Genetic Counseling Service Delivery Models in the United States: Assessment of changes in use from 2010 to 2017

Abstract

In 2010, the National Society of Genetic Counselors (NSGC) membership was surveyed about their use of genetic counseling service delivery models (SDMs) including in-person, telephone, telegenetics, and group genetic counseling. Since that time, the demand for genetic counseling services has increased in the United States (US). We hypothesized that the use of various SDMs has increased to help address the growing demand. To assess for changes in SDM use and interest in implementing innovative SDMs, the NSGC SDM subcommittee sent an electronic survey to the NSGC membership (N = 3,616), which was open from August 2017 to December 2017. Descriptive statistics and chi-square analysis were used to compare and identify differences in SDM utilization between 2010 and 2017. There were 590 total responses (16.3% response rate) with 517 usable responses, representing multiple genetic counseling specialties. Compared to 2010, significantly fewer respondents indicated they 'always' provide services in-person in 2017 (p < .04, df = 4), with 92.6% of respondents reporting 'always' or 'often' utilizing in-person SDM in 2017. Telephone genetic counseling was reported by 12.5% as a model used always or often, compared to 8% in 2010; however, the shift toward or away from telephone genetic counseling since 2010 was not statistically significant (p = .27, df = 4). The number of respondents using telegenetics always or often increased from 2.3% in 2010 to 6.7% in 2017, and more respondents report using telegenetics at an increased frequency (p < .01, df = 4). In contrast, those reporting use of a group genetic counseling SDM always or often decreased from 3.0% to 1.4%, though there was not a significant shift toward or away the frequency of respondents using group genetic counseling (p = .21, df = 4). Almost all respondents (93%) were interested in implementing an additional and/or different SDM; however, many (74%) identified barriers to implementation. There was an increase in those reporting use of 3 or 4 SDMs in practice since 2010 (p < .02). Genetic counselors may be attempting to compensate for longer wait times by implementing additional SDMs to improve access for patients. There is strong interest in learning about and implementing innovative SDMs to improve access and efficiency. However, resources need to be developed to help genetic counselors identify and overcome implementation barriers to achieve these goals. | 1127 GREENBERG Et al.

Genetic counseling service delivery models: A study of genetic counselors’ interests, needs, and barriers to implementation

“…This was the same survey used in 2010 (Cohen et al, 2013); however, additional questions were included to gain a deeper understanding of GCs’ perspectives regarding the need for new SDMs and barriers to implementation. Results comparing the use of SDMs in 2010 to 2017 are reported elsewhere (Greenberg et al, 2020). The added survey questions were analyzed as part of this study using inductive thematic analysis.…”

“…Genetics is increasingly being integrated into healthcare, causing the demand for genetic counseling services to continually escalate, which is well‐documented in North America (United States (US) and Canada) (Abacan et al, 2019; Greenberg, Boothe, Delaney, Noss, & Cohen, 2020; Stoll, Kubendran, & Cohen, 2018). The field of genetics itself is growing in knowledge and technology, resulting in the ever‐expanding array of clinically available genetic testing.…”

“…The National Society of Genetic Counselors (NSGC) Service Delivery Model (SDM) Task Force surveyed the NSGC membership in 2010 to assess then‐current service delivery practices and their capacity to improve access to care, and these data ultimately demonstrated the positive impact additional SDMs had on access to genetic services (Cohen et al, 2013). In recent years, much work has been done to explore SDMs in North America, with studies focused on the delivery modes of telephone, group, and telegenetics compared with the traditional model of in‐person one‐on‐one genetic counseling (Cohen et al, 2013; Greenberg et al, 2020; Stoll et al, 2018). Many GCs have broadened their clinical offerings to include one or more SDMs with the goal of increasing access to genetic services (Greenberg et al, 2020).…”

“…In recent years, much work has been done to explore SDMs in North America, with studies focused on the delivery modes of telephone, group, and telegenetics compared with the traditional model of in‐person one‐on‐one genetic counseling (Cohen et al, 2013; Greenberg et al, 2020; Stoll et al, 2018). Many GCs have broadened their clinical offerings to include one or more SDMs with the goal of increasing access to genetic services (Greenberg et al, 2020).…”

Please Wait for the Host to Start This Meeting: A Push for H.R. 3235 Amid COVID-19

“…In the wake of COVID-19's exchange of door handles for video chat links and incoming phone calls, the benefits of genetic counseling to patient health outcomes remain. With the practice of telegenetics as a service delivery model increasing steadily over the past decade, conducting visits through telehealth platforms is not new terrain for the field (Greenberg et al, 2020). Several past studies have supported this model, reporting high satisfaction among patients due to decreased time commitment, travel costs, and overall increased convenience of sessions (Buchanan et al, 2015(Buchanan et al, , 2016Peshkin et al, 2016;Kubendran et al, 2017).…”