Center for Cancer Risk Assessment, Massachusetts General Hospital Cancer Center, Boston, MA, USA.
J Genet Couns. 2021 Aug;30(4):984-988. doi: 10.1002/jgc4.1365. Epub 2020 Dec 4.
The COVID-19 pandemic has significantly disrupted the delivery of healthcare services, including oncology. To ensure continuity of cancer genetic counseling at a large academic medical center while also promoting the safety of patients and staff, our team transitioned to fully remote telephone genetic counseling and testing services within 48 hr. We compare differences in the six weeks following the shift to telephone genetic counseling (post-COVID) to the six weeks preceding the pandemic (pre-COVID). We maintained 99% of our total visit capacity and saw a decrease in patient no-show rate from 9.5% to 7.3%. Of all patients who received telephone genetic counseling, fewer consented to genetic testing as compared to patients seen in-person prior to the pandemic (79% pre-COVID v. 72% post-COVID; p = .012). Four weeks after this cohort was closed for analysis, 96 out of 303 samples (32%) had not been received by the genetic testing laboratory, despite at least one reminder phone call to the patient. In 13 reported instances, a second sample was required (quality not sufficient, lost or mislabeled sample), thus delaying test results. We conclude that a rapid transition to remote genetic counseling and testing allowed uninterrupted access to cancer genetics services during to the COVID-19 pandemic. Patient compliance with sample return and higher rates of sample failure emerge as potential barriers to timely genetic testing under this service delivery model.
新冠疫情大流行极大地扰乱了医疗服务的提供，包括肿瘤学。为了确保在大型学术医疗中心继续提供癌症遗传咨询服务，同时保障患者和工作人员的安全，我们的团队在 48 小时内将服务全面转为远程电话遗传咨询和检测。我们比较了疫情后（COVID 后）的六周和疫情前（COVID 前）的六周之间的差异。我们维持了 99%的总就诊量，患者未到场率从 9.5%降至 7.3%。在所有接受电话遗传咨询的患者中，与疫情前亲自就诊的患者相比，同意进行遗传检测的患者比例下降（COVID 前为 79%，COVID 后为 72%；p=0.012）。在该队列分析结束后的四周，尽管已向患者至少致电提醒一次，但仍有 303 个样本中的 96 个（32%）未送达遗传检测实验室。在 13 例报告中，需要第二次采样（质量不足、样本丢失或标签错误），从而延迟了检测结果。我们得出结论，快速过渡到远程遗传咨询和检测使癌症遗传学服务在 COVID-19 大流行期间得以持续提供。在这种服务模式下，患者对样本返回的依从性和更高的样本失败率成为及时进行遗传检测的潜在障碍。
