In order to guide healthcare systems through the complex process of implementation of genomics in healthcare, the Beyond 1 Million Genomes (B1MG) project, through its WP on Delivering Personalised Medicine cross-borders: implementation in healthcare systems and societal impact, created a playbook entitled “A roadmap for genomics in healthcare”. This document addresses issues in the entire chain of value, including technical infrastructure for genomic data, clinical guidelines and infrastructure, ELSI policies, synergies with research and industry, capacity building, economic models and governance, providing pointers to detailed information that can support the implementation of genomics in healthcare systems. The roadmap proposes a series of sequential steps: assess, learn, plan and implement. Starting with assessing the current situation and aimed maturity level of the healthcare system, further learning is encouraged from countries that have considerably advanced in their genomic strategies, and recommendations on experts from the field. The roadmap includes many pointers to best practices, tools and documents with guidelines and recommendations to support the implementation of genomics in healthcare systems.