1+MG / B1MG Maturity Level Model (MLM) User Guide

The 1+ Million Genomes Initiative (1+MG) Maturity Level Model (MLM) framework for implementation of genomics into healthcare was developed as a tool to enable healthcare systems across Europe to self-assess the level of maturity of their genomic medicine practices according to a common matrix, and define a path to optimization. As such, it aims to promote and facilitate the adoption of genomics in healthcare systems, and make personalised medicine accessible to citizens and patients across Europe.

The 1+MG MLM framework was designed to create a reference for the key domains necessary to enable genomic best practices in healthcare systems. The reference is provided by specific indicators for each domain (or subdomains). The maturity levels describe, specifically for each indicator, the possible current status relative to that indicator, and overall highlight the development path to increasingly more mature practices. This framework therefore allows the identification of the gaps in structures, processes and capacity, and the planning of future actions towards optimization. The indicators can further be used to monitor progress to maturity.

The 1+MG MLM was developed following a review of the literature and input from experts from the 1+MG Initiative Working Groups. Validation of the structure and contents of the MLM framework was carried out through a Delphi survey. It is structured in 8 Domains, covering key topics for the implementation of genomics in healthcare:

1. Governance and Strategy

2. Investment and economic models

3. Ethics, legislation and policy

4. Public awareness and acceptance

5. Workforce skills and organisation

6. Clinical organisation, infrastructure and tools

7. Clinical genomics guidelines and infrastructure

8. Data management, standards and infrastructure 

Each Domain comprises several Subdomains (totalling 33). One or more Indicators (totalling 49) were defined for each Subdomain. For each indicator, 5 levels of maturity were specifically developed, overall representing a stepwise path that can support the identification and planning of measures for optimization. In general terms, the maturity levels describe indicators as:

● Level 1: Ad hoc

● Level 2: defined at local level

● Level 3: documented, functional and monitored

● Level 4: adopted by national or regional healthcare systems

● Level 5: adaptable to opportunity and change and supporting international cooperation.