(1) Background: Genomic medicine – i.e., the use of laboratory-based biomarkers that measure the expression, function and regulation of genes and gene products to aid healthcare decision making is a rapidly emerging technology. Readiness to consider and adopt new testing programs effectively and avoid critical challenges requires health systems to harbor a number of key conditions that address infrastructural, as well operational and other needs. This assessment re-examines Canada’s state of readiness since a previously published 2023 assessment. (2) Methods: A mixed-methods approach of a review of the literature and key informant interviews with a purposive sample of experts was used. Health system readiness was assessed using a previously published set of conditions. (3) Results: This updated analysis of Canada’s state of readiness for genetic and genomic testing reveals Canada is only partially ready for a future of genomic medicine, although some progress has been made since 2023. The most established conditions were the use of appropriate service models and the integration of innovation and healthcare delivery functions. They suggest that Canada’s major healthcare regions are moving closer to a state of readiness for the consideration and adoption of new testing required for genomic medicine, although using different approaches and at different rates. These findings should be seen as generalizable to other regions internationally—health systems need to have functions that promote responsiveness and resilience i.e., are able to recognize valuable innovation and quickly shift priorities and create conditions necessary to enable it.