Clinical genetic counselor experience in the adoption of telehealth in the United States and Canada during the COVID‐19 pandemic

Abstract

The COVID‐19 pandemic has significantly impacted the service delivery model (SDM) of clinical genetic counseling across the United States and Canada. A cross‐sectional survey was distributed to 4,956 genetic counselors (GCs) from the American Board of Genetic Counselors and Canadian Association of Genetic Counselors mailing lists in August 2020 to assess the change in utilization of telehealth for clinical genetic counseling during the COVID‐19 pandemic compared with prior to the pandemic. Data from 411 eligible clinical genetic counselors on GC attitudes and their experiences prior to and during the pandemic were collected and analyzed to explore the change in SDM, change in appointment characteristics, change in billing practices, GC perceived benefits and limitations of telehealth, and prediction of future trends in SDM in the post‐pandemic era. The study showed the overall utilization of audiovisual and telephone encounters increased by 43.4% and 26.2%, respectively. The majority of respondents who provided audiovisual and telephone encounters reported increased patient volume compared with prior to the pandemic, with an average increase of 79.4% and 42.8%, respectively. There was an increase of 69.4% of GCs rendering genetic services from home offices. The percentage of participants who billed for telehealth services increased from 45.7% before the pandemic to 80.3% during the pandemic. The top GC perceived benefits of telehealth included safety for high‐risk COVID patients (95.2%) and saved commute time for patients (94.7%). The top GC perceived limitations of telehealth included difficulty to conduct physician evaluation/coordinating with healthcare providers (HCP) (73.7%) and difficulty addressing non‐English speaking patients (68.5%). Overall, 89.6% of GCs were satisfied with telehealth; however, 55.3% reported uncertainty whether the newly adopted SDM would continue after the pandemic subsides. Results from this study demonstrate the rapid adoption of telehealth for clinical genetic counseling services as a result of the COVID‐19 pandemic, an increase in billing for these services, and support the feasibility of telehealth for genetic counseling as a longer term solution to reach patients who are geographically distant.

Evolving cardiovascular genetic counseling needs in the era of precision medicine

“…For several years companies in the US have helped fill a gap in the services within certain institutions and geographic regions by offering a telehealth genetic counseling model. Further, the COVID-19 pandemic increased access to telehealth services, which in turn increased the amount of patients providers could care for ( 90 ), without jeopardizing patient satisfaction ( 91 ). Telehealth approaches could also be a complementary solution for regions without any or sufficient access to genetics services.…”

Genetics providers’ experiences using telehealth: A grounded theory approach

“…The authors acknowledge this grounded theory study may not capture all facets of telehealth work. New research has emerged because of the pandemic which considers the place of genetic services in telehealth and is a welcome addition to the growing literature of genetic telehealth.These studies include research of the before and after telehealth experiences of genetic counselors in SARS-CoV-2(Mills et al, 2021), telehealth experiences across specialties in Nebraska(Rezich et al, 2021), the U.S. and Canada(Ma et al, 2021) and more. A recent SARS-CoV-2 impact study conducted by the National Society of Genetic Counselors SARS-CoV-2 Impact Survey Working Group Survey identified a significant shift in patient care provided via telehealth, accompanied by pitfalls in reimbursement for services(Pan et al, 2021).…”

Diagnostic deserts: Community‐level barriers to appropriate genetics services

“…Given that telehealth does not require travel on a patient's behalf, it is possible that virtual clinics may serve as oases for families and patients living within diagnostic deserts, avoiding painful and difficult transportation and missing work. However, given that accurate genetic testing may require careful phenotyping and physical examinations, screen‐mediated virtual visits may prove insufficient for some patients (Ma et al, 2021).…”