Seizing opportunity in cancer telegenetics

A hallmark of quality genetic risk management is ensuring that patients receive regular follow-up as their risk profile changes and the science advances over time. Still, some organizations struggle to achieve this goal with traditional means for a variety of reasons, including capacity constraints, well patients’ reluctance to receive care in the cancer center, and the challenge of coordinating appropriate follow-up in accordance with ever-evolving guidelines. Telegenetics can present an opportunity to extend their programs’ resources to improve longitudinal cancer risk management.

Virtual follow-up genetic counseling visits

Virtual visits are one method to facilitate this longitudinal follow-up care. After patients establish the relationship with their genetic counselor in their initial visit, many are receptive to transferring recurring follow-up communication through virtual channels.

Technology facilitates long-term risk management

Some organizations have used a genetic counseling software platform such as CancerIQ to improve longitudinal cancer risk management. These platforms provide up-to-date genetic testing and risk management recommendations as the scientific evidence advances, automatic reminders and tracking of patients’ care plan compliance, and asynchronous communication features for patients and providers.

Software companies like CancerIQ that allow genetics providers to interact with and follow patients through their platform can facilitate ongoing education and communication that patients wouldn’t otherwise access.

Providing a virtual option for genetic counseling can increase patient satisfaction and demonstrate a program’s attention to patient convenience. Cancer programs can reach patients in a wide geographic area in a timely manner by making efficient use of resources via telegenetics, and enjoy greater patient satisfaction as an added benefit.

Reduce patients’ wait time and travel

At many programs, genetic counselor capacity is consistently stretched thin, which can result in months-long waiting times for appointments. Some programs increase timely access to genetic counseling by providing a virtual option, allowing patients to complete some or all of the preparation and visit remotely. Others supplement their program on an as-needed basis with third-party genetic counseling services, such as GeneMatters, which offers genetic counseling appointments via telehealth.

MidMichigan Health, a health system that covers a 23-county area across Central and Northeast Michigan and is affiliated with the University of Michigan Medicine, strategically targeted their telegenetics services to provide access to rural sites in their system. Their original process was to room the patient at their local clinic for a virtual appointment with a genetic counselor working at their main site. However, in light of the Covid-19 pandemic, they have adjusted this system to allow both patients and genetic counselors to be located in their homes during the visit, and able to use their PC, tablet, or smartphone. Patients who are eligible for genetic testing get their blood drawn at the nearest cancer center site, rather than at the main facility. Since implementing telegenetics, MidMichigan has seen a decrease in appointment no-shows.

Bring convenience full-circle with in-home sample collection

Other organizations, like Dignity Health Cancer Institute in California, also forego using clinic space for these visits and allow both patients and genetic counselors to interact remotely from their respective homes. They also make sample collection remarkably convenient for patients. Dignity contracts with external phlebotomy companies to provide mobile blood draws in the comfort of the patient’s home, and also offer mail-in saliva specimen collection kits. This dedication to convenience and service is a major patient satisfier and helps retain patients in their system.

Dignity Health genetic counselors worked directly with their genetic testing labs—Invitae, Myriad, and Ambry—to form an agreement on in-home sample collection. They formed a partnership with local phlebotomy companies to collect the blood sample from the patient in their home and deliver it to the respective genetic testing lab.

The agreements were negotiated individually with each genetic testing lab and phlebotomy company. Though setting up these three-way partnerships between Dignity Health, the local phlebotomists, and the genetic testing labs required a commitment of time and effort, the Dignity Health genetic counselors are very pleased with the arrangement and find that the processes have been implemented smoothly.

Workers’ expectations and preferences are evolving as remote work becomes more commonplace. In some regions, genetic counselor recruitment can be fiercely competitive, and many organizations struggle to hire sufficient genetic counselors to staff the program.

Some cancer programs have found that allowing genetic counselors to work remotely—either on certain days or full-time—can be an effective recruitment tool. While telegenetics is often delivered with the genetic counselor located at the facility while the patient is located at a remote site or at home, other organizations have allowed their genetic counselors to conduct these virtual visits from their home.

Dignity Health Cancer Institute, located in California, has demonstrated these staffing benefits. Their genetic counselors work from home, at times in different states than the cancer center facility. This arrangement is possible because they do not bill for their genetic counseling services, and so are not restricted to work from a specific location.

Their genetic counselors report that the ability to work remotely was a major attraction to the program, and that it can help mitigate turnover from relocation or other personal life changes. This principle holds true particularly for cancer programs in regions of the country with a more severe shortage of genetic counselors.

Organizations with strong genetic counseling programs can share this service with their affiliates virtually. Telegenetics adds value to these symbiotic partnerships by allowing sites across the network to provide genetic counseling services while the academic center collects a fee for the service.

Bayside Hospital, a teaching hospital in the Northeast, demonstrates this mutually beneficial hub-and-spoke arrangement by offering telegenetic counseling services to ten affiliate sites for a per-patient fee.

In the early stages of program implementation, Bayside Hospital genetic counselors started by working with affiliates in-person to establish provider workflows and expectations. After establishing the service in person, Bayside Hospital and the affiliates discussed transitioning to a telegenetic counseling model with genetic counselors based at Bayside Hospital. Affiliates pay a set rate for each patient who receives telegenetic counseling.

This arrangement benefits all organizations involved. The affiliate organizations benefit by keeping their patients at their home site for downstream care, while elevating the level of care they’re able to provide their patients with genetic counseling. In turn, Bayside Hospital is able to strengthen their relationship with affiliates by providing the service, advance their genetic professional’s patient base, and collect payment from the affiliate in return.

By using telegenetics to facilitate the program, Bayside Hospital’s genetic counselors can serve patients in person and virtually without interrupting workflows or traveling to other sites.

By providing exceptional virtual service, genetic counseling programs have an opportunity to elevate their perception among patients in their market and grow market share. Some organizations move beyond the traditional genetic counseling referral pathways and encourage patients to pursue telegenetics counseling on their own.

Telegenetics can be marketed strategically to patients as an attractive component of your broader cancer program. For example, institutions like Penn Medicine and Johns Hopkins market their telegenetics programs for cancer and cardiology, respectively, to patients directly on their websites.

Telegenetics can not only attract new patients by significantly extending an organization’s geographic reach, but it can also differentiate the program in the market. Capturing these patients, who are increasingly critical as they choose a health care provider, can lead to substantial downstream utilization and revenue.

A focus on high-quality service and patient convenience is necessary for a program to compete with others offering telegenetics. Patients have come to expect an excellent virtual experience, and now have the ability to choose between organizations that have prioritized accessibility and ease of use of their telegenetics services.