Pathogen genomics in healthcare: overcoming barriers to proactive surveillance: https://journals.asm.org/doi/10.1128/aac.01479-24 Summary In this conversation, Kevin Libuit and Alex Sundermann delve into the significance of pathogen genomics in healthcare, discussing its role in infection prevention and control. They explore the transition from traditional methods to genomic surveillance, the challenges of operationalizing these technologies, and the ethical implications of transparency in patient care. The discussion also highlights the need for evidence-based practices, the importance of incentives for hospitals, and the potential for lowering barriers to entry for genomic technologies in healthcare settings. In this conversation, Alex Sundermann and Kevin Libuit discuss the critical role of genomic surveillance in infection prevention and control. They emphasize the need for actionable insights from genomic data, the importance of metadata, and the challenges of data sharing across institutions. Financial sustainability and legal implications of genomic practices are explored, alongside the necessity for community standards and equitable access to genomic technologies. The conversation concludes with a call for learning from outbreaks and the importance of publishing findings to improve patient safety. Takeaways Pathogen genomics enhances understanding of disease transmission in healthcare. Genomic surveillance can significantly improve infection prevention efforts. Public health has successfully utilized pathogen genomics for outbreak detection. The evidence supporting genomic surveillance is compelling but underutilized in healthcare. Operationalizing genomic surveillance requires collaboration between hospitals and payers. Ethical considerations are crucial in the implementation of genomic technologies. Incentives and regulations are needed to encourage hospitals to adopt genomic surveillance. Lowering the barriers to entry can facilitate the adoption of genomic technologies. Commercial partnerships can help hospitals access genomic sequencing services. Methodological standards in genomics are essential for effective interpretation of results. Genomic data must be actionable for infection preventionists. Metadata is crucial for effective genomic surveillance. Data sharing across institutions is a significant challenge. Financial sustainability is essential for genomic surveillance programs. Legal liability may increase for hospitals not using genomic surveillance. Community standards for genomic practices are needed. Equitable access to genomic technologies is vital. Learning from outbreaks can improve patient safety. Publishing outbreak findings is essential for knowledge sharing. Genomic surveillance can help identify misallocated resources.