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Digging out: A regional cancer center resolved a 9-month backlog in 6 weeks by partnering with a telehealth genetic counseling company

Presented at the 2020 National Society of Genetic Counselors Annual Conference




Authors: Kiley Johnson, Thomas Alcock, Cary Armstrong, Colleen Caleshu

Background: Access to genetic counselors remains a challenge in many parts of the country. Insufficient staffing can lead to backlogs, with patients waiting many months to see a genetic counselor. Evidence is needed on approaches to improve access to genetic counseling for hereditary cancer risk and work through patient backlogs.

Purpose: We sought to examine the use of a telehealth partnership to improve access to genetic counseling in a regional cancer clinic that had accrued a patient backlog. Methods: Retrospective chart review was performed to extract appointment wait time prior to the partnership, appointment wait time during the partnership, total time needed to see all patients in the backlog, uptake of telehealth genetic counseling, and number of patients seen per week during the partnership. Appointment wait time was defined as time from scheduling an appointment until the date of the appointment.

Methods: Retrospective chart review was performed to extract appointment wait time prior to the partnership, appointment wait time during the partnership, total time needed to see all patients in the backlog, uptake of telehealth genetic counseling, and number of patients seen per week during the partnership. Appointment wait time was defined as time from scheduling an appointment until the date of the appointment.

Results: The regional cancer clinic was staffed by one part-time genetic counselor. Prior to partnering with the telehealth organization, the regional cancer clinic had a backlog of 293 patients who were waiting for genetic counseling, resulting in a 9-month wait list. A clinic nurse contacted all 293 patients to offer a telehealth genetic counseling appointment. Just under a third declined or could not be reached (31%). The remaining 202 patients (69%) proceeded with telehealth genetic counseling. Within 6 weeks of the partnership beginning, all 202 patients were seen, with a mean of 36.6 patients seen per week. Prior to the partnership, appointment wait time was 9 months. During the partnership, the mean appointment wait time was 3.7 days. Appointments were booked by patient preference, with many patients opting for visits a few days in the future despite slots being available the same day or next day. Nearly half of appointments occurred during evening (24.4%) or weekend (24.4%) hours.

Conclusions: Partnership with a telehealth genetic counseling organization was effective in resolving a backlog in a regional cancer clinic and dramatically decreasing appointment wait times. Increase in access to genetic counselors was likely attributable to the increase in staffing provided by the partnership, combined with the ability for patients to be seen on evenings and weekends.



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