Processes and outcomes from a clinical genetics e-consultation service managed by a primary care physician champion.

Autor:	Kerman BJ; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.; Harvard Medical School, Boston, MA., Zawatsky CBL; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.; Ariadne Labs, Precision Population Health, Boston, MA.; Broad Institute of Harvard and MIT, Cambridge, MA., Fieg E; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA., Frank NY; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.; Harvard Medical School, Boston, MA.; VA Boston Healthcare System, Boston, MA., Donnelly RS; Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston, MA., Green RC; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.; Harvard Medical School, Boston, MA.; Ariadne Labs, Precision Population Health, Boston, MA.; Broad Institute of Harvard and MIT, Cambridge, MA., Kennedy JC; Harvard Medical School, Boston, MA.; Department of Pediatrics, Boston Children's Hospital, Boston, MA.; Department of Pediatrics, Harvard Medical School, Boston, MA., Lakdawala N; Harvard Medical School, Boston, MA.; Division of Cardiovascular Medicine, Brigham and Womens Hospital, Boston, MA., Licurse AM; Harvard Medical School, Boston, MA., Perez EF; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA., Preys CL; VA Boston Healthcare System, Boston, MA., Krier JB; Harvard Medical School, Boston, MA.; Atrius Health, Boston, MA., Rana HQ; Harvard Medical School, Boston, MA.; Dana-Farber Cancer Institute, Boston, MA., Zettler B; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA., Vassy JL; Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Boston, MA.; Harvard Medical School, Boston, MA.; Ariadne Labs, Precision Population Health, Boston, MA.; VA Boston Healthcare System, Boston, MA.
Jazyk:	angličtina
Zdroj:	Genetics in medicine open [Genet Med Open] 2024 Feb 21; Vol. 2, pp. 101831. Date of Electronic Publication: 2024 Feb 21 (Print Publication: 2024).
DOI:	10.1016/j.gimo.2024.101831
Abstrakt:	Purpose: Timely access to clinical genetics consultations remains a barrier to timely genomic medicine services, which new service delivery models might help address. Methods: We implemented a genetics electronic consultation (eConsult) service staffed by a primary care physician (PCP) champion, supervised by genetics specialists. Chart reviews from July 2018 to January 2022 examined categories of questions received, e-consultant's recommendations, and outcomes of any conventional genetics referrals. Providers were surveyed on likelihood of ordering a conventional genetics consultation before eConsult and satisfaction with eConsult responses. Results: Conventional genetics consultation was recommended for 338 out of 462 (73%) eConsults received, among whom 254 out of 338 (75%) had an order placed for a conventional consult by the provider requesting the eConsult. Among all 462 eConsults, including in cases which conventional consult was not recommended, 279 (60%) were referred for conventional genetics consultation, of which 171 out of 279 (61%) completed a consult. Of these, 122 out of 171 (71%) were recommended for genetic testing, and 84 out of 122 (69%) completed testing. The genetic testing of 23 out of 84 (27%) patients identified informative actionable findings. Supervising genetics specialists made substantive revisions to PCP draft responses for only 8% (36/462) of eConsults. Conclusion: This case series demonstrates that a PCP champion eConsult model can feasibly triage and respond to genetics questions with PCP-relevant content and yield high provider satisfaction. Such a model warrants further evaluation as an addition to the genetic services of health care systems. Competing Interests: Robert C. Green has received compensation for advising the following companies: Allelica, Atria, Fabric, Genomic Life and Juniper Genomics; and is co-founder of Genome Medical and Nurture Genomics. All other authors declare no conflicts of interest. (© 2024 The Authors.)
Databáze:	MEDLINE
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