Clinical models of telehealth in genetics: A regional telegenetics landscape

Alissa B. Terry, Amanda Wylie, Melissa Raspa, Beth Vogel, Kunal Sanghavi, Luba Djurdjinovic, Michele Caggana, Joann N Bodurtha

Research output: Contribution to journalArticle

Abstract

The use of live video consultations in genetics has been shown to improve patient access with high satisfaction; however, little is known about the current landscape of clinical telehealth models in the field of genetics (i.e., telegenetics). This survey aimed to address that gap across seven states and the District of Columbia. Among 51 self-defined telegenetics programs responding to an online survey, 32 currently utilized live videoconferencing as at least one of their technologies (i.e., were “video-capable”). Analysis of this subgroup revealed that medical institutions were the most common program setting, and prenatal and cancer services were the most common sub-specialty. Forty-seven percent of these programs reported billing insurance for patient care. When exploring measures of patient access among these programs, 56% had a wait time of under 2 weeks, 25% saw more than 50 patients per month, 50% estimated their geographic reach at over 200 miles, and 59% were able to provide remote telegenetics consultations to patients’ homes. Professional licensure was reported as the biggest barrier, and patient access and convenience were reported as the largest benefit and success. Among the 19 remaining programs, eight currently active programs exclusively used telephone technology; these were less likely to have a geneticist (p = 0.01), had a shorter wait time (p = 0.04), and had been established for a longer time (p = 0.02) when compared to video-capable programs. Further, two currently active programs indicated the use of store-and-forward telehealth. Finally, nine programs were currently planning their programs, with a focus on video-capable technologies and more varied patient specialties. We observed a diverse landscape of telehealth models being utilized to provide genetic services, and the data demonstrated that these programs are focused on enhancing patient access. Our query about telegenetics drew responses from programs that were not using live videoconferencing technology models, which prompts further exploration, and challenges us to develop consensus around the meaning of “telegenetics.” Similarly, our data suggest a need for continued research to assess the equivalency, accessibility, and role of telephone consultations across genetic services. While a multitude of policy factors influence which service delivery models are utilized, further research on these varied approaches, and their associated patient outcomes, is also needed to inform program development.

Original languageEnglish (US)
JournalJournal of Genetic Counseling
DOIs
StatePublished - Jan 1 2019

Fingerprint

Telemedicine
Genetic Services
Videoconferencing
Technology
Telephone
Referral and Consultation
Remote Consultation
Program Development
Licensure
Insurance
Research
Patient Care

Keywords

  • access
  • genetic counseling
  • genetic services
  • rural
  • service delivery
  • telegenetics
  • telehealth
  • telemedicine
  • telephone counseling
  • underserved

ASJC Scopus subject areas

  • Genetics(clinical)

Cite this

Clinical models of telehealth in genetics : A regional telegenetics landscape. / Terry, Alissa B.; Wylie, Amanda; Raspa, Melissa; Vogel, Beth; Sanghavi, Kunal; Djurdjinovic, Luba; Caggana, Michele; Bodurtha, Joann N.

In: Journal of Genetic Counseling, 01.01.2019.

Research output: Contribution to journalArticle

Terry, Alissa B. ; Wylie, Amanda ; Raspa, Melissa ; Vogel, Beth ; Sanghavi, Kunal ; Djurdjinovic, Luba ; Caggana, Michele ; Bodurtha, Joann N. / Clinical models of telehealth in genetics : A regional telegenetics landscape. In: Journal of Genetic Counseling. 2019.
@article{acd9f3c16a864ca8a871cd353b20cade,
title = "Clinical models of telehealth in genetics: A regional telegenetics landscape",
abstract = "The use of live video consultations in genetics has been shown to improve patient access with high satisfaction; however, little is known about the current landscape of clinical telehealth models in the field of genetics (i.e., telegenetics). This survey aimed to address that gap across seven states and the District of Columbia. Among 51 self-defined telegenetics programs responding to an online survey, 32 currently utilized live videoconferencing as at least one of their technologies (i.e., were “video-capable”). Analysis of this subgroup revealed that medical institutions were the most common program setting, and prenatal and cancer services were the most common sub-specialty. Forty-seven percent of these programs reported billing insurance for patient care. When exploring measures of patient access among these programs, 56{\%} had a wait time of under 2 weeks, 25{\%} saw more than 50 patients per month, 50{\%} estimated their geographic reach at over 200 miles, and 59{\%} were able to provide remote telegenetics consultations to patients’ homes. Professional licensure was reported as the biggest barrier, and patient access and convenience were reported as the largest benefit and success. Among the 19 remaining programs, eight currently active programs exclusively used telephone technology; these were less likely to have a geneticist (p = 0.01), had a shorter wait time (p = 0.04), and had been established for a longer time (p = 0.02) when compared to video-capable programs. Further, two currently active programs indicated the use of store-and-forward telehealth. Finally, nine programs were currently planning their programs, with a focus on video-capable technologies and more varied patient specialties. We observed a diverse landscape of telehealth models being utilized to provide genetic services, and the data demonstrated that these programs are focused on enhancing patient access. Our query about telegenetics drew responses from programs that were not using live videoconferencing technology models, which prompts further exploration, and challenges us to develop consensus around the meaning of “telegenetics.” Similarly, our data suggest a need for continued research to assess the equivalency, accessibility, and role of telephone consultations across genetic services. While a multitude of policy factors influence which service delivery models are utilized, further research on these varied approaches, and their associated patient outcomes, is also needed to inform program development.",
keywords = "access, genetic counseling, genetic services, rural, service delivery, telegenetics, telehealth, telemedicine, telephone counseling, underserved",
author = "Terry, {Alissa B.} and Amanda Wylie and Melissa Raspa and Beth Vogel and Kunal Sanghavi and Luba Djurdjinovic and Michele Caggana and Bodurtha, {Joann N}",
year = "2019",
month = "1",
day = "1",
doi = "10.1002/jgc4.1088",
language = "English (US)",
journal = "Journal of Genetic Counseling",
issn = "1059-7700",
publisher = "Kluwer Academic/Human Sciences Press Inc.",

}

TY - JOUR

T1 - Clinical models of telehealth in genetics

T2 - A regional telegenetics landscape

AU - Terry, Alissa B.

AU - Wylie, Amanda

AU - Raspa, Melissa

AU - Vogel, Beth

AU - Sanghavi, Kunal

AU - Djurdjinovic, Luba

AU - Caggana, Michele

AU - Bodurtha, Joann N

PY - 2019/1/1

Y1 - 2019/1/1

N2 - The use of live video consultations in genetics has been shown to improve patient access with high satisfaction; however, little is known about the current landscape of clinical telehealth models in the field of genetics (i.e., telegenetics). This survey aimed to address that gap across seven states and the District of Columbia. Among 51 self-defined telegenetics programs responding to an online survey, 32 currently utilized live videoconferencing as at least one of their technologies (i.e., were “video-capable”). Analysis of this subgroup revealed that medical institutions were the most common program setting, and prenatal and cancer services were the most common sub-specialty. Forty-seven percent of these programs reported billing insurance for patient care. When exploring measures of patient access among these programs, 56% had a wait time of under 2 weeks, 25% saw more than 50 patients per month, 50% estimated their geographic reach at over 200 miles, and 59% were able to provide remote telegenetics consultations to patients’ homes. Professional licensure was reported as the biggest barrier, and patient access and convenience were reported as the largest benefit and success. Among the 19 remaining programs, eight currently active programs exclusively used telephone technology; these were less likely to have a geneticist (p = 0.01), had a shorter wait time (p = 0.04), and had been established for a longer time (p = 0.02) when compared to video-capable programs. Further, two currently active programs indicated the use of store-and-forward telehealth. Finally, nine programs were currently planning their programs, with a focus on video-capable technologies and more varied patient specialties. We observed a diverse landscape of telehealth models being utilized to provide genetic services, and the data demonstrated that these programs are focused on enhancing patient access. Our query about telegenetics drew responses from programs that were not using live videoconferencing technology models, which prompts further exploration, and challenges us to develop consensus around the meaning of “telegenetics.” Similarly, our data suggest a need for continued research to assess the equivalency, accessibility, and role of telephone consultations across genetic services. While a multitude of policy factors influence which service delivery models are utilized, further research on these varied approaches, and their associated patient outcomes, is also needed to inform program development.

AB - The use of live video consultations in genetics has been shown to improve patient access with high satisfaction; however, little is known about the current landscape of clinical telehealth models in the field of genetics (i.e., telegenetics). This survey aimed to address that gap across seven states and the District of Columbia. Among 51 self-defined telegenetics programs responding to an online survey, 32 currently utilized live videoconferencing as at least one of their technologies (i.e., were “video-capable”). Analysis of this subgroup revealed that medical institutions were the most common program setting, and prenatal and cancer services were the most common sub-specialty. Forty-seven percent of these programs reported billing insurance for patient care. When exploring measures of patient access among these programs, 56% had a wait time of under 2 weeks, 25% saw more than 50 patients per month, 50% estimated their geographic reach at over 200 miles, and 59% were able to provide remote telegenetics consultations to patients’ homes. Professional licensure was reported as the biggest barrier, and patient access and convenience were reported as the largest benefit and success. Among the 19 remaining programs, eight currently active programs exclusively used telephone technology; these were less likely to have a geneticist (p = 0.01), had a shorter wait time (p = 0.04), and had been established for a longer time (p = 0.02) when compared to video-capable programs. Further, two currently active programs indicated the use of store-and-forward telehealth. Finally, nine programs were currently planning their programs, with a focus on video-capable technologies and more varied patient specialties. We observed a diverse landscape of telehealth models being utilized to provide genetic services, and the data demonstrated that these programs are focused on enhancing patient access. Our query about telegenetics drew responses from programs that were not using live videoconferencing technology models, which prompts further exploration, and challenges us to develop consensus around the meaning of “telegenetics.” Similarly, our data suggest a need for continued research to assess the equivalency, accessibility, and role of telephone consultations across genetic services. While a multitude of policy factors influence which service delivery models are utilized, further research on these varied approaches, and their associated patient outcomes, is also needed to inform program development.

KW - access

KW - genetic counseling

KW - genetic services

KW - rural

KW - service delivery

KW - telegenetics

KW - telehealth

KW - telemedicine

KW - telephone counseling

KW - underserved

UR - http://www.scopus.com/inward/record.url?scp=85062373458&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062373458&partnerID=8YFLogxK

U2 - 10.1002/jgc4.1088

DO - 10.1002/jgc4.1088

M3 - Article

C2 - 30825358

AN - SCOPUS:85062373458

JO - Journal of Genetic Counseling

JF - Journal of Genetic Counseling

SN - 1059-7700

ER -