In the February, 2019 issue of the Clinical Journal of Oncology Nursing, an article entitled “Genetic Service Delivery Models,” analyzed the delivery of genetic counseling services. It found the availability and delivery of genetic counseling have room for improvement.
When genetic counseling services are provided by credentialed genetics professionals, there is greater adherence to evidence-based guidelines for care, more detailed education about the meaning and interpretation of results, better coordinated care for other family members at risk, and cost savings from appropriate ordering of testing.
Genetic counseling begins with the identification of patients and families at risk for developing cancer because of hereditary susceptibility. But identification is only half the battle. Unfortunately, there are barriers to the transition from identification of the need to actually connecting the patient with a counselor.
A report by the American Society of Clinical Oncology ([ASCO], 2017) found that only 24% of oncology practices have at least one genetic counselor on site. The balance refer patients to genetic professionals or academic institutions, or do not use genetic counselors at all. Although credentialed genetic professionals exist in all 50 states in the United States, rural areas are proportionately under-served and concerns have also been raised that the existing number of genetics professionals is insufficient to meet demands.
The article concluded additional professionals need to be trained to meet demand, and alternative delivery models can be used to increase access and better distribute the services. Genetic counseling via the use of videoconferencing technology, often referred to as Telegenetics, is an effective way to avoid travel and appointment delays for the patient in need of counseling.