Improving Molecular Genetic Test Utilization through Order Restriction, Test Review, and Guidance

Area of Science:

• Medical Genetics
• Health Services Research

Background:

• Inappropriate ordering of molecular genetic tests by non-specialist providers can lead to suboptimal patient care and increased healthcare costs.
• Lack of genetics expertise among ordering physicians may result in incorrect test selection, misinterpretation of results, and unnecessary expenditure.

Purpose of the Study:

• To enhance the appropriate utilization of molecular genetic tests.
• To reduce unwarranted costs associated with genetic testing.
• To improve patient guidance through accurate test selection and interpretation.

Main Methods:

• Instituted a genetic and genomic test review process involving genetic counselors and molecular genetic pathologists.
• Genetic counselors performed preanalytic assessment and test triage.
• Test indications and clinical findings were evaluated against test parameters under pathologist supervision.

Main Results:

• A significant decrease in the overall ordering of genetic tests was observed.
• Gross cost savings of $1,531,913 were achieved between September 2011 and December 2013.
• Improved test utilization management was demonstrated.

Conclusions:

• Requiring genetic counselors and molecular genetic pathologists for test selection improves the judicious use of molecular genetic tests.
• Limiting complex genetic test availability and providing expert guidance is an effective strategy for optimizing healthcare resource allocation.
• This approach enhances the quality of care by ensuring appropriate genetic testing and interpretation.