Design and implementation of genetic services within an HMO

Clinical application of genetic knowledge is essential for providing effective preventive health care. A large HMO such as Kaiser Permanente is an ideal setting for this application. Implementing a comprehensive program for genetic screening is complex, however, and requires informed consent, laboratory testing, test interpretation, genetic counseling, follow-up for positive screening results, and database systems. This article summarizes genetic services provided by Kaiser Permanente at four subregional genetic centers in Northern California.