

  15. Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Bo Jacobsson

  16. Lund University Collaboration Office, Lund University, Lund, Sweden

    Maria Johansson

  17. Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden

    Åsa Johansson

  18. Department of Medical Biosciences, Umeå University, Umeå, Sweden

    Maréne Landström, Pär Larsson & Richard Palmqvist

  19. Clinical Genomics Umeå, Science for Life Laboratory, Umeå University, Umeå, Sweden

    Pär Larsson

  20. Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden

    Lars-Åke Levin

  21. Institute of Biomedicine, Department of Laboratory Medicine, University of Gothenburg, Gothenburg, Sweden

    Ann Nordgren & Lars Palmqvist

  22. Department of Medical Sciences, Rheumatology, Uppsala University, Uppsala, Sweden

    Gunnel Nordmark

  23. Department of Laboratory Medicine, Clinical Pathology and Genetics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

    Paula Mölling & Bianca Stenmark

  24. Clinical Genomics Gothenburg, Science for Life Laboratory, University of Gothenburg, Gothenburg, Sweden

    Lars Palmqvist & Per Sikora

  25. Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden

    Lars Palmqvist

  26. School of Medical Sciences, Örebro University, Örebro, Sweden

    Dirk Repsilber

  27. Bioinformatics Data Center, Core Facilities, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Per Sikora

  28. Division of Medical Genetics, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden

    Peter Söderkvist

  29. Clinical Genomics Linköping, Linköping University, Linköping, Sweden

    Peter Söderkvist & Tobias Strid

  30. Department of Clinical Pathology, Biological and Clinical Sciences, Linköping University, Linköping, Sweden

    Tobias Strid

  31. Unit of Integrative Metabolomics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Craig E. Wheelock

  32. Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden

    Craig E. Wheelock

  33. Department of Medical Sciences, Clinical Pharmacogenomics, Science for Life Laboratory, Uppsala University, Uppsala, Sweden

    Mia Wadelius

  34. Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden

    Anna Wedell

  35. Division of Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden

    Anders Edsjö

Authors
  1. Thoas Fioretos
    View author publications

    Search author on:PubMed Google Scholar

  2. Valtteri Wirta
    View author publications

    Search author on:PubMed Google Scholar

  3. Lucia Cavelier
    View author publications

    Search author on:PubMed Google Scholar

  4. Eva Berglund
    View author publications

    Search author on:PubMed Google Scholar

  5. Mikaela Friedman
    View author publications

    Search author on:PubMed Google Scholar

  6. Michael Akhras
    View author publications

    Search author on:PubMed Google Scholar

  7. Johan Botling
    View author publications

    Search author on:PubMed Google Scholar

  8. Hans Ehrencrona
    View author publications

    Search author on:PubMed Google Scholar

  9. Lars Engstrand
    View author publications

    Search author on:PubMed Google Scholar

  10. Gisela Helenius
    View author publications

    Search author on:PubMed Google Scholar

  11. Therese Fagerqvist
    View author publications

    Search author on:PubMed Google Scholar

  12. David Gisselsson
    View author publications

    Search author on:PubMed Google Scholar

  13. Sofia Gruvberger-Saal
    View author publications

    Search author on:PubMed Google Scholar

  14. Ulf Gyllensten
    View author publications

    Search author on:PubMed Google Scholar

  15. Markus Heidenblad
    View author publications

    Search author on:PubMed Google Scholar

  16. Kina Höglund
    View author publications

    Search author on:PubMed Google Scholar

  17. Bo Jacobsson
    View author publications

    Search author on:PubMed Google Scholar

  18. Maria Johansson
    View author publications

    Search author on:PubMed Google Scholar

  19. Åsa Johansson
    View author publications

    Search author on:PubMed Google Scholar

  20. Maria Johansson Soller
    View author publications

    Search author on:PubMed Google Scholar

  21. Maréne Landström
    View author publications

    Search author on:PubMed Google Scholar

  22. Pär Larsson
    View author publications

    Search author on:PubMed Google Scholar

  23. Lars-Åke Levin
    View author publications

    Search author on:PubMed Google Scholar

  24. Anna Lindstrand
    View author publications

    Search author on:PubMed Google Scholar

  25. Lovisa Lovmar
    View author publications

    Search author on:PubMed Google Scholar

  26. Anna Lyander
    View author publications

    Search author on:PubMed Google Scholar

  27. Malin Melin
    View author publications

    Search author on:PubMed Google Scholar

  28. Ann Nordgren
    View author publications

    Search author on:PubMed Google Scholar

  29. Gunnel Nordmark
    View author publications

    Search author on:PubMed Google Scholar

  30. Paula Mölling
    View author publications

    Search author on:PubMed Google Scholar

  31. Lars Palmqvist
    View author publications

    Search author on:PubMed Google Scholar

  32. Richard Palmqvist
    View author publications

    Search author on:PubMed Google Scholar

  33. Dirk Repsilber
    View author publications

    Search author on:PubMed Google Scholar

  34. Per Sikora
    View author publications

    Search author on:PubMed Google Scholar

  35. Bianca Stenmark
    View author publications

    Search author on:PubMed Google Scholar

  36. Peter Söderkvist
    View author publications

    Search author on:PubMed Google Scholar

  37. Henrik Stranneheim
    View author publications

    Search author on:PubMed Google Scholar

  38. Tobias Strid
    View author publications

    Search author on:PubMed Google Scholar

  39. Craig E. Wheelock
    View author publications

    Search author on:PubMed Google Scholar

  40. Mia Wadelius
    View author publications

    Search author on:PubMed Google Scholar

  41. Anna Wedell
    View author publications

    Search author on:PubMed Google Scholar

  42. Anders Edsjö
    View author publications

    Search author on:PubMed Google Scholar

  43. Richard Rosenquist
    View author publications

    Search author on:PubMed Google Scholar

Contributions

T.F., V.W., L.C., E.B., M.F., A.E. and R.R. wrote the manuscript. All authors contributed to the article and approved the submitted version.

Corresponding authors

Correspondence to Thoas Fioretos or Richard Rosenquist.

Ethics declarations

Competing interests

T.F. is a co-founder, board member and scientific advisor of Qlucore AB and Cantargia AB. V.W. has received honoraria from Illumina and Roche. B.J. has performed NIPT (fetal diagnostics) clinical diagnostic trials with Ariosa, Vanadis and Natera, with expenditures reimbursed per patient. A.E. has received honoraria from Amgen, AstraZeneca, Bayer, Diaceutics and Roche. H.E. has received honoraria from AstraZeneca. M.L. is the founder, a board member and chief scientific officer of MetaCurUm Biotech AB aiming for precision medicine for cancer patients. A.L. has received honoraria from Illumina. C.E.W. has received honoraria from Abitec and GossamerBio. R.R. has received honoraria from AbbVie, AstraZeneca, Illumina, Janssen and Roche.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fioretos, T., Wirta, V., Cavelier, L. et al. Implementing precision medicine in a regionally organized healthcare system in Sweden. Nat Med 28, 1980–1982 (2022). https://doi.org/10.1038/s41591-022-01963-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41591-022-01963-4

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing