Here is how I would apply existing genomic technology  in my own primary care practice(s) given feasible economic availability today.

Ancestry, Ethnicity, and Sex Screening

Technology: ancestry, ethnicity, and sex screening is the greatest strength of all genomic testing and can be performed using commodity SNP chip technology

Price I Would Pay: $15 if included with a common blood test pannel, $10 if stand-alone blood test, $2 if buccal kit —it is expensive for the medical office to use oragene spit kits in serial medical procedure because they can consume up to twenty minutes of supervised provider time to fill. Thus, they must be forked to a parallel procedure which adds overhead.

Ideal Application: include with scheduled vaccinations, a new patient complete physical, and other unique-in-life medical services

Clinical Application: Most scientific research and clinical recommendations assume that a patient’s ethnicity is obvious to the medical provider: it’s not obvious. First, patients themselves often do not know their own ethnicity. Second, patients produce vague or contradictory answers which are not clinically ideal, e.g. “Asian American.” (really? what part of “Asia”?) Third, patients may not be the children of whom they believe or or whom they imply to be their parents. This is far more common than you may think. Fourth, patients lie —especially about culturally taboo topics which they do not feel are immediately relevant to their primary medical complaint. Fifth, any intake from patient interview is expensive because it requires provider attention, because any patient intake from forms or verbal interview incurs data entry overhead, and because patients tend to produce poor quality data in response to any question —in particular, responses without a definite answers— due to errors, typos, omissions, a simple attitude of evasiveness, and often, from sheer ignorance and illiteracy. I think that people on the Internet do not realize that about half of all people are functionally illiterate for the purposes of medical intake —especially the elderly. Sixth, patient sex is critical data in clinical application, and 99.9% confidence for a genomic SEX TEST is almost certainly higher than the existing confidence derived from asking the patient or trusting existing records.  Aside: I think it is hilarious to read about criticism of genomic data accuracy, because people have no idea how inaccurate actual medical data can be in real practice.