Report from the National Society of Genetic Counselors Service Delivery Model Task Force: A Proposal to Define Models, Components, and Modes of Referral

Abstract

The Service Delivery Model Task Force (SDMTF) was appointed in 2009 by the leadership of the National Society of Genetic Counselors (NSGC) with a charge to research and assess the capacity of all existing service delivery models to improve access to genetic counseling services in the context of increasing demand for genetic testing and counseling. In approaching this charge, the SDMTF found that there were varying interpretations of what was meant by "service delivery models" and the group held extensive discussions about current practices to arrive at consensus of proposed definitions for current genetic service delivery models, modes of referral and components of service delivery. The major goal of these proposed definitions is to allow for conversations to begin to address the charge to the committee. We propose that current models of service delivery can be defined by: 1) the methods in which genetic counseling services are delivered (In-person, Telephone, Group and Telegenetics), 2) the way they are accessed by patients (Traditional referral, Tandem, Triage, Rescue and Self-referral) and 3) the variable components that depend upon multiple factors unique to each service setting. This report by the SDMTF provides a starting point whereby standardized terminology can be used in future studies that assess the effectiveness of these described models to overcome barriers to access to genetic counseling services.

Identification of Genetic Counseling Service Delivery Models in Practice: A Report from the NSGC Service Delivery Model Task Force

“…Although we did remove 12 individuals from the analysis who specifically mentioned using telephone GC only for providing results, it is possible that others interpreted this incorrectly but did not comment. This particular confusion stresses the need for clear definition and language when discussing SDM, which has been attempted in a prior publication from this group (Cohen et al 2012). We suspect that the use of telephone GC as a primary SDM may be lower than reported here, however recent literature is demonstrating increased use and acceptance of telephone genetic counseling (Bradbury et al 2011;Doughty Rice et al 2010;Graves et al 2010;Shanley et al 2007;Sutphen et al 2010).…”

“…The survey instrument included a description of the four major SDMs, including in-person (previously referred to as face-to-face traditional), telephone, group, and telegenetic GC per the definitions previously defined by the SDM taskforce (Table 1) (Cohen et al 2012). In-Person genetic counseling involves cases where the patient is seen inperson, typically within a healthcare facility of private office.…”

“…Healthcare providers refer select patients to genetic counselors in the absence of a collaborative relationship and after they have encountered difficulty Self-referred Referral initiated by a patient Cohen et al (2012) and 1-2 weeks (36 %). Pediatrics had the lowest response rate for appointments at <1 week (8 %) and 1-2 weeks (8 %).…”

“…To evaluate service delivery models, the SDMTF proposed definitions for current genetic counseling service delivery models, modes of referral, and components of service delivery (Cohen et al 2012). It was proposed that current models of service delivery can be defined by: 1) the methods in which GC services are delivered (In-person, Telephone, Group, and Telegenetics), 2) the way they are accessed by patients (Traditional referral, Tandem, Triage, Rescue, and Self -referral), and 3) the components unique to each service setting (ex: documentation, specialty, physician involvement, etc.).…”

A Comparison of Telephone Genetic Counseling and In‐Person Genetic Counseling from the Genetic Counselor's Perspective

“…For this study, participants were those members of NSGC or ABGC who performed TGC according to the definition proposed by the NSGC SDMTF (Cohen et al 2012). Exclusion criteria for the study included any counselor who had not performed TGC according to the NSGC SDMTF definition.…”