Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Perelman School of Medicine, Master of Science in Genetic Counseling Program, University of Pennsylvania, Philadelphia, PA, USA.
J Genet Couns. 2021 Aug;30(4):1010-1023. doi: 10.1002/jgc4.1487. Epub 2021 Aug 6.
The COVID-19 pandemic has pushed medical providers to trial telemedicine on a scale that lacks precedent. In genetic medicine, nearly overnight genetics providers were asked to transition to telemedicine platforms, irrespective of their previous experience with these modalities. This push to telegenetics prompted a reappraisal of the practice, as genetics providers learned firsthand about the feasibility, benefits, and drawbacks of telegenetics and telesupervision, all of which raise questions about the potential incorporation of these platforms beyond the pandemic. Adding to nascent literature on the transition to telegenetics amidst the COVID-19 pandemic, we aimed to evaluate provider experiences and preferences with respect to telegenetics through qualitative semi-structured interviews with genetics providers. Nineteen providers from seven institutions participated in a semi-structured interview focused on the rapid shift to telegenetics, the benefits and drawbacks of the practice, experiences supervising students on virtual platforms, and providers' preferences. We employed a qualitative methodology so that providers working across diverse subspecialties could expand upon previously reported benefits and drawbacks. Qualitative data revealed the nuanced benefits of telegenetics which included overcoming geographic, spatial, and temporal barriers to care as well as greater involvement of patients' family members in sessions. In addition, the data indicated drawbacks related to additional tasks such as completing paperwork electronically and facilitating the collection of specimens from patients' homes. Interviews with providers from different subspecialties revealed how telegenetics may be uniquely useful for particular subspecialties, patient populations, or clinics for whom the aforementioned barriers are more significant. Providers reported that telesupervision made the provision of feedback to students more cumbersome and identified a number of methods for enriching the telesupervision experience. In keeping with previous research, most genetics providers appraised telegenetics as a valuable addition to patient care (68%, N = 13) and hoped to offer it as an option beyond the pandemic (63%, N = 12).
新冠疫情大流行促使医疗服务提供者前所未有地大规模试用远程医疗。在遗传医学领域，几乎一夜之间，遗传学家就被要求转向远程医疗平台，而不论他们之前是否有过这些模式的经验。这种向远程遗传学的推动促使人们重新评估这种做法，因为遗传学家亲身了解了远程遗传学和远程监督的可行性、益处和缺点，所有这些都引发了关于这些平台在大流行之外是否可能被纳入的问题。除了在新冠疫情期间向远程遗传学过渡的新生文献之外，我们旨在通过对来自七个机构的 19 名遗传学家进行半结构化访谈，评估他们在远程遗传学方面的经验和偏好。19 名提供者参加了一次半结构化访谈，重点是快速转向远程遗传学、该实践的优缺点、在虚拟平台上监督学生的经验，以及提供者的偏好。我们采用了定性方法，以便跨不同专业领域工作的提供者能够扩展之前报告的优缺点。定性数据揭示了远程遗传学的细微好处，包括克服了护理方面的地理、空间和时间障碍，以及患者家属更多地参与了治疗。此外，数据还表明了与电子填写文书工作和从患者家中收集样本等额外任务相关的缺点。对来自不同专业领域的提供者的访谈揭示了远程遗传学如何对特定专业、患者群体或诊所具有独特的用处，对于这些群体而言，上述障碍更为显著。提供者报告说，远程监督使向学生提供反馈变得更加繁琐，并确定了一些丰富远程监督体验的方法。与之前的研究一致，大多数遗传学家认为远程遗传学是患者护理的有价值的补充（68%，N=13），并希望在大流行之外提供这种选择（63%，N=12）。
