A pooled electronic consultation program to improve access to genetics specialists

Emma K Folkerts; Renée C Pelletier; Daniel C Chung; Susan A Goldstein; Douglas S Micalizzi; Kristen M Shannon; David A Sweetser; Eugene K Wong; Heidi L Rehm; Leland E Hull

doi:10.1016/j.gimo.2023.100819

A pooled electronic consultation program to improve access to genetics specialists

Genet Med Open. 2023 May 20;1(1):100819. doi: 10.1016/j.gimo.2023.100819. eCollection 2023.

Authors

Emma K Folkerts^{1

2}, Renée C Pelletier^{1

2}, Daniel C Chung^{3

4}, Susan A Goldstein⁵, Douglas S Micalizzi^{3

4}, Kristen M Shannon³, David A Sweetser^{4

6}, Eugene K Wong¹, Heidi L Rehm^{1

2

4}, Leland E Hull^{4

7}

Affiliations

¹ Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA.
² The Broad Institute of MIT and Harvard, Cambridge, MA.
³ Massachusetts General Hospital Cancer Center, Boston, MA.
⁴ Harvard Medical School, Boston, MA.
⁵ Massachussetts General Physicians Organization, Massachusetts General Hospital, Boston, MA.
⁶ Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA.
⁷ Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA.

Abstract

Purpose: Given limited ambulatory access to genetics specialists, innovative service delivery solutions are needed. Electronic consultation (e-consult) programs are growing to connect clinicians to specialists. We explored the utilization and outcomes of a genetics and genomics e-consult program at Massachusetts General Hospital system in its first year.

Methods: A retrospective observational analysis of genetics e-consults ordered between April 2021 and March 2022.

Results: In its first year, the e-consult service triaged 153 requests and completed 122 in a median of 2.0 days. Of the 97 e-consults with actionable recommendations, there was documentation that most ordering clinicians followed through (82%). A variety of providers used the service, though the majority (77%) were generalists.

Conclusion: e-Consult models should be considered as one way to increase access to genetics expertise.

Keywords: Access to health services; Genetic services; Healthcare delivery; Referral and consultation.