Assessing the Utilization of Electronic Consultations in Genetics: Seven-Year Retrospective Study

Area of Science:

• Medical Genetics
• Health Services Research
• Digital Health

Background:

• Limited availability of genetic subspecialists in the US poses challenges for patient and provider access.
• The University of California San Francisco (UCSF) implemented a Genetics electronic consultation (e-Consult) service to improve access to genetic expertise.
• This service facilitates asynchronous provider-to-provider communication for genetic consultations.

Purpose of the Study:

• To evaluate the impact of the UCSF Genetics e-Consult service on patient access to genetic expertise.
• To assess the efficiency and effectiveness of the e-Consult model in providing genetic consultations.

Main Methods:

• A retrospective chart review of 622 e-Consult requests was performed.
• Data collected included completion rates, response times, consultation content, and adherence to recommendations.
• Analysis focused on the period from October 2016 to March 2024.

Main Results:

• The UCSF Genetics e-Consult service received 622 orders, with a 57.8% completion rate; 54.6% were resolved without a specialty visit.
• Geneticists responded to 83.9% of e-Consults within 3 days, with high adherence (84%) to recommendations.
• Primary care providers and pediatricians submitted nearly half of the requests, primarily for diagnostic queries and test interpretation.

Conclusions:

• The UCSF Genetics e-Consult service demonstrates efficiency in delivering timely genetic consultations.
• High provider adherence to recommendations suggests the model's effectiveness.
• e-Consult frameworks show promise for expanding access to genetic healthcare services.