The impact of genetic counselor involvement in genetic and genomic test order review: A scoping review

Purpose: The increasing complexity of genetic technologies paired with more genetic tests being ordered by nongenetic healthcare providers, has resulted in an increase in the number of inappropriately ordered tests. Genetic counselors (GCs) are ideally suited to assess the appropriateness of a genetic test.

Methods: We performed a scoping review of GC involvement in utilization management initiatives in order to describe the impact of having GCs involved in this process. Five databases (MEDLINE, EMBASE, CINHAL, EBM reviews and Web of Science Core Collection) and grey literature were searched. We considered literature published in English since 2010.

Results: A total of 51 studies were included. Most commonly evaluated outcomes included cancellation rate, economic efficiencies, impact on medical management, diagnostic rate and time or triage efficiencies. Several studies also described GC impact on nongenetic healthcare providers.

Conclusion: Employment of GCs in the laboratory has been implemented widely as a solution to test misordering. These studies describe ways in which GCs can be integrated into testing workflows to reduce the number of inappropriate tests and have wider impacts on nongenetic healthcare providers ordering practices and the patient experience.