A delivery service model for genetics: The use of a genetic counselor and nurse practitioner team for diagnosis and care in specific condition populations.

Abstract

Many genetic centers are developing innovative delivery models for services to address the growing need for access to genetics in the setting of a limited genetics-certified workforce. In the literature review, alternative service delivery models-including telehealth and genetic counselor involvement with nongenetics specialty providers-aim to increase efficiency, patient access, and provider satisfaction. This paper outlines a traditional model of pediatric care, with a workflow involving a geneticist and genetic counselor, from preclinic to follow-up. We then present a workflow model of a collaborative team consisting of a genetic counselor and nurse practitioner in condition-specific pediatric clinics. We break down factors influencing the successful implementation of this model, including patient selection, pre-established and adaptive clinic goals, and differentiation of roles of the providers. Potential barriers to generalization and the ongoing success of this clinic model include provider interest in genetics and the necessity for careful triaging by clinicians. Formalized analysis of these clinics has not been performed, though at the presented institution, this clinic model is recognized as an effective way to decrease wait times for patients referred for specific indications and creates an environment that allows providers to specialize, increasing their expertize and confidence in particular genetic areas.