Understand how we got here — and how to move forward.

Our Take

Seizing opportunity in cancer telegenetics

15 Minute Read

Design telegenetics services purposefully

Genetic counseling is one of the most common services that cancer programs offer virtually: a third of cancer programs in our 2019 Trending Now in Cancer Care Survey reported that they currently provide telegenetics.

In the course of our conversations with cancer programs, we’ve found that many organizations view their telegenetics offering as a bandaid fix to a capacity issue. Oftentimes, programs stand up these offerings as a stopgap measure until they’re able to hire another genetic counselor, or to bring the service in-house, or to reduce time-to-next-available.

Strategic organizations, however, recognize greater opportunities in telegenetics. They invest in these programs as a means to promote cancer program goals and address growth challenges.


The conventional wisdom

Telegenetics—providing genetic counseling through virtual channels—arose as a solution to address the capacity and access issues that tend to impede genetic counseling programs. It’s often a second thought after developing a genetic counseling service, or viewed as a temporary fix when programs can’t meet the demand or cover the geographic reach that they’d like to with in-person genetic counselors.

Within the context of a health system’s entire service offerings, telegenetics can fall to the bottom of the priority list for development. There are several reasons that telegenetics doesn’t garner greater prioritization:

It’s viewed as a “nice-to-have” add-on service, but rarely stood up intentionally as part of the program’s broader strategy.

It’s challenging to make the case to invest in telegenetics without a clear path to securing financial returns on the service.

It’s daunting to navigate the operational challenges and highly variable regulatory policies around both genetic counseling and telehealth.

On the other hand, organizations also see these same factors as reasons to adopt telegenetics. As a service that does not require a physical exam, where reimbursement for both telehealth and in-person counseling is already dubious at best, and where there is a lower bar of regulatory restrictions for telegenetics than for other virtual medical visits, virtual genetic counseling has been a logical place to focus telehealth efforts.


According to a survey of genetic counselors, difficulty with billing and reimbursement was consistently the greatest barrier to implementing telegenetics.

Telegenetics[ tele-ge-net-ics ]noun

The delivery of genetic counseling services remotely via telecommunications technology, including real-time virtual visits and asynchronous communications.


Our take

Over the next several years, both genetic counseling and telehealth will take on increasingly prominent roles in health care. Genetics informs a growing proportion of medical decision making for cancer prevention and treatment, while telehealth has evolved from a care delivery option of the future to a mainstay of modern health care organizations. Telegenetics, at the intersection of these two forces, will certainly gain a stronger footing in this new landscape.

For organizations to stay competitive as telegenetics becomes standard, they will have to not just offer the service—but do it well.

Strategically designed genetic counseling programs recognize that telegenetics is more than a stopgap to cover a program’s weakness, but rather, an opportunity for program development. While not an identical alternative to inperson genetic counseling, telegenetics has strengths that complement the service and can help to further your program’s goals.

A systematic review of studies evaluating virtual genetic counseling revealed consistently “high levels of patient satisfaction with telegenetics.” Some programs overlook this merit when they focus on the tradeoffs made by foregoing an in-person interaction, and they are then reluctant to pursue telegenetics. In reality, the option can increase patient satisfaction and demonstrate a program’s attention to patient experience.

That being said, a focus on quality is paramount to success. Genetic counselors—along with any other professional providing virtual services—must strive to develop the unique skillsets to communicate effectively and pick up on the nonverbal cues that are muted in virtual interactions.

Disruption promotes adaptation in telegenetics

Even before the Covid-19 pandemic, health care was entering a new era of advanced telemedicine. Now, in light of loosened restrictions, temporary reimbursement parity policies, and rapid telehealth adoption across health systems, the crisis may be the impetus to push those reluctant organizations over the edge to develop a more robust telehealth strategy.

Now more than ever, it is clear that having an agile and robust telehealth infrastructure in place is critical to being able to adapt to system-wide disruption.

What’s more, it has traditionally been easy to dismiss telegenetics as just a way to reconcile two services—genetic counseling and telehealth—that are difficult to reimburse at baseline. Innovative programs, however, have pushed beyond this thinking and found opportunities to make this service financially viable.

Telegenetics advances several central goals

When developed strategically, telegenetics can help to achieve several cancer program goals. The service can improve access to genetic counseling and facilitate long-term risk management, satisfy patients, incentivize genetic counselor recruitment to maintain staffing levels, strengthen affiliate relationships, and differentiate your program in the market. Take this opportunity to build a telegenetics service with the future in mind, so that it can evolve and grow alongside your broader genetics program and telehealth strategies.


Five opportunities in telegenetics

At any stage of development, it’s a good idea to think about how telegenetics fits into your broader genetics and telehealth strategies. A strategically designed virtual genetic counseling service can integrate cohesively into your cancer program and adapt when necessary in the face of disruption.

In our conversations with cancer programs, we’ve identified key opportunities for cancer program growth and improvement that telegenetics can support. We’ll look into these five opportunities in detail, showcasing how organizations are making the most of telegenetics:

  • Opportunity

    Enhance longitudinal risk management

    Read More Collapse
  • Opportunity

    Satisfy patients with attention to preference and convenience

    Read More Collapse
  • Opportunity

    Incentivize genetic counselor recruitment with remote work

    Read More Collapse
  • Opportunity

    Strengthen networks and affiliations

    Read More Collapse
  • Opportunity

    Capitalize on telegeneticsas a market differentiator 

    Read More Collapse

Parting thoughts

Whether launching telegenetics or evaluating your existing virtual genetic counseling service, this service can unlock several opportunities to improve the quality, convenience, and attractiveness of your genetic testing and cancer programs. Understanding the strengths and flexibility that telegenetics brings to cancer programs can position the program for success.

Focus on the following five insights as you move forward on your telegenetics efforts:

  • Telegenetics can complement in-person genetic counseling, rather than being a temporary stopgap.

  • Excellent virtual experiences and expanded service offerings help maximize patient convenience and are in line with patient preferences.

  • Telegenetics affords workers flexibility that can alleviate some recruitment and retention challenges.

  • Organizations with affiliate networks add value to these relationships by providing virtual genetic counseling services.

  • Quality delivery of virtual genetic counseling is critical as programs compete with others in their market to attract patients.

Before programs can use telegenetics to pursue these opportunities, they must make decisions about how to set it up. Therefore, it is important to note that telegenetics works best when it is integrated into an organization’s broader telehealth structure, rather than existing in isolation. Organizations with disconnected and uncoordinated telehealth initiatives miss out on shared resources, operational support, and strategic development.

Those who took advantage of an existing system-wide telehealth infrastructure experience more seamless implementation of telegenetics, avoiding some operational headaches when starting up this service. Conversely, organizations can use telegenetics as a starting point for scaling up a standardized telehealth service across the cancer center or other departments. The benefits may include creating a coherent patient experience, strengthening cross-specialty partnerships, providing oncology leaders a seat at the table for system-level conversations about telehealth, and taking advantage of IT resources, regulatory guidance, and operational expertise.

We captured a few insights from the opportunities presented by telegenetics within this brief. Let them serve as a starting point to transform your program’s telegenetics approach.


More takes on this topic

A counterpoint to consider

Don’t ignore the value of in-person genetic counseling. While many patients rate telegenetics highly, they also appreciate being able to sit face-to-face with a genetic counselor to understand the implications of genetic testing and cancer risk.

This is an emotional conversation for many patients as they consider the impact of their genetic test results on themselves and their family. An in-person encounter can facilitate this candid discussion and avoid some of the technical glitches that impede virtual communication, as well as providing greater accessibility for patients requiring ASL services, for example.

For some patients, this is perceived as having a higher quality of care, and so patient choice is paramount.

Have a Question?


Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.