Traditional Care Model Research Articles

Rethinking heart failure care and health technologies from early COVID-19 experiences - A narrative review.

Heart Failure (HF), a common chronic disease, requires multidisciplinary care to optimise outcomes. The COVID-19 pandemic, its impact on people's movement and access to health services, introduced severe challenges to chronic disease management. The era that will evolve after this pandemic is likely to provide uncertainty and service model disruptions. HF treatment is based on guidelines derived from randomised clinical trial evidence. Translational shortfalls from trials into practice have been overcome with post-trial service improvement studies like OPTIMIZE-HF where a team using a process of care can translate evidence to the general population. However, gaps remain for vulnerable populations e.g. those with more severe HF, with multiple comorbid conditions, and certain demographic groups and/or residents in remote locations. Health technology has come with great promise, to fill some of these gaps. The COVID-19 pandemic provides an opportunity to observe, from Australian healthcare lens, HF management outside the traditional model of care. This narrative review describes relatively recent events with health technology as a solution to improve on service gaps.

A Scoping Review of Health Promotion in the Nursing Home Setting

Background Nursing homes in many countries continue to follow a traditional medical model of care. This study explored health promotion approaches in the nursing home setting, partly in order to move away from a medical model and to improve the well-being of residents and staff. Methods A scoping study was conducted to review the scientific literature. The Integrated Model of Population Health and Health Promotion was adapted for utilization with the literature analysis. Result A total of 64 publications met the inclusion criteria and were analysed. Five main approaches were shown to have applied health promotion in nursing homes, although gaps were present in the usage of systematically applied health promotion. Conclusion A variety of approaches do exist for the nursing home setting which apply health promotion; however, their usage is fragmented. This study revealed that a framework designed to support nursing homes in the systematic usage of health promotion, could improve the well-being for both residents and staff.

HealthyBlockchain for Global Patients

An emerging healthcare delivery model is enabling a new era of clinical care based on well-informed decision-making processes. Current healthcare information systems (HISs) fall short of adopting this model due to a conflict between information security needed to implement the new model and those already enforced locally to support traditional care models. Meanwhile, in recent times, the healthcare sector has shown a substantial interest in the potential of using blockchain technology for providing quality care to patients. No blockchain solution proposed so far has fully addressed emerging cross-organization information-sharing needs in healthcare. In this paper, we aim to study the use of blockchain in equipping struggling HISs to cope with the demands of the new healthcare delivery model, by proposing HealthyBlockchain as a granular patient-centered ledger that digitally tracks a patient’s medical transactions all along the treatment pathway to support the care teams. The patient-centered ledger is a neutral tamper-proof trail time-stamp block sequence that governs distributed patient information across the decentralized discrete HISs. HealthyBlockchain connects patients, clinicians, and healthcare providers to facilitate a transparent, trustworthy, and secure supporting platform.

Research on the Development of Shaoxing Health Care Industry under the Background of Digital Economy

In recent years,China's economy has developed rapidly and people's lives have generally improved, but there are also many problems accompanying it. The life pressure of the population is high, the rural population is migrating to cities to work, and there are many left-behind elderly in the rural areas; aging is increasing, and the retirement age in cities continues to shift. As the problem of aging in our country becomes increasingly prominent, the need to build a digital health care industry is becoming more urgent. At present, the current situation of health care in our country is problematic. In this regard, we should face up to the problems existing in the current traditional health care model, and actively introduce "Internet +" to create a digital health care industry. Through changing thinking and strengthening management, it can provide the elderly with more accurate. At the same time, the service of the elderly can also shorten the distance between the elderly and the society, and truly achieve "the elderly have a sense of support" at the same time.

Screenless Teletherapy and Silent Telesupervision: Leveraging Technology for Innovative Service Delivery and Clinician Training in Speech-language Pathology during the COVID-19 Era

The COVID-19 pandemic has upended traditional models of education and health care. Despite having a well-established evidence base, videoconferencing and related technology (i.e., “teletechnology”) were rarely utilized by most speech-language pathologists (SLPs) prior to March 2020. As operations were forced to move online, there was a rapid, unprecedented, and near-universal adoption of teletechnology for service delivery and clinical education. However, there was little time for program modification and training. Nine months later, we have settled into the transition and are able to reflect on the evidence base and potential benefits of operating through a new modality.
 This report begins by outlining commonalities in theoretical models of clinical supervision and early intervention service delivery. We discuss how teletechnology fits into—and potentially enhances—the framework. Next, we summarize the historical use of technology in SLP clinical training and service delivery, specifically, how it can be leveraged to support access, processes, and outcomes. Although SLPs are trained to serve the full range of clinical populations, we focus on their role in early intervention (i.e., services for children from birth to age five). Then, we expand upon the current research evidence with a practical discussion of quickly-developing anecdotal support for innovative practices, including “screenless coaching” and “silent supervision.” Although there are significant benefits to teletechnology, we conclude by recognizing potential limitations and discussing needs for future research. This report is written from the perspective of two experienced SLPs; however, the discussion is relevant to other therapeutic fields.

From Midwife-Dominated to Midwifery-Led Antenatal Care: A Meta-Ethnography.

Provision of antenatal care includes risk identification, prevention and management of pregnancy-related diseases, but also health education, health promotion, support and guidance to smooth the transition to parenthood. To ensure good perinatal health, high-quality, free and easily accessed antenatal care is essential. The aim of this study was to identify, integrate and synthesize knowledge of midwives’ experiences of providing antenatal care, attending to clients’ individual needs whilst facing multiple challenges. We conducted a meta-ethnography, which is a seven-step grounded, comparative and interpretative methodology for qualitative evidence synthesis. A lines-of-argument synthesis based on two metaphors was developed, based on refutational themes emerging from an analogous translation of findings in the included 14 papers. The model reflects midwives’ wished-for transition from a midwife-dominated caring model toward a midwifery-led model of antenatal care. Structural, societal and personal challenges seemingly influenced midwives’ provision of antenatal care. However, it emerged that midwives had the willingness to change rigid systems that maintain routine care. The midwifery-led model of care should be firmly based in midwifery science and evidence-based antenatal care that emphasize reflective practices and listening to each woman and her family. The change from traditional models of antenatal care towards increased use of digitalization no longer seems to be a choice, but a necessity given the ongoing 2020 pandemic.

Evaluation of Reablement Home Care: Effects on Care Attendants, Care Recipients, and Family Caregivers.

Background: The traditional home care model entails caring “for” people with disabilities, not “with” them. Reablement care has been applied to long-term care, but the evidence for care attendants, home care recipients, and family caregivers simultaneously is limited. Methods: First, a survey was conducted to explore the needs of home care recipients and family caregivers to achieve independence at home to develop the reablement home care model for home care. Then, an intervention with two groups was implemented. The experimental group included a total of 86 people who participated in the reablement home care model. The control group included 100 people and received usual home care. The self-reliance concept, job satisfaction, and sense of achievement for care attendants; quality of life for home care users; and caregiving burden for family caregivers were assessed. Results: The reablement home care model improved the job satisfaction and achievement of home care attendants, improved mutual support and independence in the self-reliance concept and quality of life among the users, and reduced the stress of the users and family caregivers. Conclusion: The reablement home care model improved the outcomes for providers, care recipients, and family caregivers. Reablement home care is suggested in long-term care policies.

The optimal living and survivorship program: Piloting a novel survivorship care model.

40 Background: Multiple agencies define cancer survivorship as beginning at the time of diagnosis. However, traditional care models deliver “survivorship care” months or years after diagnosis, which can cause care disruption and “transition anxiety”. We hypothesized that an approach centered around wellbeing could be applied across the cancer continuum (starting at diagnosis) and serve as a novel survivorship care model. Methods: We developed the Optimal Living and Survivorship Program with 3 key components: 1) a centralized model that provides multidisciplinary care; 2) an individualized Wellness Plan (WP); and 3) enrollment at the time of diagnosis to mitigate post-treatment transition. Participants complete a digital wellness questionnaire (WQ) prior to the 1st medical oncology consult, receive a validated algorithm-based WP, and meet with a Wellness Advanced Practice Provider (WAPP). The WP consists of individualized education and referrals (e.g., nutrition, exercise, financial counseling). The WAPP will assume post-treatment (“survivorship”) care. We piloted this approach in patients diagnosed with breast cancer beginning in 11/19. The primary outcome is feasibility defined by completion of the WQ. Secondary outcomes include participation in the WAPP visits, attendance at appointments, and quality of life (QOL). Results: Due to COVID-19, the pilot was paused in 2/20. Data collected from 11/19 through 2/20 reveal a total of 67 eligible patients with newly diagnosed breast cancer were approached, with 65 enrolled. All participants completed the WQ and all received a WP with supportive referrals and educational resources. All participants engaged with WP recommendations. Participants were screened at high risk for an average of 3.8 unmet needs, and 98% were at high risk for 2 or more needs at time of diagnosis. Exercise was the highest unmet need (83%). There was 76% adherence with referral to the program’s Exercise Physiologist. Other areas of needs were nutrition (59%) and sleep quality (51%). WAPP tele-visits began in 6/20; visit completion rates will be presented. Qualitative data regarding patient experience and QOL will be obtained via interviews and feedback will be categorized in thematic domains. Conclusions: Most patients enrolled in the program, completed a WQ and engaged with the WP. Our findings suggest that this early intro to survivorship is feasible. Earlier engagement and incorporation of wellness and supportive services from time of diagnosis may improve our ability to address multifactorial needs during and after cancer therapy.

Using governance and patient flow strategies to improve healthcare service efficiency.

The aim of this case study was to share lessons learned regarding strategies likely to increase healthcare service efficiency. Following quality assurance review of statewide Hospital in the Home (HITH) average length of stay (ALOS) and readmission data, Queensland's Department of Health observed that for some of the highest volume diagnoses seen in Queensland's HITH services in 2017, services that used a public-private partnership (PPP) model of care achieved a shorter ALOS than services using a traditional public model of care without demonstrably poorer patient outcomes. To understand the reasons for the differences in ALOS, ALOS and readmission data from 2017 for 10 high-volume diagnoses were retrospectively compared for five HITH services. Two of the services used a PPP and three used a public HITH model of care. Additional data were collected to determine similarities and points of difference regarding how the services operated in 2017. Hospitals that used a PPP HITH model of care achieved shorter ALOS for eight of the 10 diagnoses, with the difference ranging from 0.94 to 5.98 days. Differences between how the PPP and public HITH services operated in 2017 were identified. The findings suggest that the use of governance strategies, criteria-led discharge and financial incentives is likely to support safe shorter lengths of stay.

Meeting Personal Health Care Needs in Primary Care: A Response From the Athletic Training Profession

Context Review of the origins, history, and attributes of primary care demonstrates continued challenges for the future of primary care and care delivery. The profession of athletic training may benefit from a critical self-review to examine its readiness to assist in reinventing primary care. Objective To explore parity between primary care attributes and athletic training practice and promote a timely and relevant discussion of primary care and public health integration native to athletic training practice, competency-based education with an emphasis on milestones, and the development of clinical specialists to prepare a well-trained workforce. Background General practitioners developed educational reforms through graduate medical education that resulted in primary care as it is known today. Graduate medical education has refined its assessment of students to include milestones for the purpose of describing the progression of clinical competence with identifiable behaviors. The development of future clinical specialists in primary care will also involve competence in public health. Recommendation(s) Practicing clinicians and educators should begin to critically explore the congruencies between the primary care attributes and athletic training practice. It is important to conceptualize traditional models of care within the frameworks of primary care and public health, given that athletic training practice routinely engages patients at personal, community, and environmental levels. The athletic training skill mix should be purposefully presented within interprofessional health care teams in primary care so that stakeholders can appropriately integrate athletic trainers (ATs) at the point of first contact. It is plausible that continued structural changes in the traditional practice settings will be required to facilitate integration of ATs into primary care. Conclusion(s) The impact of ATs in ambulatory settings and primary care possesses a foundation in the current literature. The ATs are uniquely suited to create a symbiotic pattern of care integrating both primary care and public health for improved outcomes.

Adherence and acceptability of telehealth appointments for high-risk obstetrical patients during the coronavirus disease 2019 pandemic

BackgroundTelehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high-risk obstetrics and whether the implementation of a telehealth model improves access to care in nonrural settings.ObjectiveThis study aimed to describe patient and provider attitudes toward telehealth for the delivery of high-risk obstetrical care in a large healthcare system with both urban and suburban settings and to determine whether the implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.Study DesignTwo self-administered surveys were designed. The first survey was sent to all high-risk obstetrical patients who received a telehealth visit between March 1, 2020, and May 30, 2020. The second survey was designed for providers who participated in these visits. We also compared the attended, cancelled, and no-show visit rates before (March 1 to May 30, 2019) and after (March 1 to May 30, 2020) the telehealth implementation and telehealth vs in-person visits in 2020. We reviewed scheduled high-risk prenatal care appointments, diabetes mellitus education sessions, and genetic counseling and Maternal-Fetal Medicine consultations.ResultsA total of 91 patient surveys and 33 provider surveys were analyzed. Overall, 86.9% of patients were satisfied with the care they received and 78.3% would recommend telehealth visits to others. Notably, 87.8% of providers reported having a positive experience using telehealth, and 90.9% believed that telehealth improved patients’ access to care. When comparing patient and provider preference regarding future obstetrical care after experiencing telehealth, 73.8% of patients desired a combination of in-person and telehealth visits during their pregnancy. However, a significantly higher rate of providers preferred in-person than telehealth visits (56% vs 23%, P=.024, respectively). When comparing visits between 2019 and 2020, there was a significantly lower rate of no-show appointments (8.49% vs 4.61%, P<.001), patient-cancelled appointments (7.06% vs 4.96%, P<.001), and patient same-day cancellations (2.30% vs 1.35%, P<.001) with the implementation of telehealth. There was also a significantly lower rate of patient-cancelled appointments (3.82% vs 5.44%, P=.021) and patient same-day cancellations (0.60% vs 1.65%, P=.002) with those receiving telehealth visits than in-person visits in 2020.ConclusionThe implementation of a telehealth model in high-risk obstetrics has the potential to improve access to high-risk obstetrical care, by reducing the rate of missed appointments. Both patients and providers surveyed expressed a high rate of satisfaction with telehealth visits and a desire to integrate telehealth into the traditional model of high-risk obstetrical care.

Are we ready for artificial intelligence health monitoring in elder care?

BackgroundThe world is experiencing a dramatic increase in the aging population, challenging the sustainability of traditional care models that have relied on in-person monitoring. This debate article discusses whether artificial intelligence health monitoring may be suitable enhancement or replacement for elder care.Main textInternationally, as life expectancy continues to rise, many countries are facing a severe shortage of direct care workers. The health workforce is aging, and replacement remains a challenge. Artificial intelligence health monitoring technologies may play a novel and significant role in filling the human resource gaps in caring for older adults by complementing current care provision, reducing the burden on family caregivers, and improving the quality of care. Nonetheless, opportunities brought on by these emerging technologies raise ethical questions that must be addressed to ensure that these automated systems can truly enhance care and health outcomes for older adults. This debate article explores some ethical dimensions of using automated health monitoring technologies. It argues that, in order for these health monitoring technologies to fulfill the wishes of older adults to age in place and also to empower them and improve their quality of life, we need deep knowledge of how stakeholders may balance their considerations of relational care, safety, and privacy.ConclusionIt is only when we design artificial intelligence health monitoring technologies with intersecting clinical and ethical factors in mind that the resulting systems will enhance productive relational care, facilitate independent living, promote older adults’ health outcomes, and minimize waste.

From Hospital to the Community: Redesigning the Human Immunodeficiency Virus (HIV) Clinical Service Model to Respond to an Outbreak of HIV Among People Who Inject Drugs.

An outbreak of human immunodeficiency virus (HIV) among people who inject drugs in Glasgow, Scotland started in 2014. We describe 156 cases over 5 years and evaluate the impact of clinical interventions using virological and phylogenetic analysis. We established (1) HIV services within homeless health facilities, including outreach nurses, and (2) antiretroviral therapy (ART) via community pharmacies. Implementation of the new model reduced time to ART initiation from 264 to 23 days and increased community viral load suppression rates to 86%. Phylogenetic analysis demonstrated that 2019 diagnoses were concentrated within a single network. Traditional HIV care models require adaptation for this highly complex population.

Improving continuity of care of patients with respiratory disease at hospital discharge.

Continuity of care refers to the delivery of coherent, logical and timely care to an individual. It is threatened during the transition of care at hospital discharge, which can contribute to worse patient outcomes. In a traditional acute care model, the roles of hospital and community healthcare providers do not overlap and this can be a barrier to continuity of care at hospital discharge. Furthermore, the transition from inpatient to outpatient care is associated with a transition from acute to chronic disease management and, in a busy hospital, attention to this can be crowded out by the pressures of providing acute care. This model is suboptimal for the large proportion of patients admitted to hospital with acute-on-chronic respiratory disease.In a chronic care model, the healthcare system is designed to give adequate priority to care of chronic disease. Integrated care for the patient with respiratory disease fits the chronic care model and responds to the fragmentation of care in a traditional acute care model: providers integrate their respiratory services to provide continuous, holistic care tailored to individuals. This promotes greater continuity of care for individuals, and can improve patient outcomes both at hospital discharge and more widely.Educational aimsTo understand the concept of continuity of care and its effect at the transition between inpatient and outpatient care.To understand the difference between the acute and chronic models of healthcare.To understand the effect of integration of care on continuity of care for patients with respiratory disease and their health outcomes.

Transitioning to telehealth neuropsychology service: Considerations across adult and pediatric care settings

Objectives: In response to the 2020 COVID-19 pandemic, traditional, in-person neuropsychological assessment services paused in most settings. Neuropsychologists have sought to establish new guidelines and care models using telehealth neuropsychology (teleNP) services. The need to adapt to remote technology became the most difficult challenge to date for existing practice models. Results: Primary considerations for transitioning to teleNP include scope and limitations of the telehealth modality, informed consent for telehealth services, patient privacy and confidentiality, test security, and validity of telehealth assessments. Given timelines for fully re-opening clinical settings, access to traditional models of neuropsychological care remains unclear. These considerations will remain relevant even upon return to an in-office practice, as many assessment models will likely continue with teleNP to some extent. Specialists will need to consider the unique needs of their populations in ensuring quality care, as diagnostic differences and patient age will impact participation in teleNP. Conclusions: As the COVID-19 pandemic lingers, teleNP presents an opportunity as well as a challenge for neuropsychologists looking to provide patient care in the context of social distancing and stay-at-home restrictions. In this transformative time, the field of neuropsychology has opportunities to advance beyond traditional settings and focus on alternative delivery of patient care.

Why We Come: Clubhouse Members Seek Connection, Purpose and Meaning.

Approximately 4.5% of U.S. adults live with a serious mental illness (SMI) (Substance Abuse and Mental Health Services Administration, 2018). Creating a place for people seeking structure, connection, and purpose following psychiatric hospitalization or for mental health recovery is difficult given several factors associated with illness trajectories, lack of community-based support programs, and reliance on traditional models of care. Using semi-structured interviews, the current study examined the reasons people attend community programs referred to as psychosocial "clubhouses." Interviews with 140 people across 10 clubhouse programs in one state were conducted. Qualitative analyses revealed that social connections and the need to reduce social isolation were driving forces for attending. Further, individuals noted that the "structure" of engaging in meaningful activities and roles was a main reason for participating. Authors discuss the continued need for community models that provide a "place" for all people to successfully engage and recover from psychiatric illnesses.

Discussion on the Introduction of Psychological Behavior Evaluation and Intervention Countermeasures in the Whole Process of Children's Health Care

&lt;p&gt;Objective: To explore the introduction of psychological behavior evaluation methods, intervention strategies and effects in the whole process of child care. Methods: From January 2017 to December 2018, 250 children who participated in health care services in our hospital were selected as data, and 125 children were randomly grouped. The control group was a traditional child health care model. The observation group increased children's psychological behavior assessment and intervention. The physical fitness and development quotient of the two groups after 1 year, and parents' awareness of children's health knowledge are compared. Results: The height, head circumference, weight, development quotient of children and parents' knowledge about children healthcare in the observation group (P &amp;lt; 0.05, 96.00%, 94.40%, 95.20%, and 92.00%) were significantly higher than those in the control group (P &amp;lt; 0.05, 81.60%, 76.00%, 77.60%, and 70.40%). Conclusion: The introduction of psychological behavior assessment and intervention application in children's health can promote the growth of children's physique and development quotient, which is conducive to healthy growth. It also enriches parents' knowledge of children's health knowledge. The value of intervention is high.&lt;/p&gt;

Which app is right for my CVD patient?

Cardiovascular disease is a leading cause of mortality and morbidity, and despite efforts to identify and control cardiovascular risk factors, significant disease burden remains. As traditional strategies to reduce cardiovascular risk are challenged by lack of resources and growing populations, new strategies are deployed, including the use of smartphone applications (apps) designed to help patients manage their risk factors. For cardiovascular disease, some apps specifically address one risk factor, but others include a more holistic approach to manage multiple risk factors at once for primary and secondary prevention, whereas others serve as virtual cardiac rehabilitation intervention support. App stores show thousands of options in each app category, making it difficult to select the appropriate ones to recommend to patients. Very few apps in the app stores are rigorously validated for clinical efficacy or safety, making selection even more challenging. To address this, health organizations worldwide have created platforms to examine and appraise mobile health apps using standardized criteria to support clinician and patient app selection decisions. Now, with the rise of the COVID-19 pandemic, prolonged lockdowns have challenged traditional models of care. Telemedicine for cardiovascular disease patients is advancing virtual cardiac rehabilitation models to replace or improve traditional care.

Are Virtual Fracture Clinics During the COVID-19 Pandemic a Potential Alternative for Delivering Fracture Care? A Systematic Review.

Virtual fracture clinics are an alternative to the traditional model of fracture care. Since their introduction in 2011, they have become increasingly used in the United Kingdom and Ireland. The coronavirus disease 2019 (COVID-19) health crisis has driven institutions to examine such innovative solutions to manage patient care. The current controversies include quantifying safety outcomes, such as potential delayed or missed injuries, inadequate treatment, and medicolegal claims. Questions also exist regarding the potential for cost reductions and efficiencies that may be achieved. Physical distancing has limited the number of face-to-face consultations, so this review was conducted to determine if virtual fracture clinics can provide an acceptable alternative in these challenging times. The aim of this systematic review was to describe (1) adverse outcomes, (2) cost reductions, and (3) efficiencies associated with the virtual fracture clinic model. A systematic review of the PubMed, MEDLINE, and Embase databases was conducted from database inception to March 2020. The keywords "virtual" or "telemedicine" or "telehealth" or "remote" or "electronic" AND "fracture" or "trauma" or "triage" AND "clinic" or "consultation" were entered, using the preferred reporting items for systematic reviews and meta-analyses. Inclusion criteria included adults and children treated for injuries by a virtual clinic model at the initial review. Eligible injuries included injuries deemed to not need surgical intervention, and those able to be treated remotely using defined protocols. Exclusion criteria consisted of patients reviewed by telemedicine using video links or in person at the initial review. Initially, 1065 articles were identified, with 665 excluded as they did not relate to virtual fracture clinics. In all, 400 articles were screened for eligibility, and 27 full-text reviews were conducted on 18 studies (30,512 virtual fracture clinic encounters). Three subdomains focusing on adverse outcomes, cost reductions, and efficiencies were recorded. The term adverse outcomes was used to describe any complications, further surgeries, re-referrals back to the clinic, or deviations from the protocols. Efficiency described the number of patients reviewed and discharged using the model, savings in clinic slots, reduced waiting times, or a reduction in consumption of resources such as radiographs. All studies were observational and the quality was assessed using Newcastle-Ottawa tool, which demonstrated a median score of 6 ± 1.8, indicating moderate quality. Six studies reported adverse outcomes in detail, with events ranging from inappropriate splinting, deviations from protocols, and one patient underwent an osteotomy for a malunion. Efficiency varied from direct discharge proportions of 18% in early studies to 100% once the virtual fracture clinic model was more established. Cost reductions compared with estimates derived from conventional fracture clinics varied from USD 53 to USD 297 and USD 39,125 to USD 305876 compared with traditional fracture clinic visits. Virtual fracture clinics may provide a means to treat patients remotely, using agreed-upon protocols. They have an important role in the current COVID-19 pandemic, due to the possibility to provide ongoing care in an otherwise challenging setting. More robust studies looking at this model of care will be needed to assess its long-term effects on patients, institutions, and health care systems. Level IV, therapeutic study.

Setting a baseline: A 7-year review of referral rates and outcomes for serous ovarian cancer prior to implementation of oncologist mediated genetic testing

ObjectiveDespite guidelines recommending that all women with invasive serous ovarian cancer (SOC) are offered genetic testing, published referral and testing rates have been poor. Many centers have implemented novel genetic counseling service delivery models to increase testing rates. In light of increased awareness and implementation of small process changes at our center, this study aims to establish baseline referral rates and testing outcomes prior to diverging from the traditional model of care. MethodsA list of women diagnosed with SOC at Princess Margaret Cancer Center (PM) between 2010 and 2016 was obtained from the PM Cancer Registry and cross-referenced against the genetics database to determine referral rates and outcomes of genetic testing. ResultsOf 724 women with SOC, 68% were referred for genetic counseling, with an overall testing rate of 61%. Higher referral rates were seen among women with younger ages at diagnosis and high-grade tumors. Of women tested, 22% were found to have a pathogenic variant in BRCA1/2 and 9% in another cancer gene. Notably, 24% of women with a pathogenic variant reported no family history of breast or ovarian cancer. ConclusionGenetic counseling referral and testing rates for women with SOC are higher than previously reported, yet barriers to referral remain. To maximize genetic testing rates and address increasing patient volumes, clinics may be faced with integrating novel genetic counseling delivery models. Findings from this study may serve as a more accurate baseline to which large scale service delivery changes can be compared.